Hemostasis and Tissue Management Flashcards

Which electrosurgical mode cuts tissue by delivering continuous current that rapidly heats intracellular water to cause cell vaporization?

Answer: Pure cut mode

Pure cut mode delivers continuous unmodulated current that heats cells so rapidly they explode (vaporize), producing a clean incision with minimal lateral thermal damage.

A ligating clip should be placed at what minimum distance from the planned transection point to ensure secure hemostasis?

Answer: 2–3 mm

Clips should be placed at least 2–3 mm from the transection site to allow a secure bite of tissue and prevent slippage off the vessel end.

When using a harmonic scalpel (ultrasonic energy device), what is the primary mechanism of tissue sealing?

Answer: Mechanical vibration denaturing protein to form a coagulum

The harmonic scalpel uses high-frequency mechanical vibration (55,500 Hz) to denature protein and form a coagulative seal without electrical current passing through the patient.

Topical thrombin agents such as Thrombin-JMI work by activating which step in the coagulation cascade?

Answer: Converting fibrinogen directly to fibrin

Topical thrombin directly converts fibrinogen to fibrin, bypassing the intrinsic and extrinsic coagulation pathways to rapidly form a fibrin clot at the application site.

Bone wax is most appropriately used to control bleeding from which type of source?

Answer: Bleeding from cancellous bone surfaces (e.g., sternum or cranium)

Bone wax is a mechanical hemostatic agent used specifically to tamponade bleeding from cut bone surfaces such as the sternum during cardiac surgery or the cranium during neurosurgery.

Electrosurgical unit (ESU) current density is highest at which point in the circuit?

Answer: The active electrode tip

Current density is highest at the small active electrode tip where tissue effect (cutting or coagulation) occurs, and lowest at the large dispersive pad where current spreads safely.