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Additional info for MCQs and EMQs in Surgery: A Bailey & Love Companion Guide
C. difficile is the cause of the HAI, pseudomembranous enterocolitis. indb 32 20/12/14 3:35 AM 5: Surgical infection several antibiotics sequentially, and the elderly and immunocompromised are particularly vulnerable. Staphylococcus epidermidis (S. albus) is a coagulase-negative staphylococcus that is an important cause of HAI and a major threat in operations where prostheses are used (vascular and orthopaedic surgery). ➜➜ Principles of antimicrobial treatment 6. A A broad-spectrum antibiotic should not be used to treat an infection when the sensitivities are known.
A, B, D, E Skin incisions are best made along Langers’ lines (tension lines), which represent the direction of dermal collagen fibres. Therefore, incisions made parallel to these lines result in a good scar, the surgeon’s signature, which is the only part of the operation the patient actually sees. They should avoid bony prominences and skin creases and should take into account the final cosmetic result. The latter factor should not however be of paramount importance, as any incision should provide adequate access to make the operation safe and functionally effective.
This may be postoperative or from a septic focus in the body – gastrointestinal, biliary, or genitourinary tracts. This may follow on from systemic inflammatory response syndrome (SIRS). The systemic changes in SIRS are loss of microvascular integrity, increased vascular permeability, systemic vasodilatation, depressed myocardial contractility, poor oxygen delivery and increased microvascular clotting. This is also a distributive type of shock with vascular dilatation, hypotension, low systemic vascular resistance, inadequate afterload and a high cardiac output – hyperdynamic circulation.