IntroSx2- Complications

  1. Superficial incision SSI heals in _________, is located in the __(2)__, and has clinical aspects of... (5)
    30 days; skin or subQ tissues; pus, redness, pain, swelling, heat
  2. Deep incisional SSI heals in _________, is located in the __(2)__, and has clinical aspects of... (5)
    within 30 days (or 1 year if implant was used); fascia or muscle; pus, abscess, fever, pain, swelling
  3. Organ/ space SSI heals in _________, is located in the __(2)__, and has clinical aspects of... (4)
    within 30 days (or 1 year if implant was used); organ or body cavity; pus within space or organ, faver, pain
  4. What are infection risk factors? (5)
    • Patient: endocrinopathy, pyoderma, obesity
    • Procedure: wound classification
    • Pre-operative: hair removal, peri-operative antibiotics
    • Surgical: aseptic technique, environment, duration of sx, implants used 
    • Post-op: incisional care, environment
  5. How do we avoid superficial incisional SSI? (3)
    • pre-operative planning/ review risk factors
    • monitoring post-op (catch early)
    • e-collar (prevent licking)
  6. What are treatment options to treat skin infection?
    • empirical for gram +: cephalexin, clavamox (culture and sensitivity recommended)
    • +/- open wound management (open, debride, bandage, depending on extent)
  7. How can we avoid deep incisional SSI? (2)
    • re-op planning/ review risk factors
    • monitoring
  8. What are treatment options for body wall infections/ deep incisional SSI? (3)
    • antibiotic therapy: empirical or C&S
    • open incision if not already open (always!)
    • open wound management
  9. What are risk factors for dehiscence? (7)
    • technical/ surgeon error *****
    • patient factors (endocrinopathy, anemia, hypoproteinemia)
    • tension
    • infection
    • neoplasia
    • self-mutilation
    • post-op care (owner compliance)
  10. What technical errors can lead to SS dehiscence? (3)
    • improper suture placement- missed holding layer
    • suture- wrong type, too far apart, poor knot ties, poor tissue apposition, mishandling suture material
    • tension- tying suture too tightly, lose blood to wound edges
  11. What is the holding layer of the body wall?
    external rectus fascia
  12. What is the holding layer of the GI or bladder?
  13. Patient factors that may contribute to dehiscence of the GI tract or bladder post-op? (3)
    hypoproteinemia, infection, neoplasia
  14. What can lead to post-op septic peritonitis? (6)
    • dehiscence
    • contamination during sx
    • rupture or perf
    • ascending infection
    • migrating foreign objects
    • retained sponges
  15. How do septic peritonitis patients present? (5)
    • abdominal pain
    • distention
    • shock
    • vomiting
    • fever
  16. What are risk factors for post-op SS seroma? (4)
    • dead space
    • inflammation (foreign materials, irritants, trauma/ too much surgical manipulation)
    • high activity post-op
    • high motion area
  17. How do you avoid seroma formation? (6)
    • gentle tissue handling
    • minimize dead space/ place a drain
    • bandaging
    • minimize inflammation
    • post-operative care
    • surgical planning
  18. How do you treat a seroma? (5)
    warm compresses, bandaging, exercise restriction, E- collar, drain (only in refractory cases)
  19. What are risk factors for intra-op (4) and post-op (4) hemorrhage?
    • intro-op: technique, coag defects, specific procedures/ sx locations, specific diseases
    • post-op: technique, missed intra-op bleed, changes in BP, coag defects
  20. Scrotal hematoma and hemoabdomen are usually due to...
    ligature faillure
  21. How do you avoid hemorrhage? (4)
    hemostasis techniques, hemostatic agents, pre-op planning, careful patient assessment (coagulopathies, etc)
  22. What are treatment options for hematoma? (3)
    bandaging, supportive care, +/- sx
  23. What are risk factors for ileus? (7)
    • intestinal surgery
    • peritonitis
    • pancreatitis
    • hypokalemia
    • long intra-abdominal surgery
    • intestinal obstruction
    • drugs
  24. How does ileus present clinically? (5)
    inappetance, pain, vomiting, regurg, lack of gut sounds
  25. How can you treat ileus? (6)
    correct underlying problem, fluid therapy, NPO, prokinetics, discontinue medications, ambulation/ walks
  26. Risk factors for stricture? (2)
    ischemia, poor technique
  27. How do you avoid stricture? (4)
    • gentle tissue handling
    • suture selection
    • tissue approximation
    • proper closure techniques
  28. When do you do an abdominal exploratory for a suspect ovarian remnant?
    during estrus- easier to find
Card Set
IntroSx2- Complications
vetmed IntroSx2