General Surgery Principles Flashcards

A 60-year-old man develops a tender, erythematous wound with purulent discharge on postoperative day 5. Which type of surgical site infection is this?

Answer: Superficial incisional SSI

A superficial incisional SSI involves only skin and subcutaneous tissue within 30 days of surgery.

What is the most appropriate timing for prophylactic antibiotic administration in clean-contaminated surgery?

Answer: At induction, within 60 minutes before incision

Prophylactic antibiotics are most effective when given within 60 minutes before incision to ensure adequate tissue levels.

Which suture material is most appropriate for a contaminated abdominal wound closure?

Answer: Monofilament absorbable

Monofilament absorbable sutures harbour fewer bacteria than braided material in contaminated fields.

A patient has a Glasgow Coma Scale of 8 after major trauma. What is the immediate airway priority?

Answer: Definitive airway via endotracheal intubation

A GCS of 8 or less indicates the patient cannot protect their airway and requires definitive intubation.

What does a rising serum lactate in a postoperative patient most strongly suggest?

Answer: Tissue hypoperfusion

Elevated lactate reflects anaerobic metabolism from tissue hypoperfusion and warrants resuscitation review.

Which finding is most consistent with an anastomotic leak after colorectal surgery on day 5?

Answer: Fever, tachycardia and peritonism

Anastomotic leaks typically present around day 5 with sepsis signs and peritoneal irritation.

What is the primary goal of damage control surgery in an unstable trauma patient?

Answer: Control haemorrhage and contamination, then resuscitate

Damage control prioritises arresting bleeding and contamination, deferring definitive repair until physiology is restored.