Health and medicine

1. General Surgical
Considerations-1

2. GENERAL SURGICAL
CONSIDERATIONS-1
1.The Patient
2.The Instruments
3.The Surgeon
4.The Operating Room
Conduct

3. THE PATIENT-1
1. Preoperative Evaluation
PCV, TP & CBC (Elective as well as
Emergency Cases)
2. Surgical Judgment
Experience & mistakes
Professional Honesty
3. Asepsis & Antisepsis
Aseptic surgical technique
Identify high risk patients
Correction of Systemic Imbalances
Prophylactic use of antibiotics

4. Classification of Surgical
Procedures-1
1.Clean
2.Clean
Contaminated
3.Contaminated
4.Dirty

5. CLASSIFICATION DESCRIPTION PROCEDURE TYPE (EXAMPLES)
Wound Classification System
Clean Nontraumatic, noninflamed operative wounds in
which the respiratory, gastrointestinal,
urogenital, and oropharyngeal tracts are not
entered
Exploratory laparotomy
Elective neutering
Total hip replacement,
PDA
Bronchoscopy,
Cholecystectomy,
Small intestinal resection,
Enterotomy
Clean-contaminated Operative wounds in which the respiratory,
gastrointestinal, or urogenital tract is entered under
controlled conditions without unusual contamination;
an otherwise clean wound in which a drain is placed
3

6. Contaminated Open, fresh, accidental wounds; procedures in
which gastrointestinal contents or infected urine
is spilled or a major break in aseptic technique
occurs
Bile spillage during
cholecystectomy or biliary
diversion procedures,
Open cardiac massage,
Cystotomy with spillage of
infected urine, Lacerations
Dirty Old traumatic wounds with purulent discharge,
devitalized tissue, or foreign bodies;
procedures in which a viscus is perforated or
fecal contamination occurs
Excision or drainage of an
abscess, Peritonitis,
Perforated intestinal tract,
Ruptured gallbladder caused by
necrotizing cholecystitis,
Bullae osteotomy for otitis
media
4

7. Classification of Surgical Procedure-
2
To avoid intra & postoperative
complications
Routinely use ----------------
Sterile drapes
Cap, Mask
Sterile Gown and
Gloves

8. POSTOPERATIVE INFECTION &
ROLE OF ANTIBIOTICS-1
 Antibiotics are not a substitute for
asepsis
However, at occasions infection may occur
What to do?
Decision rests with the surgeon
Provision of drainage
Culture & sensitivity test
Antibiotics: Correct dosage, Correct
time & correct period of time.
Should be started preoperatively.

9. Preparing the Surgery Site

10. Clipping / Shaving (male)

11. Clipping / Shaving (Female)

12. Cleaning / Scrubbing Surgery Site

13. Ready for Draping

19. THE INSTRUMENTS-1
1. Proper use, handling and care of
instruments
Instrument should be used only for
the purpose it is meant for.
Should be handled in the correct
manner to get maximum
performance.
Proper sterilization using moist heat,
gas (ethylene oxide), chemicals,
boiling in water etc.