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Theoretical test exam: during the exam period, multiple choice questions and false/true.
Time: see at the Neptun (weekly dates will be offered).
What to study?
Topics of the lectures: see Coospace annotations:
1.Asepsis and antisepsis. Historical background. Surgical infections, sources of infections. Types, classification, risks and
prevention of wound contaminations. Sterilization, disinfection. Preparation of the patient before operation: scrub preparation
and isolation of the surgical site. Scrubbing, disinfection, gowning and gloving of the operating team. Personnel attire and
movement. Basic rules of asepsis in the operating room. Postoperative wound management. Surgical antisepsis. Design and
equipments of the operating room, basic technical background. Operating room personnel and their duties. Positioning of the
patient on the operating table. Positioning.
2.Surgical instruments. Basic surgical instruments, special surgical tools and technologies, suture materials. Wound closure
(sutures, clips, adhesive strips). Imperfections of suturing techniques. Removal of sutures. Drainage.
3.The operation. Basic surgical interventions. Indications for an operation, informed consent, operative risk, the surgeons
responsibility. Preoperative investigations. Perioperative fluid balance, fluid requirements and fluid therapy. Preoperative
preparation of the patient. Local anesthesia (drugs, types of local anesthesia, complications).
4.Wounds. Types and classification of accidental wounds. Wound healing, scar formation. Surgical wounds. Wound closure
and its complications. Management of accidental wounds. Dressings, types of bandages. Innovations in wound treatment.
5.Bleeding. Types and classification of hemorrhage. Signs and consequences of blood loss. Bleeding in surgery (pre-, intra-
and postoperative bleeding). Factors influencing operative blood loss. Surgical hemostasis (mechanical, thermal, chemical-
biological methods). Blood replacement in surgery, autotransfusion.
6.Complications. Definition and classification of complications. Complications related to surgery and anaesthesia.
Complications of wound healing. Haemorrhagic complications. Pathophysiology, signs and treatment of hemorrhagic shock
7.Basics of minimally invasive surgical interventions. Historical background. Components of the laparoscopic tower,
laparoscopic instruments.
Exams / Marks
Practical exam: during the study period on week 14 (we make it possible also for those who
missed a maximum of practices).
Everyone has to attend the practical exam on the day which is designated to her/his group.
Accordingly, 3 groups will be simultaneously present, the exam will be taken individually, in
rotation between the 3 different task stations (as follows).
Those who still would like to practice on week 14, it will be possible (place: Skills Center).
Practical exam tasks: 1. Knotting by hands under tension (1 prefered type should be showed)
2. Suturing (sec Donati) + instrument tie knotting
3. Cleansing, gowning and gloving
The practical mark is calculated as the average of the 3 task marks.
Videos of knotting and criteria of giving the marks have been uploaded to Coospace.
Only exam task with mark 1 (failing) has to be /can be repeated on week 15. Marks gotten
on week 14 cannot be improved (except for 1).
If someone does not show up on week 15 to improve mark 1, the average of the 3 marks will
be calculated (even though one of them is 1)
Exams / Marks
Final (5 grade) mark: the average of the test and practical exams (each but should be at
least 2)
Information on the Coospace
Preparation for the
practical exam
Tasks
-scrubbing, gowning
-tying a knot under tension
-wound closure with Donati-stitches
Putting on caps, mask, and Missing to put on any of them Incorrectly applied (uncovered hair, nose).
shoe cover
Preparation for mechanical Wearing ring, wrist watch, bracelet, nail polish, or if the long sleeve of the cloth
scrub covers the elbow and the forearm.
Hygienic hand wash Missing or false (not rinsing)
Hand and forearm wash Missing or false: the extent, intensity or length of time of the scrub is not
with soap appropriate, wrong order
Rinsing Inappropriate, the hand is held lower than the elbow, irregular rinsing; residual
lather;
Water tap closing The tap is closed by hand or forearm instead of the elbow (touch with washed hand
surface).
Mechanical scrub Breaching the rules of asepsis, e.g. touching non-sterile things
Drying hands Missing or disinfectant is applied on a wet hand
Desinfection Touching the feeder with hand or forearm instead of the elbow
Desinfection Missing, fewer than 5 dosages; the time is decreased or not controlled.
Desinfection Breaching the rules of desinfection (area, order)
Desinfection Rinsing the disinfectant
Desinfection Unintentional or unrecognized breaching the rules of asepsis; Hands kept irregularly,
the feeder is operated not by the elbow
Donning sterile gown Contamination of the gown while removing from the container
Putting on sterile gown Breaching the rules of putting on a gown (hanging arms, contamination)
Assisted sterile gloving Contamination of gloves (naked finger contact with sterile surface)
Removing gloves Contamination with naked fingers
Evaluation of knotting
Mounting a needle holder
Vertical matress (Donati) suture
1 cm
2 mm
Too loose stitches Too tight stiches
Knots are at different sides Not perpendicular to the wound edge
Thread was cut to too short
Distance from the wound edge is not equal
The depth of the stitch is not appropriate The distance among the stitches is not equal
Further courses offered by us (1)
ADVANCES SURGICAL SKILLS
The aim of the subject:teaching basic surgical techniques, invasive interventions and advanced
surgical knowledge to medical students interested in different surgical specialties
The aim of the subject: teaching basic surgical techniques, invasive interventions
and advanced surgical knowledge to medical students interested in different
surgical specialties