Post. Op. Ex.
Session2
3
د.عماد
1-Introduction:-greeting the pt,self introduction ,permission.
-hand washing
-asking the the pt if he has pain.
2-general look.:- :concious,well,comfortable,and so on
-color changes;paller,jundice,cyanosis,
-any abnormal discoloration
3-hand:1-signs of ischemia a-capillary refilling
b-color(pale)
c-temp.(any pair please compare)
2-sweating-may be d/t fever(complication of op.) & hypotentive
3-canula :type according to color & flow rate
4-sign of thrombophlobitis :-
نشيل الضماد فوق الكانيوال
-tender
-fever
-cord-like(late stage)
4-leg :a-sign of ischemia
b-temp.( DVT) ((DVT signs)) are:-.Increase temperature
-Increase circumferance
-Edema
c-hair distribution
d-circumference of leg:-how to measure it
‘
’from any bony promenance_measure 10cm then measure the circumference*if
you Compaired the Circumferance wih other leg if more it is edema
((is definitive oedema))
e-pulse:-start distally if U don’t feel,go to next proximal one
4-EX. Of the back(to complete the post. Op.)
To check about :bed sore((particularly in obese comatose pt)
Post. Op. Ex.
Session2
3
Abdominal Ex. In post.op
1-inspection: a-dressing ;dry or wet(stool-bile-
Color(according to duration-pinkish in 1
st
wk ---------------
Shall I open the dressing or not ?(ask the examiner) ( it’s forbidden to open in
1
st
48 hour ? Why?
A/Open after 48 due to complete epithelization of wound so can check infection ,scar.
if U opened the dress
B-talk about scar---Colour of scar: New (pink)&Old(white)
C-type of icision-
A-median or medline
B-paramedian incision(upper&lower)
C-transverse-suprapubic(pfensteil incion)
Used for c/s &bladder and prostate surgery
D-grid iron incion
Done at MC berrney point(lateral one thid
&midial one
third junction in line drawn from
AIS-umilcus) for appedectomy
E-transverse supraumbilical&infra-umbilical incision
F-marcedes bens(liver tranplantation)
G-kocher(cholecystectomy)(Lt&Rt)
,suture--------
stich----------type of matrial of it
D-sign of infection:-dischrge
-redness
-Bulging
-Pus
Post. Op. Ex.
Session2
3
Kloid& hypertrophy difference?
- Keloid exagurated edge of scar
-Hypertrophy:Only elevated scar
Cannula sizes
Complication of op.
1-Days 0 to 2:
1
-
Days 0 to 2D
1-
Days 0 to 2
1-Mild fever (T <38 °C) (Common)
-Atelectasis of microalveoli : the collapsed lung may
-become secondarily infected
-Tissue damage and necrosis at operation site
-Haematoma
2-Persistent fever (T >38 °C)
-Specific infections related to the surgery,
e.g. Biliary infection post biliary surgery,
UTI post-urological surgery
-Blood transfusion or drug reaction
Post. Op. Ex.
Session2
3
2-Days 3-5:
-superficial and deep wound infection
-Bronchopneumonia
-Sepsis
-Drip site infection or phlebitis
-Abscess formation, e.g. subphrenic or pelvic, depending on
the surgery involved
-DVT
3-Day 5: chest infection including viral respiratory tract infection, urinary tract infection and
thrombophlebitis.
4-After 5 days:-Specific complications related to surgery, e.g. Bowel anastomosis breakdown, fistula
formation, wound infection,
, -intracavitary collections and abscesses;
-infected intravenous cannula sites, DVTs,
-transfusion reactions, wound haematomas, atelectasis and drug reactions,which may
also cause pyrexia of noninfective origin. Patients with persistent pyrexia need a
thorough review.
5-After the first week
Wound infection
Distant sites of infection, e.g. UTI
DVT, pulmonary embolus (PE)
Done By: H.A.Abdulkarim