Lecture Clinical procedures for medical assisting (4/e): Chapter 10 – Booth, Whicker, Wyman

CHAPTER

10
Assisting with Minor
Surgery

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10­2

Learning Outcomes
10.1 Define the medical assistant’s role in minor surgical
procedures.
10.2 Describe types of wounds and explain how they heal.
10.3 Describe special surgical procedures performed in an
office setting.
10.4 List the instruments used in minor surgery and
describe their functions.

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10­3

Learning Outcomes (cont.)
10.5 Describe and contrast the procedures for medical and
sterile asepsis in minor surgery.
10.6 Describe the medical assistant’s duties in preparing to
assist in minor surgery.
10.7 Describe the medical assistant’s duties in preparing a

patient for surgery.

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10­4

Learning Outcomes (cont.)
10.8 Describe the types of local anesthetics for minor
surgery and the medical assistant’s role in their
administration.
10.9 Describe the duties of the medical assistant as a
floater and as a sterile scrub assistant.
10.10 Describe the medical assistant’s duties in the
postoperative period.

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10­5

Introduction
• Minor surgical
procedures
– Ambulatory care
settings
– Office practices

• Medical assistant
– Types of procedures

– Patient preparation
– Assisting physician
during the procedure
– Patient care following
the procedure

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10­6

The Medical Assistant’s Role in Minor Surgery
• Administrative
– Completing insurance
forms
– Obtaining signed informed
consent forms
– Patient education
• Explaining procedure to and
answering questions from
the patient
• Presurgical instructions

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10­7

The Medical Assistant’s Role in Minor Surgery
(cont.)

• Relative to surgical
procedure
– Prepare surgical room
– Prepare equipment
– Assist during
procedure
• Unsterile
• Sterile

– Ensure safety and
comfort of the patient

• Postoperative
procedures
– Patient care
– Dress wound
– Patient education
• Wound care
• Postoperative care

– Clean room for next
procedure

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10­8

Apply Your Knowledge

What are the medical assistant’s responsibilities in
relation to patient education and minor surgical
procedures?
ANSWER: The medical assistant may be responsible for providing
patient education concerning the following:

Explanation of the procedure

Presurgical instructions

Postoperative instructions

Wound care

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10­9

Surgery in the Physician’s Office
• Minor surgical procedure
– Safely performed in office or
clinic without general anesthesia
– Use local anesthetics affecting
only a particular area

• Reasons
–
–
–

–

Diagnose illnesses
Repair an injury
Removal of small growths
Cosmetic

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10­10

Common Surgical Procedures in an Office
• Draining an abscess –
collection of pus
formed due to an
infection

• Mole (nevus) removal
– Small discolored area
of the skin
– Done if the mole
changes shape, size,
or color

• Obtaining a biopsy specimen
– Removal of a small amount of tissue for examination
– Specimens are placed in 10% formalin, a common
preservative

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10­11

Wound Care
• Accidental
– Laceration – jagged,
open wound
– Puncture wound –
deep wound caused
by a sharp object

• Intentional – surgical
incision

• Cleaning a nonsurgical wound
– Wash with soap and
water
– Irrigate with sterile
solution
– Debridement –
removal of debris or
dead tissue

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10­12

Wound Healing
• Inflammatory phase
– Vessels in area constrict – reduces bleeding
– Platelets, clotting factors, and WBCs seal the wound,
clot the blood, and remove bacteria and debris

• Proliferation phase
– New tissue forms, closing off wound
– Phase can be sped up if edges of wound are
approximated

• Maturation phase – formation of scar tissue

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10­13

Closing a Wound
• Butterfly closures or sterile strips
• Skin adhesive
• Sutures
– Absorbable – collagen fibers
– Nonabsorbable – silk, nylon, polyester

• Staples

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10­14

Special Procedures
• Laser surgery
– Intense beam of light
used to cut away tissue
– Does less damage to
surrounding tissue

• Electrocauterization

• Cryosurgery
– Uses extreme cold to
destroy unwanted
tissue
– Patient education –
wound care

– Needle, probe, or loop
heated by electric current
to destroy the target tissue
– Requires a grounding plate
or pad to prevent an
electric shock

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10­15

Apply Your Knowledge
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?
ANSWER: Reasons for poor wound healing include:

Age
 Poor nutrition

Poor circulation
 High stress levels

Diabetes
 Weakened immune system

Obesity
 Smoking

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10­16

Instruments Used in Minor Surgery
• Cutting and dissecting instruments
– Scalpels
– Scissors
– Curettes

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10­17

Instruments (cont.)
• Grasping and clamping instruments
– Forceps
– Hemostats
– Towel
clamps

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10­18

Instruments (cont.)
• Retracting, dilating, and probing
instruments
– Retractors
– Dilators
– Probes

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10­19

Instruments (cont.)

• Suturing instruments
– Needles
– Needle
holders
– Packaged
sutures

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10­20

Instruments (cont.)
• Syringes and needles
– Inject anesthetic
solutions
– Withdraw fluids
– Obtain needle biopsy
specimens

• 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

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10­21

Apply Your Knowledge
Name at least one instrument for each of the following
ANSWER:
types:
scissors, scalpels, curettes
1. Cutting and dissecting
2. Grasping and clamping

forceps, hemostats, clamps

3. Retracting, dilating, and probing retractors, dilators, probes
4. Suturing needle holders, needles, packaged sutures

SUPER!
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10­22

Asepsis
• Priority during
surgical procedures
– Critical to heath and
safety of the patient
– Levels
• Medical – clean
technique
• Surgical – sterile
technique

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10­23

Medical Asepsis
• Reduces the number of microorganisms
and prevents the spread of disease
– Handwashing

– Personal protective
equipment

– Sharps and biohazardous
waste handling and
• Provides a barrier between disposal
• Puncture and leakwearer and infectious or

resistant containers
hazardous materials
• Biohazard symbol
• Gloves, masks, gowns

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10­24

Surgical Asepsis
• Eliminates all microorganisms
• Common procedures using sterile
technique
– Creating a sterile field
• Used as a work area during procedure
• Keep above waist level

– Adding sterile item to sterile field
• Outer one inch is “contaminated”
• Instruments and supplies
• Pouring sterile solutions
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10­25

Surgical Asepsis (cont.)
– Perform a surgical
scrub

• Removes more
microorganisms than
handwashing
• 2–6 minutes

– Put on sterile gloves
– Sanitize, disinfect, and
sterilize equipment

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