Surgery for medical students

1. REGIONAL SURGERY
TOPIC
Operative Care

2. Operative Care
INTRODUCTION
 Operative care is the physical and psychological
management and care given to a patient. It is a care given
before, during and after a surgical operation. It takes
place in hospitals, in surgical department attached to
hospitals, in free standing surgical centers or health care
provider’s offices.
 This period is used to prepare the patient both physically
and psychologically for surgical procedures and after the
surgery.

3. INPORTANCE OF OPERATIVE CARE
 It educates the patient and their families about the operation and
gives them confidence to undergo surgical procedures.
 Supplies information on any risk factors related to the surgery.
 The goal of operative care is not only to prepare the patients for their
surgery, but also for what they expect following the surgery.
 It helps to avoid complications during surgery.
 Improves success rate of procedure.

4. TYPES OF OPERATIVE CARE
 Pre-operative care
 Intra-operative care
 Post-operative care

5. 1. PRE-OPEERATIVE CARE:
 This is the management and care given to a patient before he or she is
taken to the theater for surgery.
 It involves the physical, emotional and psychological care and
management of the patient.
 This phase is used to perform tests, attempt to limit pre-operative
anxiety and may include preoperative fasting.

6. A.EMMERGENCY PRE OPERATIVE CARE
 First request for laboratory investigations to confirm diagnosis.
 Take the vital signs of the patient. blood pressure, pulse, temperature,
respiratory rate etc.
 For patients with acute abdomen, insert-gastric tube to compress the
stomach in order to empty the stomach content.
 Insert a Foley catheter.
 Open a two borehole cannula and administer IV fluid.
 Quickly manage any pre-existing condition. E.g. Hypertension, anemia etc.
 Prepare the skin of the patient.
 Give the patient a theater gown. Label the gown with: name of the patient,
the type and site of surgery.
 Inform the anesthetic about the patient.

7. B. NON-EMMERGENCY PRE-OPERATIVE CARE
 Ask the patient about the reason for the surgery.
 Take a full clinical history.
 History of present illness.
 Past medical history
 Current medication
 Social history; social life styles like alcohol intake and chewing cola nut affects the
action of anesthetic agents.
 Request for laboratory investigations. This is done to confirm diagnosis and to detect
any risk factor(s). Such as blood clotting problems etc.
 Inform the patient not to eat anything for about six to eight hours before the surgery
(nil per oral).
 Take informed consent from the patient or relative.
 Allay the fear of the patient and relatives.

8. -NON-EMMERGENCY PRE-OPERATIVE CARE
 Put the patient on prophylactic, antibiotics and analgesics before the surgery as
the case may be.
 Open an IV line and administer IV fluid.
 Check all vital signs of the patient.
 Prepare the skin of the patient, dress him in a theater gown and label with the
name of the patient, type of surgery, site of surgery, ward and doctor for surgery.
 Inform the anesthetic to review the patient before surgery.
 Give an informed consent to the patient about the anesthetic.
 Inform the doctor or surgeon about the patient.
 Ask the patient to rest and wait for the doctor or surgeon and also reassure them.

9. 2. OPERATIVE CARE INTRA-
 This is the care given to the patient or done by the theater team
during a surgical operation. The following are the steps to follow
during a surgical procedure;

10. OPERATIVE CARE INTRA-
 Wash your hands from the elbow and they should remain elevated
until they are dried or wiped with a sterile towel.
 Disinfect the site of the operation with an antiseptic.
 Drape the patient and keep only the surgical site uncovered.
 Continue assessment of the patient’s vital signs.
 If necessary keep resuscitating the patient.

11. 3. POST-OPERATIVE CARE
 This is a care given to a patient after a surgical operation.
The following should be done for a patient who fall in this
level of operative care.

12. POST-OPERATIVE CARE
 Check the patient’s vital signs immediately after the surgery and
before taking the patient to the ward.
 Check the incision site for any bleeding.
 Ask the patient if he or she has passed urine, defecate or pass gass .
 Auscultate the abdomen for bowel sound. This is done to detect
intestinal paralysis.
 Do IV resuscitation and pain management.
 Wound care: cleaning and dressing of the wound.
 Continue vital monitoring as per instruction