General Principles Of Operative Surgery Question And Answers

General Principles Of Operative Surgery Long Essays

Question 1. What is sterilisation? What are the methods of sterilizing surgical materials? Mention the merits and demerits.

Answer:

Sterilisation:

• Sterilisation is defined as a process by which an article, object or surface is free of all micro-organisms in the vegetative form and in the spore state.

Sterilisation Physical Methods

Sterilisation Chemical Agents

General Principles Of Operative Surgery Short Essays

Question 1. Autoclave.

Answer:

Autoclave

Autoclaving is the process of sterilization by saturated steam under high pressure above 100°C temperature.

Autoclave Principle:

• Water boils when its vapour pressure equals that of the surrounding atmosphere.
• When the atmospheric pressure is raised then the boiling temperature is also increased.
• At normal pressure water boils at 100oC but when pressure inside a closed vessel increases, the temperature at which water boils also increases.
• When steam comes into contact with a cooler surface, it condenses to water and gives up its Latent heat to the surface.

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Sterilisation conditions:

Sterilisation Control:

• Spores of bacillus stearothermophilus.
• Brown’s tubes.
• Thermocouples.
• Autoclave tapes.

Autoclave Uses:

• Used for sterilisation of
  • Culture media.
  • Rubber articles.
  • Syringes and surgical instruments
  • OT gowns and dressing materials.
  • Endodontic instruments.

Question 2.Absorbable suture material.

Answer:

Absorbable Suture Material

• Various processes like hydrolysis and proteolytic enzymatic degradation break down absorbable sutures.
• They are made from either natural or synthetic polymers.

Absorbable Suture Material Classification:

Question 3. Cryosurgery.

Answer:

Cryosurgery

Cryosurgery is the deliberate destruction of tissue by the application of extreme cold.

• Barnard introduced it.
• The temperature used for it is -20°C to -180°C.

Cryosurgery Methods Employed Are:

• Spray freeze technique.
• Applicator technique.
• Cryoprobe method.
• Thermocouple method.

Cryosurgery Technique:

• Anaesthetize the area.
• Freeze the exposed nerve for 2 min.
• Wait for 5 min.
• Next freeze it for another 3 min.

Cryosurgery Uses:

• Keratotic lesions.
• Granulomatous lesions.
• Hyperplastic lesions.
• Vascular and pigmented lesions.
• Salivary gland lesions.
• Gingival lesions.
• Periodontal diseases.

Cryosurgery Effects:

• Dehydration.
• Denaturation of lipid molecules.
• Necrosis of tissues, capillaries, small arterioles and venules.
• Allows the destruction of the tumoral or any other pathological tissues.

Question 4. Antiseptics

Answer:

Antiseptics

Antiseptics is chemical that is applied to living tissues such as mucous membranes to reduce the number of micro-organisms present, through inhibition of their activity

Antiseptics Requirements:

• A broad spectrum of activity
• Fast acting
• Not affected by physical factors
• Non-toxic
• Surface compactable
• Easy to use
• Odourless
• Economical

Antiseptics Agents:

1. Alcohols: ethyl alcohol
2. Iodophors povidone iodine
   • Hepatitis virus not susceptible to it
   • Formulated as 1% iodine solution
   • Not stable at high temperature
3. Hexachlorophene
   • Toxic
   • Used in patients who are sensitive to iodine
4. Chlorhexidine 0.075%

Question 5. Sutures

Answer:

Sutures Ideal requirements

• Should have
  • Adequate strength
  • Good knot-holding property
  • Least reactive
  • Easy to handle
  • Less memory
  • Easily available
  • Cost-effective

Sutures Classification

Coated Or Non-Coated: Coated with biologically inert non-resorbable compound

General Principles Of Operative Surgery Short Answers

Question 1. Antisepsis.

Answer:

Antisepsis

Antisepsis is defined as the prevention of infection by inhibiting the growth and multiplication of bacteria in wounds or tissues.

• Antiseptics are substances that kill or prevent the growth of microorganisms.
• English physician Sir John Pringle first used the word antiseptic.
• Commonly used antiseptics are:
  • Alcohol.
  • I-propanol.
  • Isopropanol.
  • Boric acid
  • Brilliant green.
  • Chlorhexidine gluconate.
  • Hydrogen peroxide.

Question 2. Asepsis.

Answer:

Asepsis

• Asepsis means precautions taken before any surgical procedure, against the development of infection.
• Elimination of infection is the goal of asepsis.

Asepsis Examples:

• Washing the hands prior to delivery reduces puerperal fever.
• Wearing gloves before any procedure.
• Cleaning the operative site with iodine.
• Sterilisation of instruments.

Question 3. Disinfection.

Answer:

Disinfection

Disinfection means the destruction of all pathogens or organisms capable of producing infection but not necessary spores.

• Disinfection is less effective than sterilisation.
• Disinfection only reduces the number of microorganisms.
• Disinfection doesn’t need any strict protocol.
• Disinfection is commonly used in daily life.
• Thus, it prevents the spread of infection.

Question 4. Sterilisation.

Answer:

Sterilisation Definition:

• Sterilisation is defined as a process by which an article, object or surface is free of all micro-organisms in the vegetative and spore form.

Sterilisation Classification:

Sterilisation Uses:

• Sterilisation of materials or instruments used in surgical and diagnostic procedures.
• For media and reagents used in the microbiology laboratory.

Question 5. Sterilisation of hot air.

Answer:

Sterilisation Of Hot Air

• Sterilisation Of Hot Air is a method of sterilization using dry heat.
• Sterilisation Of Hot Air is the most widely used.

Temperature And Time:

• 160°C for 2 hours.

Sterilisation Of Hot Air Advantages:

• Safer to use – as it does not require water and high pressure.
• Suitable to work in the laboratory.
• Smaller in size.
• Rapid method.

Sterilisation Of Hot Air Disadvantages:

• Some organisms may not killed by it

Sterilisation Of Hot Air Uses:

• Used for sterilisation of
  • Glasswares like glass syringes, flasks and test tubes.
  • Surgical instruments like scalpels, and scissors.
  • Chemicals such as liquid paraffin, and fats.

Question 6. Incineration.

Answer:

Incineration

Incineration is a waste treatment process that involves the combustion of organic substances contained in waste material.

• It converts waste into ash, fuel gas and heat.
• It is used to destroy soiled dressings, bedding, bandages, etc.
• Pathogens and toxins can be destroyed by high temperatures by it.
• An incinerator and a furnace is used for it.

Incineration Types:

• Moving grate
• Fixed grate
• Rotary kiln.
• Fluidized bed.

Question 7. Cidex,

Answer:

Cidex

• Cidex is one of the brand names of glutaraldehyde.
• It is effective against mycobacterium, fungi and viruses.

Cidex Advantages:

Doesn’t affect the lens of the instrument.

Cidex Disadvantages:

• Toxic, oils liquid.
• Harmful if inhaled or swallowed.
• Irritating to eyes and respiratory tract.
• Can cause severe damage to skin and eyes.

Cidex Uses:

• Used to sterilise cystoscopes, bronchoscopes, endotracheal tubes and metallic instruments,

Question 8. Diathermy.

Answer:

Diathermy

Diathermy is a therapeutic treatment most commonly prescribed for joint conditions.

In it, a high-frequency electric current is delivered via shortwave, microwave or ultrasound to generate deep heat in body tissues.

Diathermy Effects:

• Promotes blood flow.
• Improves flexibility in stiff joints.
• Decreases pain and inflammation.
• Causes blood to coagulate and vessels to be sealed off or centralised.
• Removes tumour cells.

Diathermy Types:

• Shortwave diathermy.
• Microwave diathermy.
• Ultrasound diathermy.

Diathermy Side-effects:

• Causes extreme heat in metal devices such as bone pins, dental fillings and metal sutures.
• Causes burn in adjacent tissues.
• Can cause shock or burn.

Diathermy Uses:

• Arthritis.
• Back pain.
• Arthralgia.
• Fibromyalgia.
• Muscle spasms.
• Neuralgia.
• Bone injuries.
• Bursitis.
• In treatment of tumour.

Question 9. Cryosurgery

Answer:

Cryosurgery

• Cryosurgery is the deliberate destruction of tissue by the application of extreme cold
• It was introduced by Barnard
• Temperature used is -20 degree C to -180 degree C
• Technique
  • Anaesthesize the area
  • Freeze the exposed nerve for 2 min
  • Wait for 5 min
  • Next freeze for other 3 min

Cryosurgery Uses:

• Keratotic lesions
• Granulomatous lesions
• Hyperplastic lesions
• Vascular and pigmented lesions
• Salivary gland lesions
• Gingival lesions
• Periodontal lesions

Question 10. Types of biopsy

Answer:

Types Of Biopsy

Type of Biopsy is the removal of part of tissue for the purpose of histological examination and analysis

Biopsy Types:

1. Punch Biopsy: The sample is obtained with the help of a punch

Biopsy Indications:

• Mucosal lesions
• Inaccessible areas

2. Incisional Biopsy:

Indication: large lesions

Tumours Edge biopsy is taken where the tumour cells can be compared with the normal cells

3. Excisional Biopsy:

Indication: small lesions

The entire lesion is excised in a single sitting and sent for histological examination

4. Needle Biopsy: FNAC

Indication: cystic cavity: A 23-26 gauge needle is used to aspirate the contents of the lesion

Question 11. Drains

Answer:

Drains Need for Drainage:

• Obliterate dead space
• Removal of foreign bodies
• Evacuate fluid/ blood/ urine from body

Drains Indications:

• Abscess cavities
• Surgical defects
• Urinary retention
• Gastric lavage
• Osteomvelitic lesions

Drains Functions:

• Escape of fluids from body
• Introduce drugs into the body

Drains Types:

1. Simple rubber catheter
2. Corrugated rubber drain
3. Infant feeding tube
4. Foley’s catheter
5. Nasogastric tube

Question 12. Name suture materials

Answer:

Suture Materials Classification:

Absorbable: Digested by body enzymes
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Natural Synthetic

Non-absorbable: Cannot be digested
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Natural Synthetic

Coated Or Non-Coated: Coated with biologically inert non-resorbable compound