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Introduction to Surgery
Study Course Description
Course Description Statuss:Approved
Course Description Version:12.00
Study Course Accepted:18.08.2022 12:16:29
| Study Course Information | |||||||||
| Course Code: | KK_008 | LQF level: | Level 7 | ||||||
| Credit Points: | 3.00 | ECTS: | 4.50 | ||||||
| Branch of Science: | Clinical Medicine; Surgery | Target Audience: | Medicine | ||||||
| Study Course Supervisor | |||||||||
| Course Supervisor: | Artūrs Ozoliņš | ||||||||
| Study Course Implementer | |||||||||
| Structural Unit: | Department of Surgery | ||||||||
| The Head of Structural Unit: | |||||||||
| Contacts: | Riga, 13 Pilsonu Street, VSIA P.Stradiņa KUS, Block No 24, kk rsu[pnkts]lv, +371 67069745 | ||||||||
| Study Course Planning | |||||||||
| Full-Time - Semester No.1 | |||||||||
| Lectures (count) | 6 | Lecture Length (academic hours) | 2 | Total Contact Hours of Lectures | 12 | ||||
| Classes (count) | 6 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 18 | ||||
| Total Contact Hours | 30 | ||||||||
| Full-Time - Semester No.2 | |||||||||
| Lectures (count) | 0 | Lecture Length (academic hours) | 0 | Total Contact Hours of Lectures | 0 | ||||
| Classes (count) | 6 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 18 | ||||
| Total Contact Hours | 18 | ||||||||
| Study course description | |||||||||
| Preliminary Knowledge: | Anatomy, physiology, biochemistry, pathological physiology, pathological anatomy and microbiology. | ||||||||
| Objective: | To teach basic knowledge in surgery and to master basic practical skills. | ||||||||
| Topic Layout (Full-Time) | |||||||||
| No. | Topic | Type of Implementation | Number | Venue | |||||
| 1 | History of surgery. Future directions. | Lectures | 1.00 | other | |||||
| 2 | Wounds. Classification. Wound healing. Basics of wound treatment. Wound primary debridement. Wound dressing principles. Wound infection. | Lectures | 1.00 | other | |||||
| 3 | Surgical infection (classification, pathogenesis, symptoms). Basics of surgical infection treatment. Bacterial skin and soft tissue infections. Sepsis (classification, signs, principles of treatment). | Lectures | 1.00 | other | |||||
| 4 | Surgical manipulations. Access to blood vessels. Access to serous cavities. Thoracocentesis. Laparocentesis. Pericardiocentesis. Surgical operation, incisions, access to organs. Principles of drainage. Sutures. | Lectures | 1.00 | other | |||||
| 5 | Bleeding; classification. Symptoms and signs of blood loss. Evaluation of clotting system. Temporary and final methods of hemostasis. | Lectures | 1.00 | other | |||||
| 6 | 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. | Lectures | 1.00 | other | |||||
| 7 | 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. | Classes | 1.00 | other | |||||
| 8 | Scrub, gown and glove procedures. Techniques for aseptic dressing and procedures. Surgical knot tying. Surgical instruments. | Classes | 1.00 | METC | |||||
| 9 | 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. | Classes | 1.00 | other | |||||
| 10 | 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. | Classes | 1.00 | other | |||||
| 11 | 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. | Classes | 1.00 | other | |||||
| 12 | Investigation aspects of surgical patient. Preoperative preparation of surgical patients. Methods to prevent/ decreasae surgical site infections. | Classes | 1.00 | other | |||||
| 13 | 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. | Classes | 1.00 | other | |||||
| 14 | Local anaesthesia. Types of suture material and suturing techniques. Skin sutures. | Classes | 1.00 | METC | |||||
| 15 | Isoserology. Basics of transfusion therapy. Management of planned and emergency blood transfusions. Blood transfusion procedure and documentation. | Classes | 1.00 | other | |||||
| 16 | Blood components descriptions and indications; patient monitoring. Types and advantages of autohemotransfusion. Transfusion alternatives. Blood substitutes: principles, methods, products. | Classes | 1.00 | other | |||||
| 17 | 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. | Classes | 1.00 | other | |||||
| 18 | Postoperative period - description and management in the surgery department. ERAS principles in surgery. Nutrition in surgical patients. Early and late postoperative period and complications. | Classes | 1.00 | other | |||||
| Assessment | |||||||||
| Unaided Work: | Students are asked to be independantly prepared for each practical class using recommended literature sources as well as materials from lectures and e-studies. | ||||||||
| Assessment Criteria: | There are two semesters in study course with six classes in each (one class in each semester is in Medical Technology center (METC) RSU). In practical classes scrub, gown and glove procedures are provided as well as techniques for aseptic dressing, surgical knot tying, local anesthesia principles and suturing and wound closure techniques. Evaluation: to pass the study course, students must attended all classes, watch all lectures, as well as attend one practical class in each semester in Medical Education Technology Centre. Exam: knowledge, skills and competence of the student about course material is evaluated during written/spoken exam in the end of study year. This can be subject to change due to restrictions in Hospitals. Exam mark makes 50% of the final grade of the study course. The other 50% are acquired by students for their performance during the study course. | ||||||||
| Final Examination (Full-Time): | Exam | ||||||||
| Final Examination (Part-Time): | |||||||||
| Learning Outcomes | |||||||||
| Knowledge: | On completion of the study course students acquire basic knowledge and comprehension about different kind of wounds, wound healing and treatment principles; knowledge about specific wounds (gunshot wounds, stab wounds, bite wounds, etc.) epidemiology and treatment peculiarities; traumatic wound management; modern wound dressings. Knowledge about wound infection, possible infection transmission mechanisms in surgery department, infection reduction, prevention and management methods. Basic knowledge about surgical, skin and soft tissue infection management. Comprehension about antibacterial treatment indications and application principles in surgery, prophylactic antibacterial treatment principles, possible antibacterial therapy complications and complications prevention. Students also acquire basic skills in surgical patient investigation; definition and importance of "Status localis" concept. Preoperative epicrisis and patient preparation for operation. Deepened insight into principles and manifestation of bleeding, methods and means of hemostasis, basics of isoserology and transfusiology. Summary about blood transfusion requirements and documentation, blood components, blood substitutes and alternatives to blood transfusions. Basic knowledge about 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 about classification of postoperative period and patient monitoring, principles of surgical patient nutrition, complications of early and late postoperative period. General information about history of development of surgery. | ||||||||
| Skills: | On completion of the study course, the student will have skills to be prepared for surgical manipulations such as hand scrub, gown and glove procedures. Techniques for aseptic dressing and procedures. Surgical knot tying. Principles of local anesthesia. Types of suture material and suturing techniques. Surgical knot tying. Wound closure technique. Skills to follow infections control procedures in surgical ward, ability to apply temporary and final methods of hemostasis; skills to determine patients blood group and crossmatch tests; skills to investigate surgical patient and local tissue changes. Students will have basic skills in surgical instruments, as well as principles of access to serous and abscess cavities and overview of operating room technologies. | ||||||||
| Competencies: | In the study process of this course students will be able to discover the source of the hospital infections, will be competent about wounds and their healing process. Students will be able to explain most common bleeding sources, evaluate patient condition as well as advise methods of temporary and final hemostasis. Students will be competent in principles of transfusiology, surgical operation, postoperative management, principles of postoperative monitoring as well as early and late postoperative complications; will be able to differ skin and soft tissue infections and give advice in treatment principles. | ||||||||
| Clinical Skills: | |||||||||
| No. | Skill | Level | |||||||
| 1 | Local infiltration anaesthesia | B1 - Basic level | |||||||
| 2 | Preparation for primary closure of the wound (arranging sterile kit/desk) | B1 - Basic level | |||||||
| 3 | Primary treatment of wounds | B1 - Basic level | |||||||
| 4 | Primary wound closure (with foreign body) | B1 - Basic level | |||||||
| 5 | Simple interrupted skin suture | B1 - Basic level | |||||||
| Bibliography | |||||||||
| No. | Reference | ||||||||
| Required Reading | |||||||||
| 1 | Ķirurģija. J. Gardovska red. 2.izd. Rīga: Rīgas Stradiņa universitāte, 2013. | ||||||||
| 2 | Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 20th, 2016 by Courtney M. Townsend | ||||||||
| 3 | Current Surgical Therapy 12th Revised edition, 2016 by John L. Cameron, | ||||||||
| 4 | Zollinger's Atlas of Surgical Operations, 10th edition, 2016. Robert M. Zollinger, E. Christopher Ellison | ||||||||
| 5 | Rutherford's Vascular Surgery, 2-Volume Set 8th Revised edition, 2014. Jack L. Cronenwett, K. Wayne Johnston | ||||||||
| Other Information Sources | |||||||||
| 1 | http://estudijas.rsu.lv | ||||||||
| 2 | http://emedicine.medscape.com/general_surgery | ||||||||
| 3 | Brūču dzīšana, MedScape https://emedicine.medscape.com/article/884594-overview | ||||||||
| 4 | Šautas brūces https://www.orthobullets.com/trauma/1059/gun-shot-wounds | ||||||||
| 5 | Brūču aprūpe, MedScape https://emedicine.medscape.com/article/194018-treatment | ||||||||
