General Surgery: Principles and Management

Comprehensive vocabulary flashcards covering general surgical principles including wound types and healing, shock pathophysiology, hemostasis, blood transfusions, surgical site infections, perioperative management, postoperative complications, and benign and malignant lesions of the skin and subcutaneous tissues.

Abrasions

Traumatic wounds caused by the skin scraping against a rough surface, resulting in the removal of the top epidermal layer, as seen in road rash or scrapes.

Lacerations

Severely damaged wounds caused by traffic road accidents or rollover trauma, characterized by compressed and devitalized tissues, irregular skin edges, scanty bleeding, and dirty ischemic margins.

Contusions (Bruises)

Injuries resulting from blunt force trauma that rupture blood vessels under the skin, producing discoloration and swelling without forming an open wound.

Primary Intention Healing

A form of wound closure occurring when the margins of a clean wound or surgical incision are approximated using sutures, staples, or adhesive, resulting in rapid healing with minimal scarring.

Secondary Intention Healing

A wound healing process that occurs when edges cannot be approximated; the defect heals from the bottom up by filling with granulation tissue, requiring more time and causing prominent scarring.

Tertiary Intention Healing (Delayed Primary Closure)

A wound management method where a contaminated or high-risk wound is intentionally left open for a period to allow drainage and reduce infection risk before being surgically closed.

Wound Dehiscence

The postoperative separation or reopening of previously sutured wound edges, typically caused by excessive tension, improper closure technique, or surgical site infection.

Seroma

A collection of liquefied serous fluid that develops beneath the skin surface at the site of surgical incision or extensive tissue excision, manifesting as a fluctuating swelling.

Shock

A life-threatening clinical state characterized by inadequate systemic tissue perfusion and oxygen delivery, leading to cellular hypoxia, defective metabolic waste clearance, and multiorgan failure.

Neurogenic Shock

A subtype of distributive shock caused by disruption of autonomic pathways following spinal cord injury above the level of the $6^{\text{th}}$ thoracic vertebra, leading to loss of sympathetic vascular tone, hypotension, and bradycardia.

Class 3 Hypovolemic Shock

A severe stage of hypovolemia resulting from a $30\text{--}40\%$ loss of circulating blood volume, manifested by marked hypotension, tachycardia, tachypnea, and mental confusion.

Virchow Triad

The three primary pathophysiological factors that promote venous thrombosis: venous stasis, vascular endothelial injury, and hypercoagulability.

Phlegmasia Cerulea Dolens

An advanced, severe manifestation of iliofemoral deep venous thrombosis characterized by intense cyanosis, massive edema, and arterial insufficiency that acts as a precursor to gangrene.

Acid Citrate Dextrose (ACD)

An anticoagulant and nutrient preservative solution added to donor blood collection bags to prevent coagulation and sustain stored red blood cells at $+2\,^\circ\text{C}$ to $+6\,^\circ\text{C}$.

Acute Immune Hemolytic Reaction

A life-threatening transfusion complication resulting from ABO incompatibility where recipient antibodies lyse donor red blood cells, causing fever, chills, chest tightness, loin pain, hypotension, and hemoglobinuria.

Citrate Intoxication

A complication of massive blood transfusion wherein excessive citrate binds serum calcium, lowering ionized calcium levels and worsening hyperkalemic cardiac effects; treated with $10\,\text{mL}$ of $10\%$ calcium gluconate.

Fresh Frozen Plasma (FFP)

A blood component separated from fresh donation that serves as the primary clinical source of vitamin K–dependent coagulation factors and the sole source of factor V.

Surgical Site Infection (SSI)

An infection occurring at or adjacent to a surgical wound within $30\text{ days}$ of an operative procedure, or within $90\text{ days}$ if a permanent prosthetic implant was placed.

Cellulitis

A diffuse, non-necrotizing bacterial infection of the dermis and subcutaneous tissues lacking a localized pus cavity, typically caused by Streptococcus pyogenes, presenting with spreading erythema, warmth, and an orange-peel texture.

Abscess

A circumscribed, tender collection of pus within the dermis or subcutaneous space, predominantly caused by Staphylococcus aureus, requiring incision and drainage for definitive treatment.

Autoclaving

A method of physical sterilization utilizing moist steam under a pressure of $70\,\text{mmHg}$ and a temperature of $120\,^\circ\text{C}$ to eliminate all forms of microbial life and spores on surgical equipment.

WHO Surgical Safety Checklist

A structured 10-point perioperative checklist divided into Sign In, Time Out, and Sign Out phases designed to prevent wrong-site surgery, manage airway and hemorrhage risks, and ensure correct instrument counts.

Post-Anesthesia Care Unit (PACU)

A specialized hospital recovery ward staffed by trained personnel and continuous monitoring equipment dedicated to managing immediate postoperative pulmonary, cardiovascular, and fluid derangements.

Patient-Controlled Analgesia (PCA)

An intravenous drug delivery system allowing the patient to self-administer small, preset doses of opioid analgesic (commonly $1\text{--}3\,\text{mg}$ of morphine) regulated by an automated lockout timer ($6\text{--}8\text{ minutes}$).

Atelectasis

The partial or complete collapse of pulmonary alveoli, representing the most common cause of morbidity and over $90\%$ of febrile episodes during the first $48\text{ hours}$ following major surgery.

Sebaceous Cyst

A retention cyst arising from obstruction of the punctum of a sebaceous gland by inspissated sebum or fibrosis, tethered to the overlying skin at the punctum and never developing on the palms or soles.

Cock's Peculiar Tumor

A descriptive eponym for an ulcerated, infected sebaceous cyst that has broken down to form a vascular, malodorous, fungating lesion that clinically mimics a malignant epithelioma.

Sequestration Dermoid Cyst

A congenital cyst that develops along lines of embryonic fusion due to inclusion of surface epithelium, most frequently located at the outer angle of the orbit (external angular dermoid).

Implantation Dermoid

An acquired cystic lesion formed by the traumatic inward displacement of epidermal fragments into the subcutaneous tissue, typically occurring on the fingers or palms of manual laborers after puncture trauma.

Cystic Hygroma

A congenital lymphatic malformation arising from a sequestrated fetal lymphatic sac, presenting in early infancy as an ill-defined, lax, brilliantly translucent cystic mass in the lower neck.

Keloid

An exaggerated scar resulting from overgrowth of vascular and fibrous connective tissue that extends beyond the boundaries of the original wound, continues growing beyond $6\text{ months}$, and tends to recur after simple excision.

Keratoacanthoma (Molluscum Sebaceum)

A rapidly developing cutaneous lesion presenting on sun-exposed facial skin as a firm, red, dome-shaped papule with a central craterous keratin plug that grows quickly over one week and regresses spontaneously in $3\text{ to }6\text{ months}$.

Pyogenic Granuloma

A benign, vascular, polypoid mass of infected, highly vascularized granulation tissue devoid of epithelial covering that frequently ulcerates and bleeds upon minimal contact.

Basal Cell Carcinoma (Rodent Ulcer)

A locally malignant skin neoplasm derived from the basal layer of the epidermis, typically appearing on the face with raised, rolled, beaded margins, a granular floor, and characteristic palisading columnar cells on histology.

Mohs Micrographic Surgery

A specialized surgical excision technique using serial horizontal tissue layer removals paired with complete microscopic frozen-section examination to confirm clear margins while sparing maximal healthy tissue.

Marjolin's Ulcer

A cutaneous squamous cell carcinoma arising secondary to chronic irritation within an old unstable burn scar, chronic venous ulcer, or draining sinus of osteomyelitis; initially painless due to a lack of scar innervation.

Squamous Cell Carcinoma (Epithelioma)

A malignant neoplasm originating in the prickle cell layer of stratified squamous epithelium, presenting macroscopically with raised everted edges and a necrotic floor, and histologically showing invasive cell nests with central keratin pearls.

Clark's Staging for Melanoma

A histological classification system for cutaneous malignant melanoma based on the anatomical micro-level of tissue invasion from Level I (intraepidermal/in situ) down to Level V (invasion into subcutaneous adipose tissue).

Breslow Tumor Thickness Measurement (TTM)

A micro-metric staging parameter for primary cutaneous malignant melanoma measuring vertical tumor thickness from the top of the epidermal granular cell layer to the deepest infiltrating malignant cell.

Kaposi Sarcoma

A malignant mesenchymal neoplasm of vascular endothelial cells presenting as purplish-red cutaneous or mucosal patches and plaques, occurring in an aggressive opportunistic form in immunocompromised individuals such as AIDS patients.

Desmoid Tumor (Recurrent Fibroma of Paget)

A non-encapsulated, locally invasive low-grade fibrosarcoma arising from musculoaponeurotic structures of the anterior abdominal wall below the umbilicus, notably appearing in females $6\text{ to }12\text{ months}$ postpartum.

Hamartoma

A non-neoplastic, benign tumor-like malformation consisting of an abnormal, disorganized mixture of indigenous, mature tissue elements native to the anatomical site.

Teratoma

A true neoplasm composed of totipotent cells that differentiate into foreign tissues representing all three primary embryonic germ layers: ectoderm, mesoderm, and endoderm.

Lipoma

The most common benign mesenchymal tumor composed of mature adipocytes, encapsulated by a thin true fibrous capsule and a surrounding false capsule of compressed host tissue, characterized by a slippery edge and pseudo-fluctuation.

Strawberry Mark (Capillary Hemangioma)

A benign vascular hamartoma presenting within $1\text{ to }3\text{ weeks}$ after birth as a bright red, lobulated mass of proliferative capillaries on the face, typically undergoing spontaneous involution by $8\text{ years}$ of age.

Port-Wine Stain

A congenital vascular malformation of mature, dilated intradermal capillaries on the head or neck that is present at birth and follows a stationary, lifelong persistence without spontaneous regression.

Glomangioma (Haemangio-myo-neuroma)

A painful, benign subcutaneous tumor originating from the specialized neuromyoarterial glomus body, consisting of vascular channels, smooth muscle cells, and unmyelinated nerves, classically found under the fingernail bed.