1. Medical Assisting Chapter 42
PowerPoint® to accompany
Medical Assisting Chapter 42
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Chapter 42
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Assisting with Minor Surgery
Objectives:
42-1 Define the medical assistant's role in minor
surgical procedures.
42-2 Describe types of wounds and explain how they
heal.
42-3 Describe special surgical procedures performed in
an office setting.
42-4 List the instruments used in minor surgery and
describe their functions.

3. Assisting with Minor Surgery
Objectives (cont.)
42-5 Describe and contrast the procedures for medical and sterile asepsis in minor surgery.
42-6 Describe the medical assistant’s duties in preparing to assist in minor surgery.
42-7 Describe the medical assistant’s role in preparing a patient for surgery.

4. Assisting with Minor Surgery
Objectives (cont.)
42-8 Describe the types of local anesthetics for minor surgery and the medical assistant’s role in their administration.
42-9 Describe the duties of the medical assistant as a floater and as a sterile scrub assistant.
42-10 Describe the medical assistant’s duties in the postoperative period.

5. Introduction
Minor surgical procedures are performed in ambulatory care settings and office practices
You must be knowledgeable of the types of procedures performed.
You will need to know how to prepare the patient for surgery, assist the practitioner during surgery, and care for the patient after surgery.

6. Role in Minor Surgery
You will perform administrative tasks prior to patient surgery
Completing forms for insurance
Obtaining signed informed consent forms
Explaining all aspects of the surgical procedure to the patient

7. Surgery in the Physician’s Office
Procedures that can be done safely in the office or clinic without general anesthesia
Minor surgery involves the use of a local anesthetic in the form of an injection or a cream applied to the skin
Minor surgery is performed to diagnose an illness or repair an injury.

8. Minor Surgeries Repair of a laceration
Irrigation and cleaning of a puncture wound
Wound debridement
Removal of:
Foreign bodies
Small growths
Nail or part of a nail
Collection of a biopsy specimen

9. Wound Healing
Initial phase – lag phase- white cells and blood components seal the wound, clot the blood, and remove bacteria and debris
Proliferation phase – new tissue forms
Maturation phase – involves the formation of scar tissue
What phase of healing is seen here?
Maturation phase

10. Special Minor Surgical Procedures
Laser Surgery – intense beam of light used to cut away tissue
Cryosurgery – use of extreme cold to destroy unwanted tissue
Electrocauterization – needle, probe, or loop heated by electric current to destroy the target tissue

11. Apply Your Knowledge
An 65-year-old female has a wound on her left calf that is healing poorly. When reviewing her chart what conditions would you look for that would indicate the reason for the poor healing?

12. Apply Your Knowledge -Answer
A 65-year-old female has a wound on her left calf that is healing poorly. When reviewing her chart, what conditions would you look for that would indicate the reason for the poor healing?
Age, poor circulation, diabetes, poor nutrition, high stress levels, weakened immune system, obesity, and smoking

13. Instruments Used in Minor Surgery
Cutting and Dissecting Instruments
Can you name these?

14. Instruments Used in Minor Surgery (cont.)
Grasping and Clamping Instruments
Can you name these?

15. Instruments Used in Minor Surgery (cont.)
Retracting, Dilating, and Probing Instruments
Can you name these?

16. Instruments Used in Minor Surgery (cont.)
Suturing Instruments
Can you name these?

17. Instruments Used in Minor Surgery (cont.)
Syringes and Needles
Instrument Trays and Packs
Laceration repair tray
Incision and drainage tray
Foreign body and growth removal tray
Onychectomy (nail removal) tray
Vasectomy tray
Suture and staple removal trays

18. Asepsis
Two types are used to maintain the safety of the patient and the health care professional
Medical asepsis (clean technique)
Surgical asepsis (sterile technique)

19. Medical Asepsis
Reduces the number of microorganisms and prevents the spread of disease
Use personal protective equipment
Use of sharps and biohazardous waste handling and disposal

20. Surgical Asepsis Purpose is to eliminate all microorganisms
Common procedures using sterile technique
Creating a sterile field
Adding sterile item to sterile field
Performing a surgical scrub
Putting on sterile gloves
Sanitizing, disinfecting, and sterilizing equipment

21. Apply Your Knowledge
Name at least one instrument for each of the following types:
Cutting and dissecting
Grasping and clamping
Retracting, dilating, and probing
Suturing

22. Apply Your Knowledge -Answer
Name at least one instrument for each of the following types:
Cutting and dissecting – scissors, scalpels, curettes
Grasping and clamping – forceps, hemostats, clamps
Retracting, dilating, and probing – retractors, dilators, probes
Suturing – needle holders, needles, packaged sutures

23. Preoperative Procedures
Preliminary duties
Preoperative instruction
Administrative and legal tasks
Easing the patient’s fears
Preparing the surgical room
Preparing the Patient
Initial tasks
Gowning and position the patient
Surgical skin preparation
Cleaning the area
Shaving the area
Applying the antiseptic

24. Intraoperative Procedures
Preparing the local anesthetic you will need to know:
Use of topical application
Use of injections
Potential side effects of the anesthetic
Use of epinephrine
Monitoring the patient
Processing specimens
Handling instruments

25. Assisting the Physician During Surgery
Serves as a floater
Monitoring and recording
Processing specimens
Other duties
Pouring sterile solutions
Keeping the surgical area clean and neat during the procedure
Reposition the patient as necessary
Adjusting lighting.

26. Assisting the Physician During Surgery (cont.)
Sterile scrub assistant – you perform a sterile scrub and wear sterile gloves
Handling instruments in the following order:
Cutting instruments
Grasping instruments
Retractors
Probes
Suture materials
Needle holders and scissors

27. Postoperative Procedures
Immediate patient care is the top priority :
Administer medications as directed
Monitor vital signs
Watch for adverse reactions
Keep the patient lying down for the prescribed length of time
Document all observations in the patient’s chart

28. Postoperative Procedures (cont.)
Dressing the wound
Sterile material used to cover the incision
Serves to keep wound clean
Reduces bleeding
Absorbs fluid drainage
Reduces discomfort to the patient
Speeds healing
Reduces the possibility of scarring

29. Postoperative Procedures (cont.)
Bandaging the wound
A clean strip of gauze or elastic material
Holds the dressing in place
May also improve circulation
Provides support or reduces tension on the wound
Prevents the wound from reopening
Prevents movement of the area of the body.

30. Postoperative Instructions
Guidelines for pain management
Instruction for wound care
Dietary restriction
Activity restriction
Follow-up appointment
Provided in writing and included in the postoperative information packet.

31. Postoperative Information Packet
Proper wound care instructions
Suggestions for pain relief
Dietary restrictions
Activity restriction
Timing for follow-up appointments

32. Surgical Room Cleanup
Place reusable instruments in a disinfectant soak that has anticoagulant properties
Place disposable waste in the sharps or biohazardous waste container
Clean the counters, exam table, and trays according to OSHA guidelines
Disinfect small pieces of nonsurgical equipment.

33. Follow-Up Care
You may be asked to change the dressing or remove the wound closures.
Suture or staple removal takes place 5 to 10 days after minor surgery.
Suture or staples are ready to be removed when a clean, unbroken suture line is observed.
No scabs, no seeping, and no visible opening should be present.

34. Apply Your Knowledge
What is the difference between a dressing and a bandage?

35. Apply Your Knowledge -Answer
What is the difference between a dressing and a bandage?
A dressing is a sterile material used to cover the incision, whereas a bandage is a clean strip of gauze or elastic material used to hold the dressing in place.

36. Medical Assistant Summary
You perform many functions during the patient’s preoperative and postoperative care.
At all times you must ensure the safety and comfort of the patient and be knowledgeable enough to function as the doctor’s “right hand” during the procedure.

37. End of Chapter
End of Chapter