Surgery

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See also: category:surgery

Surgery is a division of medicine in which practitioners, in addition to diagnosis, are trained to perform operations and interventional procedures. Traditionally, the ability to perform surgery clearly separated physicians and surgeons, but in current medical practice, intervention is no longer the preserve of surgeons and many other specialties are now able to perform interventions.

LogoKeyPointsBox.pngThe 4 Rs of Surgery
  1. resuscitate
  2. reassess
  3. repair
  4. rehabilitate

Contents

Approach to surgical problems

  1. Analysis of presenting complaint
  2. Underlying disease process (cause and risk factors)
  3. Complications associated with disease
  4. Fitness for surgery/functional assessment

History of surgery

See history of general surgery

Pre-operative Care

LogoKeyPointsBox.pngYou need an invariable routine of essentials to have been done before the patient has their surgery. Beware of:
  • Interruptions
  • Distractions
  • Assumptions
that may lead to a critical error
  • Diagnosis
  • considerations
  • Advice to patient
  • Optimising for theatre
    • Pre-operative testing
      • Anti-coagulation
      • Blood grouping
    • Medication review
  • Consent
  • Marking
  • Administrative
    • Theatre list
    • Medical record reviewed and available
    • Consent, marking all done


Peri-operative Care

Timing of Surgery

Elective Surgery

Emergency Surgery

  • Timing, see NCEPOD
  • Life and limb threatening

Theatre

  • Design (e.g. airflow, etc.)
  • 'Scrubbing'
  • Gloving, gowning
  • Drapes
  • Skin 'prep'
  • etiquette (assisting, interrupting, etc.)
  • Ergonmics (lighting, table height, etc)
  • Specimens and biopsies

Technical Aspects

Quality & Quality

  • Volume and mortality
  • Sub-specialisation
  • Teaching/training
LogoKeyPointsBox.pngCommon Post-operative complications

Medical Post & Peri-operative Care