General Surgery Principles Flashcards

A patient develops a wound dehiscence on day 7 with a 'pink serosanguinous discharge' preceding it. What is the next step?

Answer: Cover with saline gauze and return to theatre for resuture

Serosanguinous discharge heralds fascial dehiscence, which requires theatre resuture after a moist sterile dressing.

Which classification grades surgical complications by the therapy required to treat them?

Answer: Clavien-Dindo classification

The Clavien-Dindo system grades postoperative complications according to the intervention needed.

What is the most appropriate initial fluid for resuscitating a hypovolaemic surgical patient?

Answer: Balanced crystalloid such as Hartmann's solution

Balanced crystalloids are first-line for restoring intravascular volume in hypovolaemia.

A diabetic patient has a HbA1c of 9.5% before elective hernia repair. What is the best action?

Answer: Defer surgery to optimise glycaemic control

Poor glycaemic control raises infection and wound risk, so elective surgery should be deferred for optimisation.

Which of these is an absolute indication for blood transfusion intraoperatively?

Answer: Symptomatic anaemia with ongoing haemorrhage and hypoxia

Transfusion is indicated for symptomatic anaemia with active bleeding and inadequate oxygen delivery.

What is the recommended first-line management of a small, stable, postoperative seroma?

Answer: Observation as most resolve spontaneously

Most small seromas reabsorb spontaneously and need only observation.

In the WHO surgical safety checklist, when is the 'time out' performed?

Answer: Before skin incision

The 'time out' occurs immediately before incision to confirm patient, site and procedure.