Theory Unit 2 Objectives 20-28 2019 PDF

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SURG1050 Surgical Technology Theory – Fall 2019 Unit 2: Instruments, Supplies, and Equipment Objectives Stapling Devices 20. State (4) advantages of staples/stapling devices. a. Less tissue reaction: stainless steel is the least reactive of all wound closure materials. i. Except on the skin because it causes scar tracks b. Less operating and anesthesia time: Takes less time to perform, resulting in less blood loss during the procedure c. Efficiency: Creates an airtight and leek-proof anastomosis or closure. i. Faster than sewing d. Accelerated wound healing: Tissues are not handle as much during closing, increasing the odds that the wound will heal without incidence. The B-shape line allows nutrients to pass through the staple line to the tissue edges. 21. Identify staplers by type, name, and applications. (no written prep, just read information in table below) a. Staple cartridges are color coded and they come in various lengths b. The color of the cartridge signifies the depth of the staples Type of stapler Brand names Use Ethicon Covidien skin stapler Proximate Generic: skin stapler skin closure linear stapler Proximate GI tract, lung TA 1 Thoracic abdominal Fires 2 double rows of staples: tissue is cut manually GIA2 linear cutter Proximate GI tract, lung resection Fires 2 double rows or staples and cuts Gastrointestinal between anastomosis 3 4 ILS EEA circular tubular organ anastomosis Intraluminal Fires 2 double circular rows or staples and stapler cuts between Used to connect the bowel through the rectum ligating clips Endoclip Surgiclip ligate blood vessels, ducts such as the cystic ducts 1 TA stands for Thoracic-abdominal 2 GIA stands for gastrointestinal anastomosis 3 ILS stands for intraluminal stapler 4 EEA stands for end-to-end anastomosis 22. List (5) types of tissue repair and replacement materials (meshes and biologicals). a. Synthetic: i. Polygalactin 910 mesh (Vicryl mesh) is absorbable that provides temporary support during healing. ii. Stainless steel mesh is rig and hard to apply, which cause discomfort for the patient. It is the most inert of the mesh materials and can be used in the presence of an infection. 1. Rarely used iii. Polyester fiber mesh (Mersilene mesh) is the least inert of the synthetic meshes and must SURG1050 Surgical Technology Theory Unit 2 Objectives Page 1 of 4

never be used in the presence of infections because its multifilament fiber construction can harbor bacteria. b. Biological i. Fascia lata from cattle muscle or from the patient’s own thigh. ii. In-growth mesh (Surgisis) is a biological mesh harvested from porcine (pig) small intestine submucosa and the manufacturing process leaves the collagen fibrous matrix in place, so that it is porous to allow for new tissue in-growth. Specialized Surgical Equipment Chapters 6 and 10 The Electrosurgical Unit (ESU) 23. Define terms related to electricity and electrical flow. a. Circuit the path that the electricity travels from the energy source to a device and then back to the energy source. b. Conductor are materials that allow free electrons to flow through it such as silver, copper (the most commonly used conductor), aluminum, zinc, brass, iron, saltwater, carbon, and some acid. Water is also a very good conductor, therefore it is very important to consider the humidity within an environment. High humidity can result in static charge leakage, while low humidity causes sparks. All in all, the humidity in the OR should be maintained at around 20 to 60 percent. c. Current is the flow of electric charge or the rate of the flow of electrons, measure in amperes (amps). d. Frequency is the number of wave cycle per second. e. Ground NIT: A direct electrical connection to the earth f. Insulator are materials that inhibit the flow of electrons such as plastic, rubber or any other nonconductive materials. Conductors made from copper and other metals are wrapped with an insulating material that does not conduct electricity in order to prevent electron leakage. g. Isolated circuit NIT: a circuit that isolates current from ground by referencing it within the generator h. Radio frequency are electromagnetic waves. Frequency is the number of wave cycle per second. The energy will travel through the transmitter to the antenna. Depending on the frequency, the waves will travel through the atmosphere or space. i. Resistance NIT: Obstacle to the flow of current, measured in ohms (impedance = resistance) j. Voltage is the potential energy of electrons (or the electric charge) at any given tinme between two points. To create voltage, electric systems uses batteries or generator to move the electricity from one point to another. k. Hertz is the standard unit of measurement used for measuring frequency. Frequency is measured in cycles per second, one hertz equals one cycle per second. l. Load is the portion of the circuit that consumes electric power m. Cycle exist in any form of wave motion per second of an alternating current. 24. Identify basic principle of electrical flow. (provided for you, no written prep necessary) Electricity flows from ground to power source to load (device to be powered) and back to ground (For more ESU information, see the Medtronic (Covidien) Electrosurgery Self-Study Guide, click Launch http://www.covidien.com/pace/clinical-education/273622)

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25. Identify the two types of electric current. a. Alternating current b. Direct current i. Dermatome ii. Ophthalmic cautery 26. Trace the flow of current in a monopolar electrosurgical unit (ESU). a. The flow of the current in a monopolar ESU goes from

27. Trace the flow of current in a bipolar electrosurgical unit (ESU). a. The flow of the current in a bipolar ESU goes from: i. Generatoràactive electrodeà

28. State (5) safeguards to use when placing an ESU dispersive grounding pad (inactive electrode) for monopolar units. a. Apply the grounding pad after the position the patient to avoid wrinkling, gapping, or movement of the pad. b. Apply the pad on a large, fleshy area, preferably over a muscle mass that is clean and dry. i. Do not place the pads over boney prominence. SURG1050 Surgical Technology Theory Unit 2 Objectives Page 3 of 4

ii. Make sure that the area is free of scars c. If the pad placed but the placement is not satisfactory, remove the pad and replace it with a new one. Do not use the pad that was remove again. i. To maintain the pad’s adherence and conductivity. d. Jewelry or other metallic object that belong to the patient should be remove immediately before the surgery to prevent possible patient burns from the current that is seeking an alternate exit pathway. e. Do not place the pad over a metallic prosthetic because the electrical current may travel through the metal and internally and externally burn the patient. f. Pad must have full contact of the patient’s skin

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