Basics of Surgery
Study Course Implementer
Riga, 13 Pilsoņu Street, kk@rsu.lv, +371 67069745
About Study Course
Objective
Provide students with the opportunity to acquire basic knowledge and skills of surgery.
Preliminary Knowledge
Anatomy, physiology, biochemistry, pathological physiology, pathological anatomy and microbiology.
Learning Outcomes
Knowledge
1.On completion of the study course students acquire basic knowledge and understanding of: - Different kind of wounds, wound healing and treatment principles. Incidence of particular types of wounds (gunshot, stab, bite, etc.) and their management. Examination of traumatic wound patients, management, prioritisation and description. - Modern wound dressings, wound infection, possible infection transmission mechanisms in surgery department, infection reduction, prevention and management methods; - Basic knowledge of surgical, skin and soft tissue infection management. - Understanding of antibacterial treatment indications and application principles in surgery, prophylactic antibacterial treatment principles, possible antibacterial therapy complications and complication prevention. - Insights into the aspects of surgical patient examination, the meaning of the concept "pre-operative epicrisis" and patient preparation for operation. - In-depth insight into principles and manifestation of bleeding, methods and means of haemostasis, basics of isoserology and transfusion medicine. Summary about blood transfusion requirements and documentation, blood components, blood substitutes and alternatives to blood transfusions. - Basic knowledge of the principles of surgical operation, types of incisions, surgical instruments, principles of drainage and applicable medical technologies and techniques; most frequent complications of surgical operations and procedures and their prophylaxis, treatment. - Overview of the classification of postoperative period and patient monitoring, principles of surgical patient nutrition, complications of early and late postoperative period. - General information about the history of the development of surgery.
Skills
1.Upon completion of the study course, the student will be able to: prepare for surgical manipulations, such as hand scrub, gown and glove procedures; set out the sterile field for primary wound dressing and apply soft wound dressing; follow infection control procedures in a surgical ward; dress simple wounds and prepare a wound for treatment; apply local infiltration anaesthetics; manage suturing material in surgery, tie surgical knots, apply wound closure techniques, recommend temporary and final methods of haemostasis; determine patient blood groups and manage compatibility tests before blood transfusions and complete the appropriate transfusion documentation; examine a surgical patient; describe and evaluate local changes in tissue in surgical patients; manage basic instruments in surgery; know basic principles of access to serous and abscess cavities and give an overview of technologies used in the operating theatre.
Competences
1.On completion of the study course students will be able to discover the source of the hospital infections, will be competent in assessing wounds and their healing process. Students will be able to explain most common bleeding sources, evaluate patient condition as well as advise on methods of temporary and final haemostasis. Students will be competent in principles of transfusion, surgical operation, postoperative management, principles of postoperative monitoring as well as early and late postoperative complications; will be able to distinguish between the skin and soft tissue infections and advise on treatment principles.
Assessment
Individual work
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Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Individual work |
-
|
-
|
|
Students independently prepare for each class using lectures and other materials from E-studies as well as recommended literature sources.
|
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Examination
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Test |
30.00% from total grade
|
10 points
|
|
Student receives assessment of study course if all classes have been attended, including practical classes in the Medical Education Technology Centre. The final assessment of the course (grade) is calculated from: - the results of the knowledge control tests of the 5th and 6th semester classes in E-studies (30%). |
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|
2.
Exam |
70.00% from total grade
|
10 points
|
|
Exam at end of 6th semester (70%) |
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Study Course Theme Plan
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
History of surgery. Future directions.
|
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
Wounds. Classification. Wound healing. Basics of wound treatment. Wound primary debridement. Wound dressing principles. Wound infection.
|
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
Surgical infection (classification, pathogenesis, symptoms). Basics of surgical infection treatment. Bacterial skin and soft tissue infections. Sepsis (classification, signs, principles of treatment).
|
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
Surgical manipulations. Access to blood vessels. Access to serous cavities. Surgical operation, incisions, access to organs. Principles of drainage.
|
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
Bleeding; classification. Symptoms and signs of blood loss. Evaluation of clotting system. Temporary and final methods of hemostasis.
|
-
Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
2
|
Topics
|
Basics of transfusiology. Blood transfusion procedure and documentation. Principles of modern transfusiology. Blood components descriptions and indications. Blood substitutes: principles, methods, products. Autohemotransfusion. Adverse reactions and complications in transfusiology. Massive transfusion protocol. Transfusion alternatives. Principles of blood / volume replacement therapy.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Wounds (classification; clean and contaminated). Wound healing, influencing factors. Particular types of wounds (gunshot, stab, bite, etc.) incidence and management. Tetanus and rabies. Basics of wound treatment. Modern wound dressing. Scars.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
-
|
3
|
Topics
|
Local anaesthesia. Types of suture material and suturing techniques. Skin sutures.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Bacterial skin and soft tissue infections (erysipelas, panaritium, folliculitis, furuncle, carbuncle, phlegmon, hidradenitis, abscess, lymphadenitis, lymphangitis). Necrosis, gangrene, ulcers, pressure sores. Anaerobic infections. Clostridial/ nonclostridial myonecrosis.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Surgical infection (classification, pathogenesis, symptoms). Basics of surgical infection treatment. Surgical site infection (SSI), classification and incidence in different surgical fields. SIRS, MODS, sepsis. Purulent wound treatment. Principles of negative pressure treatment.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Principles of antibacterial therapy treatment in surgery. Prophylactic administration of antibiotics in surgery; antibiotics used in the most common surgical manipulations. Complications of antibacterial therapy, prophylaxis.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Investigation aspects of surgical patient. Preoperative preparation of surgical patients. Methods to prevent/ decrease surgical site infections.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Isoserology. Basics of transfusion therapy. Management of planned and emergency blood transfusions. Blood transfusion procedure and documentation.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Bleeding; classification. Types of internal/external bleeding. Symptoms and signs of blood loss. Diagnostic methods of bleeding. Evaluation of blood clotting system, its value in haemostasis. Temporary and final methods of haemostasis.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
-
|
3
|
Topics
|
Scrub, gown and glove procedures. Techniques for aseptic dressing and procedures. Surgical knot tying. Surgical instruments.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Blood components descriptions and indications; patient monitoring. Types and advantages of autohemotransfusion. Transfusion alternatives. Blood substitutes: principles, methods, products.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Postoperative period - description and management in the surgery department. ERAS principles in surgery. Nutrition in surgical patients. Early and late postoperative period and complications.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Other
|
3
|
Topics
|
Surgical operation. Surgical incisions for adequate access to organs. Abscess incision. Principles of drainage. Access to serous and purulent cavities. Thoracentesis. Laparocentesis. Urinary catheter insertion procedure.
|
Bibliography
Required Reading
Ķirurģija. J. Gardovska red. 2.izd. Rīga: Rīgas Stradiņa universitāte, 2013. (akceptējams izdevums)
Townsend, C.M. 2021. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier.Suitable for English stream
Cameron, J.L., Cameron, A.M. 2023. Current Surgical Therapy. 14th ed. Elsevier.Suitable for English stream
Zollinger, R.M., Ellison, E.C. 2011. Zollinger's Atlas of Surgical Operations. 11th ed. New York: Mc Graw Hill (akceptējams izdevums)Suitable for English stream
Fisher, R.A., Ahmed, K., Dasgupta, P. 2017. Introduction to Surgery for Students. Switzerland: Springer International Publishing.Suitable for English stream