principles of surgery

• I. ASEPTIQUE TECHNIQUE

  a set of practice/procedures that re performed to maintain asepsis
• II. PROPHYLACTIC ANTIBIOTICS

  -prevention of infection complications using antibacteria therapy

  -also called PREOPERATIVE ANTIBIOTICS
• III. INCISION

  -cutting of or into a body tissue/organ by a surgeon during surgical operation

  -clean cut through tissues by a sharp instrument to facilitate procedure
• IV. FLAP DESIGN


  -Procedure/ guidelines/technique in proper execution and construction of flap design
• V. TISSUE HANDLING

  -Careful handling of tissue for optimal healing
• VI. HEMOSTASIS

  -Maintains blood fluid

  -Complex process which changes blood from a liquid state to solid state

  -important for preserving a patients oxygen carrying capacity
• VII. DECONTAMINATION AND DEBRIDEMENT

  -Combination of wound irrigation and careful removal of injured tissues that would impelled wound healing
• VIII. EDEMA CONTROL

  -Procedure that are implemented to decrease swelling and address the symptoms associated with swelling.
• IX. SUTURING

  -Approximation of surgical flaps or wound edges to facilitate proper healing using sutures

  -Act of bringing tissue together
• X. PATIENTS GENERAL HEALTH AND NUTRITION

  -Essential for optimal healing
• All living organisms require energy for maintenance of vital functions of the body
• Energy is required for cardiac muscle contraction, conduction of nerve impulses, and various active transport mechanisms involved in different absorptive and secretory processes
• Synthetic reactions involved in growth and development are also energy dependent
• The energy is provided by the oxidation of food stuffs like carbohydrates, fats and proteins
• Basal metabolic rate


  The energy requirement for metabolic processes in the body occurring even at rest, e.g. cardiac contraction, conduction of nerve impulse, hepatic metabolism, active transport mechanism in the body
• Physical work


  May vary from simple standing or even sitting to heavy manual labor, e.g. carrying load upstairs
• Total caloric requirement


  Calculated by adding the basal metabolic requirements to the energy required for the nature of his profession and other recreational/household activities
• According to ICMR (Indian Council of Medical Research), an average sedentary male requires 2400 kilocalories per day. A sedentary female requires 80 percent of this value
• Components of a balanced diet

  • Carbohydrates
  • Fats
  • Proteins
  • Vitamins
  • Minerals
  • Water

  
• Carbohydrates


  Constitute the cheapest dietary source of energy, fulfilling over 50 percent of the total caloric requirement
• A minimum intake of 50 to 100 g of carbohydrates per day is essential to prevent the development of ketosis and loss of muscle protein
• Ingestion of sucrose in large quantities

  Harmful in a variety of ways
• Dietary fiber


  All the plant cell wall components consisting mainly of nonstarch polysaccharides, which cannot be digested in the human gastrointestinal tract
• Dietary fiber


  • Slows down gastric emptying, retains water making feces larger in bulk and softer, has cholesterol lowering action, associated with reduced incidence of diabetes mellitus, coronary artery disease, cancer of colon, diverticulosis of colon, and gallstones
• Fats


  The most compact form of food, yielding 9 kcal per gram compared to 4.5 kcal for carbohydrates and proteins

  
• Animal fat


  • Source of essential fatty acids like linoleic acid, linolenic acid and arachidonic acid, but promotes increase in plasma cholesterol level leading to increased risk of atherosclerosis and associated disorders

  
• Vegetable oils


  • Cholesterol free and contain a large percentage of polyunsaturated fatty acids, which have a plasma cholesterol lowering action

  
• Recommended fat intake is about 20g animal fat per day for an adult
• Proteins


  Indispensable constituents of diet, required for growth, maintenance, and repair of tissues
• Animal proteins


  • Have amino acid composition almost similar to that of human tissues, hence can be economically used in the body (high biological value)
• Vegetable proteins


  • Deficient in one or more of the essential amino acids, hence cannot be used economically in the body (low biological value)
• Recommended protein intake is at least 1 g/kg body weight/day for mixed vegetable proteins, or 0.6 g/kg body weight/day for animal proteins

  
• Calcium


  99% present in the skeleton, maintains plasma calcium level within a narrow normal range, involved in neuromuscular excitability, myocardial function, and numerous intracellular biochemical reactions
• Recommended calcium intake is 400 mg/day, increased to 1 g/day in pregnancy and lactation
• Iron


  Important component of hemoglobin, myoglobin, and enzymes involved in cellular oxidative reactions
• Recommended iron intake is 28 mg for men, 30 mg for nonpregnant adult women, and 38 mg for pregnant women
• Iodine


  Essential component of thyroxin, regulating basal metabolic rate
• Recommended iodine intake is about 150 μg/day

  
• Vitamins


  Organic compounds needed in minute amounts but essential for normal health, classified as water-soluble and fat-soluble

  
• Fat-soluble vitamins


  Absorbed along with fats in the diet and stored in the body's fatty tissue and liver