HTHSCI 2F03 Lecture Notes - Lecture 9: Orthopedic Surgery, Urinary Retention, Smoking Cessation
26 Dec 2020
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Document Summary
Commonly employed in colorectal and orthopaedic surgery. Minimise adverse physiological / immunological responses to surgery. Cortisol and insulin (absolute or relative) Speeded of recovery and return to function. Recognise abnormal recovery and allow early intervention. Admission on day of surgery, avoidance of prolonged fast. Carb loading prior to surgery: e. g. carb drinks. Fully informed pt. , encouraged to participate in recovery. Early resumption of oral intake (inc. carb drinks) Bleeding at the end of surgery or early post-op. Void to running taps or in hot bath. If failed, may be sent home c silicone catheter and urology outpt. f/up. Mucus plugging + absorption of distal air collapse. Anaesthetics mucus production mucociliary clearance. Clean: incise uninfected skin w/o opening viscus. Clean/cont: intra-op breach of viscus (not colon) Contaminated: breach of viscus + spillage or opening of colon. Dirty: site already contaminated faeces, pus, trauma. Comorbs: e. g. bm, uraemia, chronic cough, ca. Iap: e. g. prolonged ileus distension.
