Basic surgical skills

Non specific skills:

1- Accurate measuring of blood pressure, pulse and temperature.
2- Withdrew many venous samples and insert many canulae.
3- Withdrew arterial samples and know WRERE to analyze and learn reading.
4- Inserting male and female urinary catheters.
5- Dealing with central lines (see insertion, how to give through, withdrew from
and how to measure CVP).
6- When, what type, why and how to prepare blood transfusion and other blood
components.
7- How to communicate with residents, staff, nurses and patients (how to tell bad
news, death, cancer, risky operation and strict follow up?
8- How to write requests for consultation and referral? And stay beside every
consultant and see how they examine and take decision.
9- Try to read every X ray, C.T., ECG, MRI, ERCP, …….. You meet.
10- Don't go to any request unless you know its value and every thing about the
patient.
Specific skills:
Surgical dressings
1- How to do proper dressing for clean, septic, open and closed wounds.
2- What is the frequency of dressings?
3- When to use saline, alcohol, betadine, iroxol, EUSOL, paraffin oil, glycerin,
tincture benzoic and others?
4- How to use instruments, gauze and bandages.
5- How to make wound depridement.
Drains:
1- What is the value?
2- How to read, evacuate, fixate and dress?
3- When and how to remove?
Suters and stiches:
1- What are their types and when to use every type?
2- Take simple interrupted, continuous, mattress and subcuticular stiches.
3- How to give local anesthesia and ring anesthesia?
4- Know how and when to remove.

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5- Know their care (dressing & antibiotics).

Management of specific cases:

1. Polytraumatized patients:
Resuscitation, needed history, proper examination, essential investigation,
initiative and definitive treatment.
2. Post concussion:
Definition, when to admit, when to discharge, investigation and treatment?
3. Chest trauma:
Watch intercostals tube insertion; know its care, indication and when to remove?
4. Acute abdomen:
How to differentiate between surgical and medical causes?
How to take history, do examination and ask for investigation for:
-Acute appendicitis.
-Acute cholicystits and biliary colic.
-Intestinal obstruction.
-Perforated viscus.
-Renal colic and acute retention.
Watching and doing P.R. examination.
Watch and interpret upper GI endoscopy, colonoscopy, ERCP, mammography,
Ba enema and gastrographin meal and follow through.
Preoperative preparation:
1. How to write and take surgical consent?
2. How to do colonic lavage, ask for shaving, fasting, resuscitate and give
preoperative analgesics and antibiotic?
Operations:
1. Sterilization and toweling for the patient.
2. Sterilization of you and how to wear gown and gloves?
3. Watch induction and termination of anesthesia try to do endotracheal intubation.
4. Assist in some operations and do closure of: thyroidectomy, hernial repair,
appendectomy and mastectomy.
5. Watch other major operations to take an idea e.g. Whipple's, colectomy and
others.
6. Interested personal can do appendectomy, abscess drainage and removal of
cysts and swellings.
7. How to use surgical instruments and why every one?
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8. How to write operative details?

Postoperative management:
1. What is the treatment given to every case?
2. When to do postoperative dressing?
3. When and how to start oral feeding and what are the fluids given to nothing per
os N.P.O. patients?
4. What Total Parentral Nutrition TPN and when to start?

Conference ‫ المرور‬:
1. Try to learn how senior staff take decision and think of surgical cases e.g.
obstructive jaundice, breast lump, bleeding per rectum etc.
2. Ask about any thing you don't understand. Don't be ashamed it's your last
chance to learn surgery.

CONCLUSION:
Try to learn and do what junior resident surgeons know and do.

N.B.
5 Days in burn unit:
1. Try to know and see surgical dressings of burns.
2. Watch some surgical management of burns e.g. grafts, flaps and escharecromy.

:‫أعمال إداريه لكنها هامه‬

‫ تجذيذ‬-‫ ملخص حالت المشيض عنذ الخشوج‬-‫عياداث) – كتابت تقاسيش طبيت‬-‫حجز تزاكش المشضى (حىادث‬
.‫ كتابت شهادة وفاه‬- ‫ أرن ششاء أدويو‬- ‫ عمل استباط‬-‫عالج‬