(Orthopedics) some of the modern surgical materials/instruments that improve prognoses by dr. kalimullah wardak
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History of classic amputations and the importance of surgeon's speed in the prognosis of procedures. SUTRUE, SPONGESTAN, bone wax
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(Orthopedics) some of the modern surgical materials/instruments that improve prognoses by dr. kalimullah wardak
- 1. HISTORY Robert Liston: • (1794 –1847) • A pioneering Scottish surgeon. Speedy amputator. • Initially anatomist then surgeon • He died of an aneurysm. 1 Robert Liston بسم هللا الرحمن الرحیم By: Dr. Kalimullah Wardak Department of Orthopedics and Traumatology WMAK Hospital, Kabul-Afghanistan
- 2. HISTORY Robert Liston: • (1794 –1847) • A pioneering Scottish surgeon. Speedy amputator. • Initially anatomist then surgeon • He died of an aneurysm. 2 Robert Liston
- 3. HISTORY… • Liston became the first Professor of Clinical Surgery at University College Hospital in London in 1835. • He also performed the first operation in Europe under modern anesthesia using ether, on 21 December 1846 at the University College Hospital. • He invented see-through isinglass sticking plaster, Bulldogs forceps (a type of locking artery forceps), and a leg splint used to stabilize dislocations and fractures of the femur, and still used today 3 Robert Liston
- 4. HISTORY… • Liston became the first Professor of Clinical Surgery at University College Hospital in London in 1835. • He also performed the first operation in Europe under modern anesthesia using ether, on 21 December 1846 at the University College Hospital. • He invented see-through isinglass sticking plaster, Bulldogs forceps (a type of locking artery forceps), and a leg splint used to stabilize dislocations and fractures of the femur, and still used today 4 Robert Liston
- 5. HISTORY… 1. Removal in 4 minutes of a 45-pound scrotal tumor, whose owner had to carry it round in a wheelbarrow. 2. Argument with his house-surgeon. Was the red, pulsating tumour in a small boy's neck a straightforward abscess of the skin, or a dangerous aneurism of the carotid artery? 3. Amputated the leg in 21⁄2 minutes, and testicles as well. 4. Amputated the leg in under 21⁄2 minutes, the patient and two others died. 5 Robert Liston
- 6. HISTORY… 1. Removal in 4 minutes of a 45-pound scrotal tumor, whose owner had to carry it round in a wheelbarrow. 2. Argument with his house-surgeon. Was the red, pulsating tumour in a small boy's neck a straightforward abscess of the skin, or a dangerous aneurism of the carotid artery? 3. Amputated the leg in 21⁄2 minutes, and testicles as well. 4. Amputated the leg in under 21⁄2 minutes, the patient and two others died. 6 Robert Liston
- 7. MORAL OF THE STORY: • Learn anatomy and function • Train your hands on cadavers: Practice makes things perfect • And for better accuracy, lesser errors: get used to high-tech instruments 7 summary
- 9. VOLUME REPLETION (INFUSION PUMP) Power infuser: 9 Resuscitation
- 11. NERVE BLOCK (NERVE MAPPER) 11 Nerve mapper
- 12. NERVE BLOCK… (HAND-HELD ULTRASOUND) 12 Ultrasonic guide
- 14. HEMOSTASIS… Spongostan: Sterile, water-insoluble, malleable, porcine gelatin absorbable sponge intended for hemostatic use by applying to a bleeding surface.1 Indicated to be able to be used with thrombin or sterile saline 14 Hemostasis
- 15. HEMOSTASIS… Spongostan: Sterile, water-insoluble, malleable, porcine gelatin absorbable sponge intended for hemostatic use by applying to a bleeding surface.1 Indicated to be able to be used with thrombin or sterile saline 15 Hemostasis
- 16. HEMOSTASIS… SealFoam®: is derived from purified plant starch, which goes through a proprietary engineering process that modifies the plant starch into an ultra-hydrophilic, adhesive forming hemostatic material. The material is biocompatible, non- pyrogenic, latex free, absorbable and contains no animal or human components, thereby eliminating risks associated with the transfer of animal and human pathogens. 16 Hemostasis
- 17. HEMOSTASIS… SealFoam®: is derived from purified plant starch, which goes through a proprietary engineering process that modifies the plant starch into an ultra-hydrophilic, adhesive forming hemostatic material. The material is biocompatible, non- pyrogenic, latex free, absorbable and contains no animal or human components, thereby eliminating risks associated with the transfer of animal and human pathogens. 17 Hemostasis
- 18. SEALFOAM VS SPONGOSTAN Spongostan™ is a porcine gelatin sponge and represents another version of a gelatin sponge. (See: Is SealFoam® a gelatin sponge?). Spongostan™ should not be used in patients with known allergies to porcine collagen. Patients with religious beliefs surrounding pork or bovine should be consulted prior to usage. Spongostan™ should be removed from the body to avoid the possibility of dislodgement of the device or compression of other nearby anatomic structures. SealFoam® can be used on patients with porcine allergies as SealFoam® contains no animal components. SealFoam® can be left in the body and will be absorbed within a few days. 18 Hemostasis
- 20. WOUND CLOSURE (SUTRUE SUTURING DEVICE) Sutrue: 20 Wound retention
- 21. WOUND CLOSURE…(SURGICAL STAPLER) Surgical stapler 21 Wound retention
- 22. WOUND CLOSURE… (STERI-STRIPS, ZIPPERS) 22 Wound retention
- 23. WOUND CLOSURE… (BIOGLUE) 23 Wound retention
- 24. 24
Editor's Notes
- Liston was noted for his skill in an era prior to anesthetics, when speed made a difference in terms of pain and survival. Liston received his education at the University of Edinburgh,
- Liston was noted for his skill in an era prior to anesthetics, when speed made a difference in terms of pain and survival. Liston received his education at the University of Edinburgh,
- 'Pooh!' Liston exclaimed impatiently. 'Whoever heard of an aneurism in one so young?' Flashing a knife from his waistcoat pocket, he lanced it. Houseman's note – 'Out leaped arterial blood, and the boy fell.' The patient died but the artery lives, in University College Hospital pathology museum, specimen No. 1256. (the patient died afterwards in the ward from hospital gangrene; they usually did in those pre-Listerian days). He amputated in addition the fingers of his young assistant (who died afterwards in the ward from hospital gangrene). He also slashed through the coat tails of a distinguished surgical spectator, who was so terrified that the knife had pierced his vitals he feignted from fright.
- 'Pooh!' Liston exclaimed impatiently. 'Whoever heard of an aneurism in one so young?' Flashing a knife from his waistcoat pocket, he lanced it. Houseman's note – 'Out leaped arterial blood, and the boy fell.' The patient died but the artery lives, in University College Hospital pathology museum, specimen No. 1256. (the patient died afterwards in the ward from hospital gangrene; they usually did in those pre-Listerian days). He amputated in addition the fingers of his young assistant (who died afterwards in the ward from hospital gangrene). He also slashed through the coat tails of a distinguished surgical spectator, who was so terrified that the knife had pierced his vitals he feignted from fright.
- John Snow was one of the first physicians to study and calculate dosages for the use of ether and chloroform as surgical anaesthetics, allowing patients to undergo surgical and obstetric procedures without the distress and pain they would otherwise experience. He designed the apparatus to safely administer ether to the patients and also designed a mask to administer chloroform.[16] He personally administered chloroform to Queen Victoria when she gave birth to the last two of her nine children, Leopold in 1853 and Beatrice in 1857 and was still not yet knighted,[17] leading to wider public acceptance of obstetric anaesthesia. Snow published an article on ether in 1847 entitled On the Inhalation of the Vapor of Ether.[ Snow was a skeptic of the then-dominant miasma theory that stated that diseases such as cholera and bubonic plague were caused by pollution or a noxious form of "bad air". The germ theory of disease had not yet been developed, so Snow did not understand the mechanism by which the disease was transmitted. His observation of the evidence led him to discount the theory of foul air. He first published his theory in an 1849 essay, On the Mode of Communication of Cholera,[21] followed by a more detailed treatise in 1855 incorporating the results of his investigation of the role of the water supply in the Soho epidemic of 1854.[22][23]
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- According to OSHA, there are between 600,000-800,000 needlestick injuries every year in the U.S. alone. As many as 500 million used needles are added to trash dumps and landfills every year as a result of vaccination. 75 million of those needles may be infected with blood borne illnesses.9 Needlestick injuries can expose healthcare workers to up to 20 different blood borne pathogens including HIV and hepatitis B and/or C. Each needlestick injury costs approximately $3,000 for lab fees, labor, post-exposure follow-ups, etc
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails
- Sanitation: The policy and practice of protecting health through hygienic measures Disinfection Disinfection: Eliminates most pathogens but not necessarily all types of microbes. Disinfection reduces the level of microbial contamination. Chemical disinfection does not kill spores, unlike chemical sterilization. Some common laboratory disinfectants include freshly prepared10% bleach and 70% ethanol. Sterilization A sterile surface/object is completely free of living microorganisms and viruses. Sterilization procedures kill all microorganisms. Methods used in sterilization procedures include heat, ethylene oxide gas, hydrogen peroxide gas, plasma, ozone, and radiation. Decontamination Decontamination renders an item or material safe to handle. The level of microbial contamination is reduced enough that it can be reasonably assumed free of risk of infection transmission. Sterilization, disinfection, and antisepsis are forms of decontamination. Antiseptics and disinfectants both kill microorganisms, and many people use the terms interchangeably. Adding to the confusion, antiseptics are sometimes called skin disinfectants. ... An antiseptic is applied to the body, while disinfectants are applied to nonliving surfaces, such as countertops and handrails