Fundamentals Of Surgical Care Quiz 12 Review

What are the 2 types of hemostasis

Mechanical - Clamp or burn
Biological - Medication

What is a Hemostatic Agent

Used to enhance the clotting mechanism of blood

What is Oxidized Cellulose and what is it used for

- Hemostatic Agent
- Surgicel/Oxycel
- Comes from the blood (Usually animal blood)
- Bactericidal - Fights infection
- Used in the Liver bed, Uterus, etc.

How Does Oxidized Cellulose Need to be Applied

Needs to go on dry

What is Gelatin Sponge and what is it used for

- Hemostatic Agent
- Comes from pig skin
- Gelfoam/Surgifoam or Gelfilm
- Used in neuro, ortho, and vascular

How Does Gelatin Sponge Need to be Applied

- Normally goes on wet
- Gelfoam powder and Gelfilm has to go on dry

What is Fibrin Sealant and what is it used for

- Hemostatic Agent
- Combo of gelfoam powder and human thrombin that is made into a paste
- Vascular and spine
- AKA Tisseel, Crosseal, Evicel, Surgiflo, Floseal

What is Microfibrillar Collagen and what is it used for

- Hemostatic Agent
- comes in powder or as a sheet
- Once bleeding has stopped it is irrigated off
- Avitene, Helistat/Colastat

What is BioGlue and what is it used for

- Hemostatic Agent
- Bovine Albumin
- Good for Aortic dissection - Sprayed onto the aorta to stop bleeding and seal it

What is Bone Wax and what is it used for

- Hemostatic Agent
- No medication in it
- Mechanical method of hemostasis
- Seals edges in bone when cut and allows blood to clot naturally
- Has to be peeled off once bleeding stops

What Are Chemical Hemostatic Agents and what are some examples

- Burns tissue to cauterize and stop bleeding
- Monsels - Cervical
- Silver Nitrate - Used for nasal bleeders or cervix
- Tannic Acid - Powder that is made into a paste. Mixed with 1% Neosynephrine. Cauterizes nasal bleeders or tonsils

What are Systemic Coagulants and what are some examples

- Reverses effects of anticoagulants
- Protamine Sulfate is used for heparin
- Vitamin K can be injected IV or IM to reverse an anticoagulant. Very strong

What is the purpose of a Dressing

- Cushions Wounds
- Protects from trauma and contamination
- Absorption and Drainage
- Supports and Splints
- Pressure aids in hemostasis
- Anesthetic Appearance
- Comfort for pt
- Maintains moist environment

What are the different types of dressings

- One Layer Dressings
- Three-Layer Dressings
- Pressure Dressings
- Bulky Dressing
- Rigid Dressings
- Packing
- Specialty Dressings

How is the type of dressing used determined

- surgeons preference card
- patients age
- Size of incision
- condition of the surrounding skin

Describe the layers of a dressing

Primary Layer
- One Layer dressing
- Placed directly over the wound

Secondary Layer
- Goes over the primary layer and used to absorb Fluid in a three layer dressing

Third Layer
- Used for compression of the wound

What is Tegaderm/Opsite and what is it used for

- Transparent Film adhesive
- Used over IV or can be used over the umbilical port of a laparoscopy
- Can be used to cover a contaminated area on the sterile field

What is Mastisol and what is it used for

- Skin Adhesive to hold tape in place
- Used with Steri-strips
- Can come in a vial or in a spray bottle

What is Benzion and what is it used for

- Skin adhesive to hold Steri-Strips on
- Is poured in a medicine cup and then spread on the skin with a Q-tip

What is Collodion and what is it used for

- Liquid Dressing that makes a thick layer over the incision

What is DermaBond and what is it used for

- Not a dressing but considered skin closure
- Seals tissue
- Used to close incisions used for Trocars

What is a 2x2 and what is it used for

- Gauze used for small incisions
- ENT
- Called a mustache dressing in nose Sx

What is a Drain Sponge and what is it used for

- Used as a dressing over a drain

What is a 4x4/4x8 and what is it used for

Gauze use for Primary or Secondary dressing layer

What are Fluffs and what is it used for

- 4x4 crumpled up
- Used to hold hand open after hand sx

What is Kling and what is it used for

- Used for hands and feet
- Wraps fingers or toes
- Used as third layer

What is Kerlix and what is it used for

- Used on arms and legs
- Similar to Kling but not as soft

What is Webril and what is it used for

- Made of cotton
- Used to absorb fluid
- Dressing that is placed under the cast material
- Used mostly after arthroscopy to absorb the saline in the joint

What is a Eye Pad and shield and what is it used for

- Used after major eye surgery

What is an Abdominal Pad/Combine and what is it used for

- Used for major Abdominal, Cardiac, or Thoracic Sx
- Used to cushion a large abdominal wound and absorb fluid
- Usually second layer in abdominal sx

What is Plain Packing and what is it used for

- Used for Vaginal sx
- nothing on it

What is Iodoform Packing and what is it used for

- Rectal Sx or any wound that needs to heal by granulation

What is a Maternity Pad and what is it used for

- Used after an vaginal Sx or child birth
- Absorbs blood

What is a Splint and what is it used for

- Rigid Dressing
- Is applied to one side of a structure
- Prevents unidirectional movement
- Ex. Knee and Shoulder Immobilizer and slings

What is a Philadelphia Collar and what is it used for

- neck brace that is used after cervical spine sx

What is a Scrotal Support and what is it used for

- Supports the scrotum after scrotal sx

What is an Abdominal Binder and what is it used for

- Used after major abdominal sx
- Supports that abdomen
- Seen in plastics

What is a Surgical Bra and what is it used for

- Support used after breast sx

What is a Girdle and what is it used for

- Used after Liposuction

What is a Cast and what is it used for

- Made of plaster or fiberglass
- Used on extremities

What is an Abduction Pillow and what is it used for

- Used after Hip sx
- Stops pt from bringing their legs together

What is Coban and what is it used for

- Bandage that Sticks to itself and wraps around

What is an Ace Bandage and what is it used for

- Bandage used for Compression

What is a Stent/Bolster Dressing and what is it used for

- Specialty Dressing
- A Piece of gauze with silk sutures tied around it
- Used to put pressure and secure Grafts in plastics

What are Montgomery Straps and what is it used for

- Specialty Dressing
- Used for Frequent Dressing Changes on older patients

What is a Wound Vac Dressing and what is it used for

- Specialty Dressing
- Vacuums and seals to put pressure on the wound
- Used on burn patients

What is a Jobes Dressing and what is it used for

- Specialty Dressing
- Used on burn patients
- Cannot use tape on burn patient so this dressing keeps the gauze in place
- Looks like a net
- Also prevents contracture

What is a Biological Dressing and what is it used for

- Specialty Dressing
- Made of something natural like the tissue from animals or cadaver
- Used to cover burns to help patient retain body heat

When are Nonadherent Dressings used

- Primary Dressing layer
- Used to prevent dressings and clothing from sticking to the wound that has a raw edge

What is Xeroform and what is it used for

- Nonadherent Dressing
- Impregnated with Petroleum and betadine
- Occlusive dressing
- Very common in Ortho sx

What is Vaseline/Petroleum Gauze and what is it used for

- Nonadherent Dressing
- Occlusive Dressing
- Looks similar to xeroform but does not have betadine

What is Adaptic and what is it used for

- Nonadherent Dressing
- Semi-permeable dressing

What is Betadine Gauze and what is it used for

- Nonadherent Dressing
- Semi-permeable dressing
- Impregnated with betadine

What is Telfa and what is it used for

- Not a true non-adherent Dressing
- Can stick to a wound if it is a raw edge
- Not impregnated with anything

What is Elastoplast and what is it used for

- Most adhesive tape
- made of fabric
- Used as the last layer of a dressing

What is an Island Dressing and what is it used for

- Adhesive and has telfa on it
- Used a lot in abdominal sx

What are pressure dressings used for

- Puts pressure over a dressing for support and hemostasis
- Helps with swelling and fluid build up
- Gauze can be used as a pressure dressing if it is folded a bunch of times (The more layers the more pressure that is applied)

What are the layers of a Knee Arthroscopy Dressing

- Xeroform (3 Small pieces for each port)
- 4x4 (The more layers the more pressure that is applied)
- ABD/Combine
- Webril
- Ace bandage

What are the layers of a Hand sx Dressing

- Xeroform
- 4x4
- Fluffs
- Kling

What are the layers of a Abdominal sx Dressing

- 4x4
- Combine
- Elastoplast/Island Dressing
- Abdominal Binder if needed

How is packing added to the sterile field

- Circulator Opens the container
- Scrub grabs the end with forceps
- They then pull the rest out into an emesis Basin with the end hanging out

How is a wound packed

- Doctor puts packing into patient with Singly ring forceps
- 4x4 is applied
- Taped is applied

How is a moist dressing applied

- Antibiotic Ointment is needed to be applied to the dressing
- If a single use ointment then the scrub squeeze it onto the 4x4
- If ointment is in a reusable tube then the circulator squeezes the ointment onto the 4x4
- Doctor uses the end of an empty blade handle to spread the ointment

How are Steri-Strips applied

- Have to ask the doctor how they want the strips (In half or in thirds)
- A Clean straight scissor is used to cut the strips
- Then the paper is peeled off and laid on a clean towel sticky side up
- Mastisol or Benzion is then applied to the incision
- Adson with teeth is used by the doctor in order to apply the strips

What does wet to dry mean

Moist dressing on skin then dry dressing further up

What is a Simple Dressing

4x4 and tape

What are the steps to applying a dressing

- Dressings are requested (After the last closing suture and opened after the closing count is correct)
- Circulator Opens the dressings
- Clean towel is opened over the instrument tray to lay the clean dressings on
- Remove all dirty instruments off the mayo stand
- Bring the towel with the dressings onto the mayo stand
- Patient is cleaned with a Wet and Dry lap pad
- Dressings are applied by the doctor
- Doctor leaves and the scrub removes the drapes while holding the dressings in place
- Patient is cleaned again with a new wet and dry lap pad
- Circulator comes and tapes the dressings to the patient

What drains the bladder

Catheters
- Foley, malecot, Pezzer, robinson

What suture is used to secure a drain

2-0 Silk

What drains the Gallbladder

Biliary T Tube

What drains the stomach

NG Tube

What is the Stryker Consta-vac

- Active Drain
- Used in total Knee replacements.
- Can give back patients blood

What is a Hemo-Vac Drain

- Active Drain
- Used on Orthopedic (Craniotomy)

What is a Jackson Pratt Drain

- Active Drain
- Breast Sx (Mastectomy), ENT, General
- Tube can be cut if too long (If done than circulator needs to be informed how much was cut off)

What is a Pleur-evac Drain

- Active Drain
- Re-establishes Negative Pressure inside the Pleural Cavity

What is a Christmas Tree Adaptor and what is it used for

- used connect one tube coming out of the patient to the Pleur-evac

What is a Y Adaptor and what is it used for

- used connect two tubes coming out of the patient to the Pleur-evac