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DIPLOMA IN CLINICAL MEDICINE”p-ij
MODULE 15: CS4 SURGERY
Hours: Theory – 134 hours
Practical – 570 hours
AIM
The aim of this module is to provide students with knowledge, skills
and attitudes to enable them provide surgical care.
BROAD OBJECTIVE:
By the end of the module the student should be able to diagnose
common surgical conditions and diseases for the provision of
appropriate management.
UNIT 1: GENERAL SURGERY
TIME ALLOCATION: Theory: 104 Hours
Practical: 410 Hours
SUB UNIT 1: ORGANIZATION OF A SURGICAL SERVICE
Time Allocation: 10 hours
SPECIFIC OBJECTIVES
By the end of this sub-unit the student should be able to:
1. Outline the surgical services
2. Outline disaster situations
3. Develop a disaster plan
4. Explain the trauma triage
CONTENT:
1. Surgical services
Casualty
Wards
Minor theatre
Major theatre
Orthopaedics
High Dependence Unit
Intensive Care Unit
Anaesthesia
Laboratory
Radiography
2. Disaster situations
Trauma
Public health disaster.
Natural disasters.
War and civil unrest.
3. Disaster plan
General Disaster Planning
Trauma Disaster Planning
4. The trauma triage
Goal of triage
Steps in establishing a trauma team
Responsibilities of trauma team leader
SUB UNIT 2: SURGICAL DOMAIN “CREATING A SAFE
ENVIRONMENT FOR SURGERY”
Time allocation: 6 hours
SPECIFIC OBJECTIVES
By the end of this sub-unit the student should be able to:
1. Explain infection control measures and asepsis in surgery.
2. Explain the appropriate use and care of basic surgical
instruments and equipment.
3. Outline the basic requirements and standard procedures for the
correct use of the operating room.
CONTENT
1. Infection control measures and asepsis in surgery.
Hand washing
Aseptic technique
Prevention of transmission of infectious diseases
Operative procedure list
Disinfection, Cleaning and Sterilization
2. Appropriate use and care of basic surgical instruments and
equipment
Care and repair
Use
3. Requirements and standard procedures for the correct use of
the operating room.
Basic requirements of an operating room
Standard procedures for the correct use of an operating
room.
SUB UNIT 3. FUNDAMENTALS OF SURGICAL PRACTICE
Time allocation: 12 Hours
SPECIFIC OBJECTIVES
By the end of this sub-unit the student should be able to:
1. Outline the approach to the care of a surgical patient.
2. Describe the activities involved in the care of a surgical patient
3. Describe the common post-operative complications
CONTENT
1. Approach to the care of a Surgical Patient
Pre-operative care
Intra-operative care
Post –operative care
2. Activities involved in the care of a surgical patient
Diagnostic work-up
Pre-operative evaluation
Pre-operative preparation
Anaesthesia and operation
Post-anaesthetic observation
3. The Common Post-operative Complications
Wound complication
Respiratory
Intra-peritoneal
Gastro-intestinal
Renal
Cardiovascular
SUB UNIT 4.0: BASIC SURGICAL TECHNIQUES
Time allocation: 4Hours
SPECIFIC OBJECTIVES
By the end of this unit the student should be able to: -
1. Outline the basic surgical techniques.
2. Describe incision making.
3. Explain the methods of homeostasis.
4. Describe suture materials and suturing technique
CONTENT
1. Basic surgical techniques.
Incisions
Haemostasis
Tissue handling
Suturing
Suture Technique
2. Incision making.
Principles of incisions
Types of incisions
3. Methods of haemostasis.
Pressure over gauze
Ligation
Cautery
4. Suture materials and suturing technique
Sutures materials
Suturing techniques
SUB UNIT 5.0: INFLAMMATION, INFECTIONS AND SUPERFICIAL
CONDITIONS
Time allocation: 12 hours
SPECIFIC OBJECTIVES
By the end of this unit the student should be able to: -
1. Describe fundamentals of surgical infections
2. Describe common surgical infections and inflammatory
conditions.
3. Describe surgical superficial conditions
4. Manage common surgical infections, inflammatory conditions
and superficial conditions
CONTENT
1. Fundamentals of surgical infections
Pathogenesis of surgical infections
Complications and spread of surgical infections.
Diagnostic studies.
General principles of treatment
2. common surgical infections and inflammatory
conditions
Abscess in general
Cellulitis
Fournier’s Gangrene
Hand Infections
Clostridial Infections
o Gas Gangrene
Gas abscess (Welch’s abscess)
Crepitant clostridial cellulitis
Localised clostridial myositis
Oedematous gangrene
o Tetanus
2. Superficial conditions
Ganglion
Cyst
Lipoma
4. Management of common surgical infections, inflammatory
conditions and superficial conditions
Conservative
Chemotherapy
Surgical :- incision
Excision
UNIT 6: GASTRO INTESTINAL CONDITIONS AND DISEASES
TIME ALLOCATION: 20 Hours
SPECIFIC OBJECTIVES
By the end of this unit the student should be able to: -
1. Describe common congenital neonatal conditions and
diseases.
2. Manage common neonatal conditions and diseases.
3. Describe common surgical abdominal conditions and
diseases.
4. Manage common surgical abdominal conditions and diseases.
5. Describe the anal rectal conditions.
6. Manage common anal rectal conditions
CONTENT
1. Common congenital neonatal conditions and diseases
Oesophageal Atresia
Hypertrophy Pyloric Stenosis
Cleft Lip and Palate
Spinal Bifida (Meningomyelocele)
Imperforate Anus
2. Management of common neonatal conditions and
diseases.
Conservative
Surgical
3. Common surgical abdominal conditions and diseases.
Pancreatitis
Peptic Ulcerations
Appendicitis
Bowel Obstruction
Cholecytitis
Peritonitis
4. Management common surgical abdominal conditions and
diseases.
Conservative
Surgical
5. Common anal rectal conditions.
Haemorrhoids
Anorectal Abscesses
Ano-fistula
Fissure in- ano
Colorectal carcinoma
6. Management of anal rectal conditions
Conservative
Chemotherapy
Surgical
UNIT 7: OESOPHAGEAL, THYROID AND BREAST PATHOLOGY
TIME ALLOCATION: 16 Hours
SPECIFIC OBJECTIVES
By the end of this unit the student should be able to:
1. Describe oesophageal diseases and conditions
2. Manage oesophageal diseases and conditions
3. Describe thyroid diseases and conditions
4. Manage thyroid diseases and conditions
5. Describe breast diseases and conditions
6. Manage breast diseases and conditions
CONTENT
1. Oesophageal diseases and conditions
Carcinoma of the Oesophagus
Reflux Oesophagitis
Achlasia Cardia
2. Management of oesophageal diseases and conditions
Conservative
Surgical
Palliative
3. Thyroid diseases and conditions
Goitre
Carcinoma of thyroid
4. Management of thyroid diseases and conditions
Conservative
Surgical
Radiotherapy and chemotherapy
Palliative
5. Breast diseases and conditions
Physiological
Infections
Benign
Malignant
6. Management of breast diseases and conditions
Conservative
Surgical
Radiotherapy and chemotherapy
Palliative
UNIT 8.0: MALE GENITAL URINARY CONDITIONS
Time allocation: 14 hours
By the end of this unit students should be able to:
1. Describe the male genital urinary diseases and conditions.
2. Manage the male genital urinary diseases and conditions.
Content
1. Male genital urinary diseases and conditions.
Hydrocele
Bladder Carcinoma
Prostatic Enlargement
Urethral Stricture
Inguinal Scrotal Swellings
Hernia
Torsion of the testis
Phimosis and Paraphimosis
Hypospadias
2. Management of male genital urinary diseases and
conditions.
Conservative
Surgical
Chemotherapy
UNIT 9.0: TRAUMATOLOGY
Time allocation: 20 hrs
By the end of this unit the student should be able to:
1. Explain the principles of primary trauma care management
2. Describe phases of trauma care management
3. Describe trauma conditions
4. Manage trauma conditions
CONTENT
1. Principles of primary trauma care management
ABC management.
2. Phases of trauma care management
Triage
Primary survey
Secondary survey
Stabilisation
Transfer
Definitive care
3. Trauma conditions
Haemorrhage
Shock
Head Injury
Chest Injury
Abdominal Injury
Pelvic Injury
Burns
Bites and stings
4. Management of trauma conditions
Conservative
Surgical
UNIT 2 ORTHOPAEDICS
Time Allocation: Theory -30 hours
Practical- 80 hours
By the end of the unit the student should be able to:
1. Outline the approach to the care of an orthopaedic patient.
2. Classify orthopaedic conditions
3. Manage orthopaedic conditions
CONTENT
1. Approach to the care of an orthopaedic patient.
History
Physical examination
Investigations
2. Classification of orthopaedic conditions
Trauma
Fractures
Dislocations
Sprains
Strains
Subluxations
Infection and inflammation
Acute osteomyelitis
Chronic osteomyelitis
Tuberculosis
Pyomyositis
Arthritis
o Osteoarthritis
o Gout arthritis
Congenital and developmental conditions
o Club foot
Neoplasitic conditions
o Benign
o Malignant
Metabolic and endocrine
Sensory disturbances and muscle weakness
3. Management of orthopaedic conditions
Management principles of fracture and dislocation
Management of specific orthopaedic conditions.
TEACHING METHODS
Lecture/discussion
Group discussion
Demonstration /return demonstration
Case studies
Clinical attachments
Role plays
Presentations
Tutorials
Question and answers
TEACHING MATERIALS
Chalk board
Overhead projector/transparencies
Slides and projector
Wall charts
Power Point projector
Hand outs
Flip charts
Human models
Realia
ASSESMENT
Objective structured clinical examination
Quizzes
Written examination
Case studies
Assignment
Observations
PRESCRIBED REFERENCE:
Mann C.V., Russell R.C.G. and Williams N.S. (), Bailey and Love’s
Short practice of Surgery Chapman and Hall Medical, London
Kings M., and Bewes, P., Primary Surgery (Trauma and Non
Trauma) (2000), Oxford Medical Publications, Oxford
Louis, S., David, J.W., and Selvadurai, J. (2001), Apley’s system of
Orthopaedics and Fractures, Vol. 1 and 2 , 8th Edition, Oxford University
Press Inc. New York
World Health Organisation (2003), Surgical Care at the District
Hospital, Interprint limited, Malta.
RECOMMENDED REFERENCE:
.
Hardy, J.D. Hardy's Text Book of Surgery. 2nd Edition, J.B. Lippincolt
Company, Philadelphia, 1988.
Macfarlane, D.A. and Thams, L.P, Textbook pf Surgery, Longman
Edinburgh, 1972.
Way, L.N. (Editor) Current Surgical Diagnosis and Treatment, 8th
edition, Mange Medical Book, Sanfrancisco, 1988.
