Methodical pointing to work of students on practical employment

Semantic module 4.

Traumatism and damage

Practical employment № 14

Theme: wounds and ranoviy process. Prophylaxis of development of infection in a wound. Medical treatment of clean wounds

Theoretical questions for the pozaaouditornogo independent study and discussion to practical employment № 14:

1.Особливості surgical structure of wounds, that matters for motion, diagnostics and their medical treatment .

2.Класифікація wounds.

3.Клінічні symptoms of wounds.

4.Діагностичні features of separate types of wounds.

5.Сучасні phases of ranovogo process and their diagnostic value;

6.Метод anaesthetizing and method of conducting of primary surgical treatment at patients with clean wounds

7.Методика conducting of bandaging of clean wound.

8.Догляд after drainpipes.

9.Методика removal of stitches from a clean wound.

Literature:

Basic:

1. Methodical developments for audience and independent work of students.

2. General surgery / After red. S.P.Gouchenco, M.D.Gelibi, S.D.Himicha – Kiev.: Health, 1999.

3. Cherenco M.P., Vavric G.M. General surgery with anesteziologieyo, by the bases of reanimatologii and care of patients – Kiev.: Health, 1999.

4. Gostishev V.C. Obshaya hirourgiya: Oucheb. – M.: Medicine, 1993.

5. Gostishev V.C. "Roucovodstvo c practichescim zanyatiyam on obshey hirourgii"., "Medicine" - 1987.

Additional:

1. A.A. Simodeyco, S.S. Filip, O.O. Boldigar General surgery in questions and answers. Ouggorod, «Iva» - 2005.

2. S.M. Genic, M.V. Procopishin, V.M. Crisa and in. Situation tasks from surgery. Ivano-Francovsk, «Lileya-N.В» – 2003.

Distributing of marks, that are appropriated to the students:

At mastering of theme № 14 from rich in content to the module № 4 for educational activity to the student the estimation for 4th is proposed by a mark (traditional) scale which are after converted in marks as follows:

Estimation	Marks
“5”(fine)	6 marks
“4” (well)	4 marks
“3”(satisfactorily)	2 marks
“2” (unsatisfactorily)	0 marks

Tests and tasks for verification of initial level of knowledges

For a fresh wound characteristically all, except for:

limforei

pain

bleeding

posmicouvannya of muscles

gaping

The degree of expressed of pain in a wound determines all, except for:

quantities of nervous elements in the area of damage

the nervovo-psihichnogo state of sick

speeds of wound

the state of immunity of sick

sizes of damaging object

sharpness of damaging object

What the linked degree of gaping of wound is with:

by the depth of damage

by localization of wound

by the damage of nervous trunks

by the damage of fastsiy

by the damage of muscles and tendons

by direction of elastic fibres of skin

Microorganisms at primary inficouvanni get in a wound with:

to pincers at bandaging, at surgical treatment

scalpel

hands of surgeon

skins of poranenogo

surgical filaments

clothes of injured

What wounds heal over quick than other:

rizana

chopped

it is bitten

it is hammered

scratch

rozmigchena

To development of infection a lot of factors assist in a wound, except for:

haematomas

damage of nerves

crovovtrati

shock

exhaustion

absence of foreign bodies

In a vognepalniy wound all areas of damage are distinguished, except for:

areas of ranovogo channel

areas of molecular concussion

areas of hemorrhage

areas of primary necrosis

areas of parabiozou

areas of cellular concussion

For the oscolchastih wounds of wounds characteristically all, except for:

difficult anatomic damages

presence of foreign bodies

high degree of inficovanosti

even ranovogo channel

obligatory presence of the entrance and initial opening

unequal damages of skin

For the local signs of inflammation characteristically all, except for:

edema

cyanosys

rise of temperature

violation of sensitiveness of skin

violation of function

pain

What wounds more reliable development of infection is in?

rizana

it is bitten

chopped

vognepalna

it is placed on a face

it is scalped

It is needed to understand under primary surgical treatment of wound:

carving of edges and bottom of wound

opening of pockets

deleting of festering maintenance

carving of edges, walls and bottom of wound

washing of wound by antisepticom, gemostaz

stop of bleeding

There is a wound with the limited area of necrosis of edge of skin. What needs to be executed?

to conduct the urgent prophylaxis of stupor

to appoint OUVCh to the wound

to impose a bandage with hypertensive solution

to impose a bandage with ointment Vishnevscogo

drenouvati wound

to carve the dead area of skin

For And phases of ranovogo protsessou in a clean wound characteristically all, except for:

development of atsidozou

increase of quantity of ions of hydrogen

increase of ions of calcium

increase of quantity of ions to potassium

increase of permeability of vessels

development of alcalozou

There are different types of cicatrization of wound, except for:

primary

detained

under a scab

repeated

second

deferred

What signs characteristic for a colotoi wound

small gaping

deep ranoviy channel

concussion of surrounding fabrics

the second necrosis

zabiy of fabrics

necrosis of fabrics

Situation tasks.

A patient entered permanent establishment concerning the for a slaughter wound of frontal area which he got 5 hours backwards. How to treat a wound?

At a patient the wound of front abdominal wall which is located in a right zdouhvinniy area is determined. At a review: a skin is pale, AT 100/60 mm rt.st., pulse 124 in 1 hv . It is exposed at implementation of primary surgical treatment of wound, that she gets to the abdominal region.

Diagnose. What surgical tactic?

A patient acted concerning the for a slaughter wound of the left forearm, which he got 12 hours backwards. Wound not clean. A patient needs to be transported on large distance. Edges of wound of giperemovani, has not the slight swelling of edges of wound. Whether the shown primary surgical treatment of wound and what its features?

A patient with two sword-cuts on palm's surface of the left brush acted in the surgical separation, which he got 3 hours backwards. What features of primary surgical treatment of such wounds?

In the surgical cabinet of district policlinic a patient which 3 hours was backwards bitten by an unknown dog is delivered. At a review: on a right shin six bitten-lacerated wounds filled by blood clots are exposed, with the easy edema and bolyochistyo round. What volume of help is needed to give to the patient?

Asked you to give first help to the man which half a hour therefore fell down with to the bicycle. On the external surface of right shin there is the large hammered-lacerated wound muddy by sand and dry grass. In Your arsenal there is a motor-car medicine chest. What volume of help you will you give to the victim?

In a hospital a patient with a sword-cut is delivered by sizes 2,5х0,4 sm in overhead third of right forearm, which inflicted unknown him 2 hours backwards. What volume of surgical help is needed to give to the patient?

A patient with the lacerated wound of the left thigh acted in the surgical separation. 12 Hours passed from the moment of wound. At a review the easy edema of fabrics round a wound is marked, the edges of wound are unequal, sinyoshni. What medical tactic you will you choose?

In a travmatologichniy point a patient with the cosopoperechnoyo inficovanoyo sword-cut of palm's surface of right brush is delivered. Active bend motions in the migfalangovih joints of the II-IV fingers are absent. About the damage of what anatomic educations it is needed to think? What Your medical tactic?

A patient with the blind coloto-rizanoyo wound of the left shoulder came in the induction centre. Got the wound 4 days ago. In the area of wound the slight swelling is determined, bolyochist. From a wound серозно-festering maintenance in a two-bit is selected. The surgeon of induction centre executed the high-quality rest room of wound, tightly tamponouvav by its tampon, moistening him by hypertensive solution of chloride of sodium, imposed a bandage. To the patient the executed urgent specific prophylaxis of stupor. What error was assumed by a surgeon?

In a travmatologichniy point a patient with the large scalped wound of hairy part of head is delivered. A trauma happened 1,5-2 hours backwards. He the stupor sick prishepleniy. What volume of skilled help is needed to give to the patient?

In a district hospital there is the delivered boy which half a hour was therefore bitten by a snake. A child grumbles about pain in a right foot. A boy is put on the brakes, sleepy. On the rear of foot two little wounds with a hemorrhage in their area and expressed edema are found. Your actions?

In the medical card of sick P., 43 years, hospitalized in surgical permanent establishment, a duty surgeon did a record about conducting of primary surgical treatment of wound. What volume of help was executed by a surgeon?

In the surgical separation it is delivered the victim F., 40 years, which got the vognepalne wound of thigh 14 hours backwards. What maximally possible terms of primary surgical treatment of wound from the moment of wound?

In a policlinic a boy, 9 years, is delivered, with the wound of right shoulder. According to the victim, he was struck to the edges of ink-pencil by a comrade on a school desk. At a review on the lateral surface of shoulder there is a point wound with the slight swelling round. Next to her under a skin stor is determined