(BQ) Part 2 book Lange Q & A surgical technology examination has contents: Wound healing and dressings, general surgery, plastic and reconstructive surgery, biomedical science (electricity, hemostasis, lasers, and computers), occupational hazards fire safety, endoscopy, minimally invasive surgery, and robotics,... and other contents.
www.downloadslide.net _ CHAPTER 17 _ Wound Healing and Dressings Factors that affect wound healing include: • Age • Obesity • Nutritional status • Smoking • Immunocompromised patients • Radiation exposure Complications of wound healing include: • Infection • Hemorrhage • Dehiscence—the wound separates after it has been closed • Evisceration—the contents of the abdomen protrude out from the wound • Dead space—separation of wound layers where air and/or blood accumulate and cause infection • Fistula—an abnormal tube-like passage from a normal cavity or tube to a free surface or to another cavity • Sinus tract—a tract that is open at one end only It runs between two epithelial-lined structures It causes infection and drainage • Suturing material and technique used Types of Wounds 319 www.downloadslide.net • Contusion—bruise • Laceration—tear or cut • Thermal—can be caused by heat, cold, or chemicals • Abrasion—scrape • Closed wound—skin remains intact Some damage to underlying tissue • Open wound—skin is cut/open • Clean wound—clean cut, skin edges can be approximated • Contaminated wound—open wound with bacteria and infection • Complicated wound—a foreign body may remain in the wound, the edges of the wound cannot be approximated because of tissue loss • Chronic wound—a wound that takes an extended period of time to heal Dressing is used to: • Immobilize • Apply even pressure over the wound • Collect drainage • Provide comfort for the patient • Protect the wound Biologic dressings • Integra • Dermagraft Integra • It is a bilayer matrix wound dressing made of bovine tendon and collagen matrix Dermagraft • It is manufactured from human fibroblast cells derived from newborn foreskin tissue Skin grafts • Autologous skin graft—taken from the patient’s own body • Homograft—taken from a cadaver donor • Xenograft/heterograft—a graft taken from another species • Porcine—pigs 320 www.downloadslide.net 321 www.downloadslide.net Pressure Dressing/Bolster Dressing/Tie-Over Dressing • This is a type of three-layer dressing • Commonly used in plastic surgery following skin grafts • It is applied tightly to: Immobilize an area Absorb excessive drainage Provide even pressure Eliminated dead space Reduces edema Reduces hematoma formation • Stent dressing—this is a type of pressure dressing The primary layer usually consists of Xeroform gauze The secondary layer is fluffs Tertiary layer consists of silk suture securing the dressing in place • Wet-to-dry dressing The dressing is soaked in saline, applied wet to the wound, and allowed to dry The dressing is then removed with a layer of the wound tissue • Wet-to-wet dressing Wet sponges are applied to the wound and removed before they dry This type of dressing also debrides the wound but with less pain than the wet to dry dressing • Thyroid collar/Queen Anne collar—a circumferential wrap is used to secure dressing • Ostomy bag—dressing applied over a stoma • Drain dressing—surgical dressing cut in the shape of a “Y” to wrap around a drain • Tracheostomy dressing—surgical dressing used to secure a tracheostomy • Eye pad—oval-shaped gauze pad used to cover the eye and keep the eyelid closed • Eye shield—rigid oval-shaped shield used to cover the eye pad and protect the eye from trauma • Perineal/Peri-Pad—this is a pad used to absorb vaginal and perineal drainage 322 www.downloadslide.net • Packing material—long strips of gauze used to: Provide hemostasis Pressure, eliminate dead space Support a wound Comes plain or impregnated with an antiseptic (iodoform) and a radiopaque mark Burns—can be caused by: • Heat • Chemicals • Electricity • Gases • Radiation Burns are classified by four degrees: • Burns are assessed by: The rule of nines—this is the method used to calculate the body surface area involved in burns using the value of “9” The head and neck = 9% The front of the body trunk = 9% The back of the body trunk = 9% Arms—4.5 right arm/4.5 left arm = 9% Legs—9 right leg/9 left leg = 18% 323 www.downloadslide.net Perineal area = 1% Lund and Browder—is a method used for estimating the extent of the burns to the body surface relating to different ages Commonly used for children 324 www.downloadslide.net Questions A surgical wound that is sutured together heals by: (A) granulation (B) primary intention (C) inflammatory means (D) second intention Which classification of wound healing is involved with perforated bowel? (A) Secondary intention (B) Primary intention (C) Third intention (D) Fourth intention Which wound is assigned to tissue healing by granulation? (A) Secondary intention (B) Third intention (C) Fourth intention (D) Inflammatory intention Which type of wound healing requires debridement and continuous irrigation? (A) Primary (B) Secondary (C) Third (D) Fourth What will be the correct order of wound healing process: (1) remodeling, (2) proliferation, and (3) inflammatory? (A) 1, 2, (B) 2, 3, (C) 3, 2, (D) 2, 1, Which of the following is associated with secondary intention wound healing? 325 www.downloadslide.net (A) Wound that is sutured together (B) Infected contaminated wound (C) Wound space that is packed (D) Wound that is not sutured During which phase of healing is a scab formed? (A) Inflammatory (B) Proliferation (C) Remodeling (D) Primary Conditions that affect wound healing include: (A) surgical technique (B) obesity (C) age (D) All of the above A sunburn is classified as a: (A) second-degree burn (B) first-degree burn (C) third-degree burn (D) Not classified 10 Which of the following burns cause destruction of the entire thickness of skin? (A) First degree (B) Second degree (C) Third degree (D) Fourth degree 11 Which burn classification is characterized by dry white skin and generally have little pain associated with this burn? (A) First degree (B) Second degree (C) Third degree (D) Fourth degree 12 Another name for a scar is: (A) fibrin (B) keloid 326 www.downloadslide.net (C) hydrocolloid (D) infection 13 Which nonadherent surgical dressing is used for a clean surgical wound and also care of specimens? (A) Sterile gauze (B) Telfa (C) ABD (D) Xeroform 14 What type of dressing is most often used on a skin graft? (A) Pressure (B) Stent (C) Flat (D) Both A and B 15 What type of pressure dressing is molded into a thick pad that fits into the graft area and is secure with sutures? (A) Supportive (B) Stent (C) Flat (D) Tegaderm 16 Gauze packing is used: (A) on a small incision (B) wrapping a limb (C) in nose or open wound (D) when compression is needed 17 A strong thin transparent liquid useful in sealing certain wound edges is: (A) Dermabond (B) tincture of benzoin (C) collodion (D) Both A and C 18 The main purpose of Webril is: (A) cast padding (B) under pneumatic tourniquet (C) pressure dressing (D) Both A and B 327 www.downloadslide.net 19 What type of gauze dressing is used on a circumcision? (A) Sponge (B) Tegaderm (C) Vaseline gauze (D) Roll gauze 20 What is the correct order of dressing a surgical wound? (1) Place dressings, (2) wash the incision, (3) cover sterile dressing with a towel, and (4) remove drapes (A) 1, 2, 3, (B) 2, 1, 3, (C) 3, 4, 1, (D) 3, 4, 2, 21 A circumferential bandage should be applied to an extremity: (A) distal to proximal (B) proximal to distal (C) anterior to lateral (D) medial to anterior 22 The classification of the wound without infection including a hernia, CABG or craniotomy is: (A) class I (B) clean wound (C) class II (D) Both A and B 23 Dead space is termed: (A) separation of wound layers (B) the contents of the abdomen protrude outside the incision (C) the separation of the wound after healing (D) space where an organ has been removed 24 A tract which is open at both ends that runs between two epithelial line structures: (A) fissure (B) dead space (C) fistula (D) Both A and C 25 A one-layered dressing include all EXCEPT: (A) a small wound with minimal drainage 328 www.downloadslide.net Menometrorrhagia, 240 Mentoplasty, 298, 304 Mersilene, 189, 193 Metabolic acidosis, 345, 347 Metacarp/o, 1, Methicillin-resistant S aureus (MRSA), 10, 14 Microbial death, 8, 13 Microtia, 296, 303 Microvasive evacuator, 161, 175 Midas Rex, 366 Midbrain, 364 Millin, 158, 174 Minimally invasive surgery (MIS), 340–341, 422, 428, 447 Miochol solution, 258, 264 Mitral stenosis, 343, 346 Modified Trendelenburg position, 106 Moist padding, 279 Monocytes, 41, 43 Monofilament suture, 185, 190 Monopolar coagulation, 371, 376 Morcellation, 448 Moustache dressing, 285 Muscle relaxants, 27, 35 Muslin wrappers, 47, 53 storage life for, 48, 53 thickness of, 48, 53 Myasthenia gravis, 328, 331, 336 Mydriatics, 263, 264 Myelogram, 157, 173 Myelography, 129, 132, 133, 134, 366, 373, 377 Myelomeningocele, 368, 378 Myocardium, heart, 339, 344, 347 Myringotomy, 285 N Naloxone, 23, 33 Nasal polyps, removal of, 277 Nasal setup, 156, 172 745 www.downloadslide.net Natural disasters, 436, 438 Neck (radical) procedure, 147, 151 Needle holder, 154 Needles, 180 Needles counting, 110 Negligence, 124, 127 Nervous system, 363 Neurology instruments, 366 Neurolysis, 370, 376 Neuroma, 371, 376 Neurosurgical sponges, 371, 377 “Neutral zone” technique, 179 Neutrophils, 41, 43 Nitrous oxide, 31 No hands technique, 436, 438 Nonsterile equipment, preparing, 81, 88 Nuchal cord, 242 Nucleons, 424, 429 Nurse, circulating, 109, 111, 113 Nylon, 47, 53 O Obesity, 199 Occluding peripheral vessels, 357, 360 Occupational Safety and Health Administration (OSHA), 301, 305 Off-pump coronary artery bypass (OPCAB), 341 Olecranon fracture, 390, 399 Omni-Tract, 158, 174 Oophorectomy, 2, 3, 241 Open-glove technique, 54 Open thoracotomy, 331, 335 Operating room attire, 81 room temperature in, 80, 88 table, 98, 105 Operative paperwork, 125 Orchiopexy, 317, 323, 409, 414 Orthopedic fracture table, 102, 106 746 www.downloadslide.net Orthopedic implants, 393, 400 Orthopedic saws, 393, 401 Orthopedic surgery, 391, 399 Oste/o, 1, Osteogenesis, 390, 398 Otitis media, 409, 413 Otorhinolaryngologist, 374, 378 Ovarian cystectomy, 2, Oxygen-dependent bacteria, 8, 13 Oxytocics, 245, 251 P Pacemaker, 339, 343, 347 Package wrappers opening, 48, 53 safety margin on, 48, 53 Palmar fascia, 296, 303 Pandemic, 12, 15 Panniculectomy, 298, 304 Panoramic views, x-ray, 133, 134 Papanicolaou, 245, 251 Papaverine, 341 Papaverine hydrochloride, 343, 346, 350, 356, 360 Parotidectomy, 279, 287 Parotid glands, 286 Patent ductus arteriosus, 2, 3, 341 Patient positioning aging patient, 101, 106 for anesthetized, 99, 106 changes in, 101, 107 crossing arms across chest, 99 for C-section, 106 on fracture table, 101, 106 history and physical, 133, 134 for laminectomy, 100, 106 lateral, 99 lithotomy, 99, 102 for open bladder surgery, 100, 106 747 www.downloadslide.net patient safety and surgical site exposure, 101, 107 prone, 100, 106 pudendal nerves injury, 101, 106 risk, 102, 107 supine, 99, 101, 105, 106, 107 for thyroid surgery, 100 unconscious/immobile patient, 102 using armboard, 99, 105 Patient transportation with fractured femur, 98 from OR table, 98, 105 roller for, 98, 105 safety strap, 105 from transport stretcher to OR table, 98 PCO2 levels, in blood, 40 Peanut sponges, 109 Pectus deformities, 328 Pectus excavatum, 333, 337 Pedal pulses, 354, 359 Pedicle clamp, 154, 171 Pedicle flap, 299, 304 Peel pouches, 72 PEG tube, 411, 415 Pelviscopy, 246, 252 Penfield dissector, 374, 378 Penile condylomata, 316, 322 Peracetic acid, 66, 71 Percutaneous transluminal angioplasty (PTA), 356, 360 Pereyra needle, 315, 322 Pereyra procedure, 317, 323 Pereyra/Stamey, 174 Perfusion, 342, 346 Pericardial effusion, 339, 344, 347 Pericarditis, 339 Pericardium, 339, 344, 347 Peripheral nervous system (PNS), 363 Peripheral vascular surgery, 349 748 www.downloadslide.net Permanent specimens, 117, 119 Personal protective equipment (PPE), 67 Phacoemulsifier, 257, 263 Phantom pain, 353 Pharmacokinetics, 27, 35 Photons, 424, 429 Photo receptive layer, 259 Pia mater, 364, 372, 377 PID—pelvic inflammatory disease, 240 Pig tissue, 297, 304 Pilocarpine, 257, 263 Pinna, 300, 305 Pituitary gland, 375, 379 Pituitary instrument, 167, 176 Pituitary rongeur, 371, 377 Pixels, 452 Placenta previa, 2, Plaster, 391, 399 Platelets, 39, 42, 43 Pledgets, 350 Plethysmography, 131, 133, 134 Pleur-evac/closed water seal drainage system, 327–328 Pneumatic tourniquet, 394, 401 Pneumonectomy, 2, 4, 328, 333, 336 Pneumoperitoneum, 2, Pneumothorax, 2, 4, 328 Poly-, 2, Polyglactin 910, 186, 191 Polymethylmethacrylate (PMMA), 393, 401 Polypropylene, 47, 53 Pons, 364 Pontocaine, 263 Poole’s suction tip, 153, 171 Portable x-ray machine, 129 Portal circulation, decompression of, 342, 346 Positron emission tomography (PET), 130 Potts-Smith scissors, 174 Potts-Smith scissor, 357, 360 749 www.downloadslide.net Pour solution, 48 Povidoneûiodine, 145, 150 Power, 422, 428 Prep solutions, 147, 151 Pressure ulcers, 299, 305 Prolene, 190 Prostate, 315, 322 Protamine sulfate, 341, 350, 354, 355, 359, 360 Protective eyewear, protocol for, 81 Prothrombin time (PT), 40 Protruding ears, 412, 415 Proximal interphalangeal (PIP) joint, 395, 401 Proxim/o, 1, Pulmonary angiography, 130 Pulmonary function tests (PFTs), 329, 331, 333, 336 Pulmonary valve, 344, 347 Pulse oximeter, 42, 44 Purse string suture, 183, 190 Putti–Platt, 394, 401 Q Quality Assurance (QA) programs, 124, 127 R Radiation, 435, 438 Radiation exposure, 435, 438 Radical mastectomy, modified, 1, Radiofrequency sponges, 109 Radiographic diagnostic test, 319, 324 Radiography/roentgenography, 129 Radionuclide scan, 130 Radiopaque × sponges, 112, 114 Radio waves, 421 Randall stone forceps, 157, 172, 173, 176 Raney clips, 370, 376 Rapid infusion pump, 42, 44 Raytec sponge and, 117, 119 Rectal surgery prep, 147 750 www.downloadslide.net Rectocele, 2, 3, 240 Rectovaginal fistula, 240 Red blood cell count, 39 Red blood cells (RBCs), 42, 43 Red Robinson catheter, 166 Res ipsa loquitur, 110 Respondeat Superior, 124, 127 Retention sutures, 185, 186, 190 Retina, 264 Retin/o, 1, Retrobulbar anesthesia, 264 Reverse sterilization procedure, 318, 323 Reverse Trendelenburg, 101, 107, 447, 452 Rhinoplasty, 300, 305 Rhizotomy, 368, 375, 379 Rh negative, 41, 43 Rh positive, 41, 43 Ribbon retractor, malleable, 355, 359 Ribs, 327, 334, 337 Richardson retractor, 153, 171 Richter scale measurement, 437, 439 Rickettsia, 11, 14 Rigid endoscope, 447, 452 Rod-like–shaped bacteria, 9, 13, 14 Rongeur, 154, 167, 171–172, 176 Rotator cuff tear, 396, 402 Rubber tubing, 63, 70 Rummel tourniquet, 350, 358, 361 S Sagittal suture, 363 Salpingectomy, 2, 3, 240 Salpingo-oophorectomy, 241 Saphenous vein in situ, 352 Sarot bronchus clamp, 157, 176 Sauerbruch, 155, 172, 176 Scalene, biopsy of, 331, 335 Scalene nodes/supraclavicular nodes, 328 751 www.downloadslide.net Scalpel blades, 55 Scatter radiation effects, 80 Scleral buckling, 263 Sclerotherapy, 351, 358, 361 Scoliosis, 369, 374, 378 Scoville nerve root retractor, 176 Scoville retractor, 155, 172 Scrub nurse, 296, 303 Scrub tech, 109, 111, 113 Scrub technique, 49 Sealing vessels, 423, 428 Seamless tubular cotton, 389, 398 Sedative/tranquilizer, 25, 34 Segmental resection, 328, 333, 336 Seizure, 248, 254 Sellica turcica, 375, 379 Sentinel lymph node biopsy, 1, Septic shock, 411, 415 Severe vertigo, 276 Sexual impotence, 316, 322 Shave prep, 145 Shock, 358, 361 Shock-this condition, 350 Silk, for closure of dura, 374, 378 Silk suture, 186, 191 Single-lung transplant, 331, 335 Sinoatrial node, of heart, 339 Skeletal traction, 157, 158, 159, 173, 174 Skene’s glands/periurethral glands, 239 Skin, oil glands of, 397, 403 Skin cancer, 298, 304 Skin closure methods, 181 Skin gun, 184 Skin stapler, 188, 192 Skull, 363 Slow exhaust, and solutions, 65, 71 Sodium bicarbonate, 345, 347 Sodium hyaluronate, 263 752 www.downloadslide.net Sodium hypochlorite, 132, 134 Soiled instruments, scrubbing, 153 Soiled sponges, 111, 113 Solu-Medrol, 24, 33 Somatic nervous system, 363 Sources of latex, 436, 438 Specimens, 115 bullet, 117, 119 damage/loss of, 116, 117, 119 femoral implant, 117, 119 frozen, 117, 119 frozen section, 116, 119 gram-negative, 120 gram-positive, 117, 120 permanent, 117, 119 Raytec sponge and, 117, 119 removal, 116, 119 stones, 116, 117, 118, 119, 120 Spina bifida, 365, 368, 373, 378 Spinal nerves, 367–368 Spinal tap, 131, 133, 134 Spine lateral curvature of, 390, 398 Spirometer, 329, 333, 336 Splenectomy, 156, 171 Sponges, 109 consideration for, 110 counting, 112, 114 Raytec, 117, 119 soiled, 111, 113 Squamous suture, 363 Staghorn stone, 315, 322 Stainless steel suture, 371, 376 Stamey endoscopic procedure, 246, 252 Standard precautions, 35, 40, 50, 54 Stapedectomy, 156 Staphylococcus aureus, 8, 13 Stapling devices, 183 753 www.downloadslide.net Statinsky vena cava clamp, 176 Stealth craniotomy, 367 Steam sterilizer, 63, 70 Steffee plate, 159, 174 Stellate fracture, 395, 402 Stent dressing, 153, 164, 200, 202 Stereotactics, 367, 372, 375, 377, 379 Sterile gowns, 50, 54 Sterile item, flipping, 48, 53 Sterile personnel, 50, 55 Sterile saline, 331, 335 Sterile supplies, 50 Sterile tables, 47, 53 Sterility, 145, 244, 250 Steroids, 24, 33 Stille shears, 157, 173 Stockinette, 146, 150 Stones specimens, 116, 117, 118, 119, 120 Streptokinase, 341, 343, 346 Stripping and ligation, 353 Subarachnoid space, 364 Subdural hematoma, 365, 370, 376 Subdural space, 364 Subluxation, 396, 402 Suction irrigator, 177 tubing, 145, 150 Super/o, 1, Suprapubic catheter, 241 Surgical case, 80 hand scrub, 49, 54 technique, 199 Sutures, 350, 363, 366–367 absorbable, 184 boots, 350 classification of, 179 coding, 180 754 www.downloadslide.net gauges, 350, 358, 361 memory, 185, 190 monofilament, 184 needle, 184 purse string, 184 techniques, 186, 187 types of, 179 Swagged, 185, 190 Sympathectomy, 371, 376 Sympathetic system, 373, 378 Synarthrotic joints, 363, 374, 378 Syndactyly, 296, 303 Synergist agent, 31 Synovial membrane, 395, 402 Systole, 343, 347 Systolic blood pressure, 350 T Tachycardia, 339 Talc, 331, 335 Tattoo removal, 300, 305 Telescope handling, guidelines, 448 Telfa, 200, 202 Temporal mandibular joint (TMJ), 279 Tenckhoff catheter, 351, 358, 361 Tend/o, 1, Tensile, 190 Terminal sterilization, 67, 72 Testes, 316, 322 Tetracaine, 263 Tetralogy of Fallot, 2, 3, 341 Thalamus, 364 Thoracentesis, 115, 117, 119, 131, 133, 134, 329, 333, 336 Thoracic outlet syndrome, 102, 107, 329, 330, 335, 355, 359, 369 Thoracocentesis, 2, Thoracoscopy, 328 Thoracotomy, 328 instruments, 327 755 www.downloadslide.net lap pads/towels and, 332, 336 Thorocoabdominal staple gun, 177 Three-way Foley catheter, 175 Thrombin, 350 Thromboembolic disease, 349 Thrombus, 2, 3, 349 Thymectomy, 328, 331, 336 Thymus gland, 328, 333, 337 Thyroidectomy, 279 Thyroplasty, 279, 287 Tidal volume test, 329, 331, 336 Time method, 49, 54 Tissue expanders, 156 Tissue plasminogen activator, 341, 343, 346 Tonsil sponges, 109 Toomey syringe, 175 Topical thrombin, 370, 372, 376, 377 Total laryngectomy, 278, 286 Trachelorrhaphy, 240 Tracheostomy, 277, 286 TRAM flap, 299, 305 Transsphenoidal hypophysectomy, 367, 372, 377 Transurethral resection of the prostate (TURP), 315, 322 Triclosan, 146, 151 Trigeminal nerve, decompression of, 367 Trigone, 320, 325 Trocar, 154, 171, 447, 452 T-tube, 164, 172, 175 Tubal ligation, 240 Tuffier retractor, 334, 337 Tunica vaginalis, 317, 323 Tympanoplasty, 276, 285 Type AB blood, 39, 41, 43 Type O blood, 42, 44 U Ulnar nerve damage, 99, 106 Ulnar nerve transposition, 367 756 www.downloadslide.net Ulnar neuropathy, 102 Ultrasonic aspirator, 366 Ultrasonic cleaner, 63, 70 Ultrasound, 130, 132, 134 Undermining, 154 Universal blood donor, 39, 41, 42, 43, 44 Universal plasma donor, 41, 43 Universal precautions, 54 Urethral catheters, 319, 324 Urethral meatal stenosis, 317, 323 Urethral meatus, 320, 325 Urethral strictures, 315, 322 Urethrovaginal fistula, 240 Urinary bladder, 320, 325 Uterine ablation, 240 Uterine cavity, 247, 253 Uterine tube, 239 V Vaginal hysterectomy, 240 Vaginoplasty, 248, 254 Vagotomy, 156, 172 Vagus nerve, 332, 336 Van Buren dilators, 160, 174 Varicosity, 349 Vascular anastomosis, 351 Vascular grafts, 350, 355, 359 Vascular setup, 164, 175 Vascular surgery, 349 Vaseline gauze, 202 Vasoconstrictor, 30 Veins, 349 Vein stripping/ligation, 351 Vena cava filter, placement of, 351 Venous circulation, avoiding, 98, 105 Ventricles, 364 Ventricular aneurysm, 340 Ventricular arrhythmia, 31, 339 757 www.downloadslide.net Ventricular assist devices (VADs), 341, 343, 346 Ventricular fibrillation, 339, 342, 346 Ventricular septal defect, 341 Ventriculoatrial (VA) shunts, 365, 372, 377 Ventriculography, 130, 132, 134 Ventriculoperitoneal (VP) shunts, 365, 371, 372, 373, 377, 378 Ventriculoscopy, 365 Venus catheter, 351 Vertebral disk, 368 Vesicovaginal fistula, 240, 321, 325 Vessel loops, 350 Vessels, 327 Vestibular schwannomas, 364, 373, 378 Video-assisted thoracic surgery (VATS) procedure, 328 Video cables, 448, 452 Vitreous humor, 258 Vulvectomy procedures, 240 W Warfarin, 341 Web research, 426, 430 Webril, 200, 202 Webster needle holder, 155, 172 Wedge resection, 328 Weitlaner, 155, 172 Weitlaner retractor, 356, 360 Westcott scissors, 154, 171 White blood cell count, 39, 41, 42, 43 in adult male, 41, 43 White blood cells, 41, 43 types of, 41, 43 White balancing, 448 White blood count differential, 39 Wide cuff, 146, 151 Wilms tumor, 409, 413 Wire localization, 1, 3, 155, 172 Woodson dissector, 374, 378 Wound, 301, 306 758 www.downloadslide.net complications, 302, 306 edges, 10 zipper, 181 Wound healing, 199, 301, 306 factors in, 202 order of, 199, 202 second intention of, 199 third intention of, 202 Wrapped basin sets sterilization, 64, 70 Wrapping materials, 67 Wydase, 258, 264 X Xylocaine, 29, 341, 344, 347 Y Yasargil, 373, 378 Y-shaped/trifurcate incision, 286 Z Zofran, 28, 35 Z-plasty procedure, 297, 411, 415 759 ... • LAPAROTOMY a surgical opening into the peritoneal cavity • LAYERS OF THE ABDOMINAL WALL: Skin Sub -q Fascia External oblique Internal oblique Transverse abdominis Fascia Peritoneum • LAPAROSCOPY... (D) 3, 4, 2, 21 A circumferential bandage should be applied to an extremity: (A) distal to proximal (B) proximal to distal (C) anterior to lateral (D) medial to anterior 22 The classification of... fistula (D) Both A and C 25 A one-layered dressing include all EXCEPT: (A) a small wound with minimal drainage 328 www.downloadslide.net (B) Opsite (C) Tegaderm (D) ABD 26 Another name for a scrape