Surgical Drains and Power Instruments

Chapter 10- Keypoints and study guide Penrose Gravity drain uses capillary action Jackson Pratt Active closed drainage "grenade" Hemovac Active closed round collection device Sump Utilizes air to displace fluid Water Seal Chest tube device T-Tube Passive drain placed in CBD after a CBDE What type of power source uses a pressure gauge on a regulator? Nitrogen Identify the types of motion: (A) An oscillating saw uses a(n) _____ motion. (B) A reciprocating saw uses a(n) _____ motion. (C) A drill, driver, or reamer uses a(n) _____ motion. (A) Side to side (B) Back and forth (C) Rapid rotary Insufflators: (A) What kind of gas does the laparoscopic (A) Carbon Dioxide Co2 insufflator use? (B) How is the gas initially introduced? (B) A verres needle or a Hasson blunt trocar Secures dressing for frequent dressing changes Montgomery straps Used to secure dressings when a digit is involved Tube gauze Most frequently used to secure dressings Tape (paper, silk, adhesive) Used for intermediate absorbent layer ABD pad Secures a splint dressing on an extremity Kerlix, coban, ace wrap Prevents movement by incorporating proximal and distal joint Fiberglass Occlusive dressing around chest tube Vaseline gauze or Xeroform gauze Semipermeable dressing on chronic wounds to debride Hydrocolloid dressing or inspections Example of a complete three-layer dressing Band-aid Nonadherent- painless when removed Telfa or Adaptic distal joint Describe the following properties of drapes and relate why each is important to the patient. (A) Lint free (B) Fluid resistant (C) Porous (D) Flame retardant Identify one advantage and one disadvantage of each type of fabric: (A) Nonwoven fabrics (B) Woven fabrics (A) Prevent airborne particles from entering the surgical wound. (B) Prevent strike-through contamination. (C) Body heat is not retained, resulting in hyperthermia. (D) Prevent them from igniting if exposed to the beam of laser or spark from an ESU. (A) Advantage: Disposable; Disadvantage: May need extra fabric around the fenestration. (B) Advantage: Cheaper and impermeable to liquid; Disadvantage: Need to be washed, folded, inspected and sterilized after each use. (A) Have an adhesive backing that may be impregnated with an antimicrobial iodine agent Describe each the following types of drapes: (A) Incise drape (B) Aperture drape (C) Isolation drape (D) Fenestrated drape (E) Split drape (F) Stockinette that is slowly released after application. (B) Small, clear, plastic drapes with openings surrounded by an adhesive backing. (C) Large, clear plastic drapes with an adhesive backing surrounding the fenestration. (D) Have openings for exposure of the area to be incised. (E) One end it open down the center, creating a "U" shape. (F) Stretchable gauze tubes to cover extremities; One end is closed to cover distal end, open end for proximal end. Identify the types of sponges in Figure 10-5, the usual number in a pack, and where they are (A) Laparotomy; 5; On large incisions, such laparotomy and in the abdomen typically used. (A) Name; Number; Used (B) Raytec (4x4); 10; On small incisions, also used as a sponge stick for sponging and retracting (B) Name; Number; Used within an abdominal wound. Neurosurgical Sponges: (A) Name of sponge (B) May be moistened with (C) Number in a pack (D) Where are they arranged on the field? (A) Patties/Cottonoids (B) Saline (C) 10 (D) Kidney basin Describe each one and identify the usual number in a package: (A) Cotton-filled gauzes with a string attached; 5 (B) Dissecting sponges, small rolls of cotton (A) Tonsil sponge (B) Kittner tape; 5 (C) Small gauze sponges used for blunt (C) Peanut dissection; 5- picked up with Kelly or vandy Identify the proper type of dressing for the situation: (A) Dressing that prevents unidirectional movement (B) Large three-layer dressing with additional absorbent material but no pressure (C) Dressing that eliminates dead space (D) Dressing layer that provides and airtight and watertight seal (E) Dressing layer that allows passage of air and fluids (A) Rigid dressing (casts and splints) (B) Bulky dressing (C) Pressure dressing (D) Occlusive dressing (E) Semi-occlusive dressing (F) Permeable or nonexclusive (Telfa) (F) Dressing layer that draws secretions from the wound by wicking action Wet-to-dry gauze Where does a heterograft come from? most commonly used Soaked in antibiotic/ saline mixture 3 layers of wet-dry gauze needs changed every 3-4 hours One species to another species that involves tissue that is transplanted. (A) Self-retaining; Remains in position within an Identify the catheters pictured in Figure 10-6 and what each is used for. organ w/o further support (B) Non-retaining; Withdraws fluid from a body cavity (C) 2-way Foley; Deflated balloon inflated with sterile water once inside the bladder, allows for retention (D) 3-way Foley; Irrigating, urine drainage (E) Pezzer (Mushroom); Nephrostomy drainage (F) Malecot (4-winged); Drainage of different bodily fluids such as bile, urine, pus (G) Robinson (Plain); Facilitate intermittent drainage (H) Coude; Urine drainage, easily move around blockages or narrow parts of the urethra (I) Whistle Tip; Access and catheterization of the urinary tract (J) Multi-eyed; Drainage Closed wound suction devices connected to active drains use ______ ______ to remove fluids and/or air. Passive drains use _______ or absorbent dressings to remove fluids and air. Vacuum System Gravity 20 Blade- C-section Most commonly used: Scalpel Blades and Handles 11- used to make holes for trochar 10- general 15- plastics- precise cutting A. Metzenbaum- used for medium to fine tissue Cutting and Dissecting Scissors B. Curved Mayo- often the scissors of choice for heavy tissue C. Potts- Smith- for incisions into ducts, veins, or arteries Designed to manipulate tissue  Reduce and stabilize  May or may not have ratchets: Grasping and Holding Instruments Tissue forceps Bone-holding clamps Allis Babcock Kocher