Sef lucrari dr.

Tamas

Surgical fundamental skills

Iind year, medicine

We need to know:
- anatomy
- phisiology
- microbiology

goal:practical activity in clinic (oncalls)

Surgical fundamental skills

1. Preparing the surgeon for surgery

Surgical fundamental skills

2. Preparing the patient for surgery

positioning

monitoring

Isolating the operatory field

decontamination

Surgical fundamental skills

preparing for the intradermal test

3.Local anesthesia

subcutaneous injection
testing the patients reaction intradermal injection

testing the quality of local anesthesy

Surgical fundamental skills

4. Organising the table with sterile instruments

Surgical fundamental skills

5. Surgical knots- Ethicon plate

Surgical fundamental skills

discontinuous(separate stiches)

VI.Skin suture

simple continuous
intradermal

continuous suture entrapment

Surgical fundamental skills

VII. bandages and dressings

Surgical fundamental skills

medical specialties

SURGICAL SPECIALTIES

Surgical fundamental skills

SURGERY
medical field that treats diseases
by cutting and opening

SURGERY(as proceeding) any technique/

proceeding on a patient, performed in a hospital , by a
surgical team.

preparing the surgical field for the

management of a superficial wound
SURGICAL WOUND

WHAT IS A WOUND
absence of skin/mucosa
cut
wound
surgical wound

burn

preparing the surgical field for the

management of a superficial wound

SUPERFICIAL WOUND

TOPOGRAFIC ANATOMY

LAYERS

Superficial
Middle
Deep

preparing the surgical field for the

management of a superficial wound

superficial
skin,
celular tissue ,
superficial fascia.

testing the cutaneous fold

preparing the surgical field for the management of

a superficial wound

middle
deep fascia

muscle

blood vessel

nerve

preparing the surgical field for the

management of a superficial wound

Deep

bones
deep vessels and nerves

preparing the surgical field for the

management of a superficial wound

ANATOMY: the separation between the superficial and deep tissues

DEEP FASCIA

preparing the surgical field for the

management of a superficial wound

DECONTAMINATION

BACTERIA

CONTAMINATION/ INFECTION
DESINFECTION
STERILIZATION

preparing the surgical field for the

management of a superficial wound

CONTAMINATION
direct contact with an infection source

INFECTION:
the entrance and developement of some pathogenic
agents ,in a living body, (parasites,bacteria or
viruses ) and the tissuess reactions to this
agression, meaning the inflamation
tumor
rubor
calor
dolor
functio laesa

DESINFECTION
procedure with temporary result ,wich
exterminates/annihilates
the bacteria and viruses
- works in inert environments , using physical and
chemical means

STERILISATION:

complete elimination/annihilation of any kind of micro-organism , including

the bacterial spores

active and efficient on

the inert objects

preparing the surgical field for the surgical

management of a superficial wound

operation room

the place where the surgical act develops

structure

Filter

Circuits:sterile materials, unsterile materials, medical staff,

patient

Rules for maintaining sterility

Protocoles for the activity

preparing the surgical field for the

management of a superficial wound

operation room

the place where the surgical

act develops

structure

Filter

Operation room - Filter

before surgery

special place for scrubbing

special scrubbing rules

Operation room
1

coating sterile surgical gawn

5
6

coating sterile surgical gloves

Circuits: sterile materials,unsterile

materials,medical staff, patient

Rules for maintaining the sterility

Protocols for the activity

II. Preparing the patient for surgery

positioning

monitoring

Isolating the operatory field

decontamination

surgical field

region or segment to be operated

+cleaning

+decontamination

+isolating

preparing the surgical field for the

management
of a superficial wound

sterile handling of the materials and surgical instruments

+sterile protection equipment
+sterile forceps for handling the materials
+circuits for surgical room

preparing the surgical field for the surgical

management of a superficial wound

preparing the surgeon for surgery

+equipament(costume for the
surgical room,masc,bonnet)
+surgical scrubbing(special
solutions,technique,timing)
+sterile surgical gawn
+sterile gloves

preparing the surgical field for the surgical

management of a superficial wound
preparing the patient for surgery
outside the operation room
+informed consent

+cleaning(shower,eliminating the
hair)
+special equipament (single use)

preparing the surgical field for the surgical

management of a superficial wound
left lateral position

preparing the patient for surgery

inside the operating room
+correct positioning on the surgical table

positioning on the orthopedic table

gynecological positioning

inside the surgical room

+superficial venous acces (cannula)
pressure,heart rate,O2

+monitor(blood
peripheric

level)

+testing the patients reaction to local anesthesia

preparing the surgical field for the

management of a superficial wound

preparing the surgical field

+ the correct use of a hemostatic band(tourniquet)= reduce the
bleeding ,better view

1. protection
gause

2. placing the band proximal to

the surgical field

preparing the surgical field for the

management of a superficial wound

preparing the surgical field

+ correct use of the hemostatic band = reduce the bleeding

3. flexion of the fingers

4. elastic band application

from distal to proximal

preparing the surgical field for the

management of a superficial wound

preparing the surgical field

+ correct use of the hemostatic band = reduce the bleeding

5. inflate the band

using the elastic band

reduces the blood volume
from distal segment of the limb

6. check the pulse

absence of pulse
skin color
temperature

preparing the surgical field for the

management of a superficial wound

preparation
+decontamination (solutions,limits,technique)

+limits( sterile drapes- unique or multiple use,

technique)

preparation of a surgical field for the

surgical management of a superficial
wound
preparing the table with sterile instruments

+draping the table with sterile materials

+correct ,sterile handling and manipulating for the

instruments

+correct position of the instruments on the surgical

table

+preparing the materials for local anesthesia

+sterile draping of the surgical table

+handling and manipulating the

sterile instruments

+sterile handling of the surgical

instruments

+correct position of the instruments on

the table

+correct position of the instruments on

the table
incision

soft tissue manipulation

disection
scissors

scalpel

surgical forceps
surgical haemosthasis

haemosthasis forceps

suture

needle-holder

+preparing and testing the solutions

for local anesthesia

Thank
you!!!