Pre-requisites for Vac Dressing Components of Vac Dressing 1. Pump for Negative Pressure: In a study, 3 closed suction drainage systems were studied – Davol Reliavac 400 Evacuator, Jackson-Pratt Closed Wound Suction Drainage System, and Snyder Hemovac 400. In all three systems, maximal negative pressures (-71 to -175 mm Hg)…
Tag: General Surgery
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ECG Guide for Surgeons
There is an old saying that two surgeons and an ECG form a double-blind-study. Then, there’s a protocol for surgeons intended for humor: All spikes up: Operate All spikes down: Call Medics All spikes missing: Recently: Call Anesthetist A long time ago: Complete death certificate So, let’s think of heart…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Perioperative Management of Venous thromboembolism (VTE)
Recommended duration of anticoagulant prophylaxis The recommendations are as follows: 1. Provoked DVT (with reversible surgical or nonsurgical provoking factor): 3 months 2. Unprovoked isolated distal DVT (has low risk of recurrence): 3 months 3. Unprovoked proximal DVT or PE: Indefinite therapy if D-dimer positive after 1 month after 3 months of therapy or second VTE…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Mnemonic based management of Acute Pancreatitis
Acute pancreatitis along with case based discussion has been already covered earlier here: To remember the initial management of acute pancreatitis, one can remember the mnemonics given below: iPA-NCREAS (Ye et.al.) Investigations: Imaging (CT, MRI or Ultrasonography) Prognostic screen to identify severe pancreatitis Amylase and lipase levels Initial treatment: Nutritional…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Stages of Skin Graft take : Mnemonic
Mnemonic: AIIRR I – Adherence Formation of fibrin bonds between graft and it’s recipient wound bed II – Imbibition (1st 2-4 days) Donor tissue receives nutrition from absorption from the recipient site wound bed via capillary action (graft drinks from recipient bed) Graft increases in weight and volume and appears…
Surgical Skills 
Techniques of Securing Surgical Drain to Skin (Drain Fixation)
Choice of Suture: Non-absorbable (braided suture provides slightly superior grip on tubing than monofilament sutures) Technique 1: Create a series of knots around the drain. The long end of the thread (attached to the needle) is passed through the skin directly next to the drain exit site, to create a…
Surgical Skills 
Zancolli-Lasso Procedure
Based on the preoperative clinical examination, the decision on which donor superficialis (FDS) tendon to use is made (commonly FDS middle finger is used). Transverse incision is made at the level of the distal palmer crease. Care should be taken to avoid the neurovascular bundles and the flexor tendons must…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Wound Myiasis (Maggot Infestation)
Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. The order Diptera is a large order of insects that are commonly known as true flies. Wound myiasis occurs when fly larvae infest open wounds of a mammalian host. Majority of flies that are likely…