More Surgical Hand Antisepsis & Scrub Attire
True or False: The purpose of the surgical hand scrub is to sterilize the skin
False—skin cannot be sterilized; the purpose is to (1) remove debris and transient organisms, (2) reduce resident microbes to minimum, (3) inhibit rapid regrowth of organisms
These are two characteristics of polypropylene sutures
Non-absorbable
Monofilament
Does the insertion of a drain impact wound classification?
The insertion of an open drain (i.e., Penrose) changes a Class I (clean) procedure to Class II (clean-contaminated)
The scrubbed person must ensure that his/her hands are this when placing drapes in order to avoid contamination
Cuffed
This technique is used to separate instruments that have come into contact with dirty or contaminated areas.
Bowel/isolation technique
This is how long the surgical scrub should take (by either method)
4-6 minutes (not including pre-wash of 1 minute)
These are the two suture materials that can be characterized as natural and non-absorbable
Silk
Stainless steel
List 5 patient factors that influence wound healing
Respiratory and circulatory status
Age
Pre-existing conditions (diabetes, renal failure, alcoholism, immunocompromising conditions)
Immune system response
Nutritional status
In order to prevent contamination, it is recommended that these drapes be placed first when draping for lithotomy
Leggings
True or False: All staplers stocked at VCH have a maximum firing of 8 times
False
TLC = 8
TX = 8
Echelon = 12
CDH/EEA = 1
Contour = 6
Your first pair of gloves should be put on using this technique
Closed gloving
Name at least two absorbable sutures
Vicryl
PDS
Gut
Monocryl
What is a stitch that is separate and tied independently of other sutures called?
Interrupted
Identify at least 4 different types of drapes
Sterile towels
Incise drapes
Laparotomy drapes
Upper/lower extremity drapes
Lithotomy drapes
Split sheets
This is the correct way to unload and clean a used stapler
Carefully remove the cartridge using a sponge to avoid contaminating your glove
Place the used cartridge in a separate area of the back table
Rinse/swish the stapler in a jug of sterile water
Wipe the anvil with a sponge to remove any excess staples/water/tissue
Double gloving reduces the risk of injury/exposure; wearing two different colours of glove assists with this
Recognizing perforations in the outer glove
Arrange these sutures from smallest to largest: 8-0, 0, 3-0, 5-0, 2
8-0
5-0
3-0
0
2
Why is negative pressure wound therapy used?
Decrease the edema and bacterial load
Promote wound contracture and healing
Surgical drapes should be placed according to these principles
Drape from the incision site to the periphery (Exception: placing an approach sheet to allow better access)
Drapes are handled as little as possible
Cuff hands to avoid contamination
The top surface of the drape is considered sterile
Once placed, the drape is not moved
The surgeon asks for a TLC stapler, what information should you ask before going into sterile core?
Size (TLC55, TLC75, TLC100)
Colour/tissue type (vascular = white, regular = blue, thick = green)
Number of cartridge reloads
When removing your sterile gown and gloves, this is the order they should be removed
Gown, then gloves; your top layer glove may be removed prior to the gown
This is the most appropriate needle point for performing vascular anastomosis
Taper
In this type of wound healing, closure is delayed due to gross infection or considerable tissue loss; the wound is cleaned, debrided, and packed
Delayed primary closure (tertiary intention)
If a surgical drape is placed in an incorrect position, this is the best course of action
Discard and replace the drape
These are the two types of staplers you will require for a sigmoid colon resection with end-to-end anastamosis
GIA/TLC x2 firings
EEA/CDH x1 firing