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Surgery I
Bandaging & Casting
| Question | Answer |
|---|---|
| What is the advantage of a dry dressing? | It protects the wound while allowing for air circulation and evaporation of moisture from the skin |
| What bandaging material is most commonly used for a dry dressing? | Gauze |
| When is a nonadherent dressing indicated? | When a wound has a raw surface or is expected to have active drainage |
| Why are frequent dressing changes not optimal? | May increase the risk of infection |
| Under what conditions and for how long should post-op dressings be placed? | Placed under sterile conditions and remain in place for 2-5 days, depending on wound size |
| What are the indications for Montgomery straps? | Used when repeated dressing changes are required, such as an abdominal wound that has re-opened |
| How should adhesive tape (steri-strips) be applied and removed? | Applied perpendicular to wound edges and removed by pulling toward the wound |
| What are the indications for the use of Collodion spray? | Small lacerations, such as the scalp |
| What are the indications for use of reversed spiral bandaging | Tubular structures of changing diameter such as the calf or forearm |
| How long should wet comporesses be used? | No more than 24 hours, may result in skin maceration |
| Which "support" material is the most versatile? | Plaster-of-Paris, can be molded into many shapes |
| When is posterior splinting most useful? | For quick and initial mobilization of acute injuries, such as nondisplaced fractures and severe ankle sprains. |
| Which type of drain is attached to suction and used to decrease fluids from large wounds? | Sump drains - attached to SUCTION |
| What type of environment is optimal for wound healing? | 1. Free from dead tissue 2. Free and protected from infection 3. Moist at the wound surface (but not wet) |
| What are the signs of an infected wound? | 1. Increased pain 2. Erythema around wound 3. Discoloration of wound bed tissue |
| In comparing plaster vs. synthetic casting material, which is: 1. cheaper 2. stronger 3. more water resistant 4. quicker to dry | 1. plaster 2. synthetic 3. synthetic 4. plaster |
| what is an important advantage of using a splint in a fresh fracture? | Allows for significant swelling and immobilization prior to application of a cast |
| What are the indications for the following splints: 1. thumb spica 2. ulnar gutter 3. radial gutter 4. upper extremity posterior splints 5. lower extremity posterior splints | 1. thumb sprain, scaphoid fracture, immobilization following laceration repair. 2. 4th and 5th metacarpal fractures 4. bicep tendonitis, radial head fracture, stable distal humerus fracture 5. stable ankle fractures |
| What are the indications for the use of cast braces? | Used to hold a fractured bone immobile while allowing for joint motion above and below the fracture site, allowing for early ambulation and rehabilitation |
| Name the different lays that are applied to create a cast | 1. Stockinette 2. Webril (soft cotton roll) - tow to three layers, more over bony prominences 3. Plaster or fiberglalss bandages |
| Name the pre and post splint checks | FACTS = Function, arterial pulse, capillary refill, temperature of skin, Sensation |
| What are common complications associated with casting? 1-3 | 1. Foreign body causing ulceration or infection; 2. plaster burn; 3. pressure sores - require immediate "window" formation and inspection |
| What are common complications associated with casting? 4-7 | 4. Nerve palsy/vessel compromise - requires immediate bi-valve of the cast through all material 5. Diffuse osteoporosis 6. Joint stiffness 7. Dermatitis or loose-cast syndrome |
Created by:
eedavila
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