b. Surgery produces physical stress relative to the extent of the surgery and the
injury to the tissue involved. Surgical intervention may be for one or more reasons. The
following descriptors classify surgical procedures by purpose:
(1)
Ablative--removal of a diseased organ or structure (e.g., appendectomy).
(2)
Diagnostic--removal and examination of tissue (e.g., biopsy).
(3) Constructive--repair a congenitally malformed organ or tissue. (e.g.,
harelip; cleft palate repair).
(4) Reconstructive--repair or restoration of an organ or structure (e.g.,
colostomy; rhinoplasty, cosmetic improvement).
(5) Palliative--relief of pain (for example, rhizotomy--interruption of the nerve
root between the ganglion and the spinal cord).
(6) Transplant--transfer an organ or tissue from one body part to another, or
from one person to another, to replace a diseased structure, to restore function, or to
change appearance (for example, kidney, heart transplant; skin graft).
c. The physical stress of surgery is greatly magnified by the psychological stress.
Anxiety and worry use up energy that is needed for healing of tissue during the
postoperative period. One or more of the following may cause the patient psychological
stress.
(1)
Loss of a body part.
(2)
Unconsciousness and not knowing or being able to control what is
happening.
(3)
Pain.
(4)
Fear of death.
(5)
Separation from family and friends.
(6)
The effects of surgery on his lifestyle at home and at work.
(7)
Exposure of his body to strangers.
d. Surgical procedures usually combine several classifications and descriptors.
For example, a trauma patient may require major, reconstructive, emergency surgery.
Regardless of the risk, any surgery that imposes physical and psychological stress is
rarely considered "minor" by the patient.
MD0906
8-4