Procedure for suturing wounds or hecting actions - a brief medical study martinshaji
Wound closure techniques have evolved from the earliest development of suturing materials to comprise resources that include synthetic sutures, absorbables, staples, tapes, and adhesive compounds. The engineering of sutures in synthetic material along with standardization of traditional materials (eg, catgut, silk) has made for superior aesthetic results. Similarly, the creation of topical skin adhesives (the monomer 2-octyl cyanoacrylate), surgical staples, and tapes to substitute for sutures has supplemented the armamentarium of wound closure techniques. Aesthetic closure of a wound, whether traumatic or surgically induced, is based on knowledge of healing mechanisms and skin anatomy (see the image below), as well as an appreciation of suture material and closure technique. Choosing the proper materials and wound closure technique ensures optimal healing.
this is a brief study on different suturing techniques and tools used
please comment
thank u
Salivary gland tumors 12 (nx power lite) /certified fixed orthodontic courses...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document provides a summary of the history and types of needles and sutures used in surgery. It discusses key historical landmarks in suture development, including the earliest known medical records describing sutures from Ancient Egypt. It also outlines the development of mass-produced sterile catgut sutures in the late 19th century. The document describes the anatomy of surgical needles and various suture materials, sizes, and packaging. It compares absorbable and non-absorbable, natural and synthetic, monofilament and braided suture types. Finally, it discusses ideal suture characteristics and factors to consider when selecting a suture for a procedure.
Surgical staplers are medical devices that can be used instead of sutures to close wounds and incisions. They close large wounds or incisions more quickly than sutures and are less painful for patients. Surgical staplers come in reusable and disposable models and resemble construction staplers. They are used internally to seal tissue during surgery and are useful for minimally invasive procedures. Surgical staples are typically made of stainless steel or titanium and are designed to insert and close multiple staples at once to quickly seal wounds and prevent bleeding.
The document discusses various energy sources used in surgery, including electrosurgery, cryotherapy, infrared coagulation, ultrasound, lasers, and ultrasonic knives. It provides details on how each method works, such as how electrosurgery uses radiofrequency energy to cut and coagulate tissue, cryotherapy uses freezing to ablate tissue, and lasers emit coherent light that can be used for cutting and coagulation. The document also discusses advantages and disadvantages of different energy sources as well as complications that can occur.
The document discusses different types of suture materials and techniques. It describes the properties of ideal suture materials and categorizes them as absorbable or non-absorbable. Common natural and synthetic materials are listed, along with their characteristics. Absorbable materials like catgut and polyglycolide are degraded over time in the body. Non-absorbable materials like silk require later removal. The document also covers suturing instruments, needles, and interrupted versus continuous suturing techniques.
Basic surgical skills^j by dr mehraj ud deen kulooMehraj Din
The document provides an overview of basic surgical skills, including principles of asepsis such as hand washing, gowning, and gloving. It discusses skin preparation and draping, and handling of common surgical instruments such as scalpels, scissors, forceps, and retractors. Guidelines are provided for skin incisions, wound closure techniques including suturing methods and knots, and alternatives to sutures. The document also covers surgical needles and their classification. The overall aim is to understand principles for maintaining sterility and performing common surgical procedures.
The origins of surgery can be traced back many centuries, with practitioners using various materials and techniques for closing wounds. Ancient methods included using ants or thorns to close wounds. In more modern times, catgut made from sheep intestine was used. Post-World War II, sutures were developed with needles attached to reduce tissue trauma. Sutures are classified based on material and absorbability, and appropriate suture selection depends on factors like the tissue and wound characteristics.
Procedure for suturing wounds or hecting actions - a brief medical study martinshaji
Wound closure techniques have evolved from the earliest development of suturing materials to comprise resources that include synthetic sutures, absorbables, staples, tapes, and adhesive compounds. The engineering of sutures in synthetic material along with standardization of traditional materials (eg, catgut, silk) has made for superior aesthetic results. Similarly, the creation of topical skin adhesives (the monomer 2-octyl cyanoacrylate), surgical staples, and tapes to substitute for sutures has supplemented the armamentarium of wound closure techniques. Aesthetic closure of a wound, whether traumatic or surgically induced, is based on knowledge of healing mechanisms and skin anatomy (see the image below), as well as an appreciation of suture material and closure technique. Choosing the proper materials and wound closure technique ensures optimal healing.
this is a brief study on different suturing techniques and tools used
please comment
thank u
Salivary gland tumors 12 (nx power lite) /certified fixed orthodontic courses...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document provides a summary of the history and types of needles and sutures used in surgery. It discusses key historical landmarks in suture development, including the earliest known medical records describing sutures from Ancient Egypt. It also outlines the development of mass-produced sterile catgut sutures in the late 19th century. The document describes the anatomy of surgical needles and various suture materials, sizes, and packaging. It compares absorbable and non-absorbable, natural and synthetic, monofilament and braided suture types. Finally, it discusses ideal suture characteristics and factors to consider when selecting a suture for a procedure.
Surgical staplers are medical devices that can be used instead of sutures to close wounds and incisions. They close large wounds or incisions more quickly than sutures and are less painful for patients. Surgical staplers come in reusable and disposable models and resemble construction staplers. They are used internally to seal tissue during surgery and are useful for minimally invasive procedures. Surgical staples are typically made of stainless steel or titanium and are designed to insert and close multiple staples at once to quickly seal wounds and prevent bleeding.
The document discusses various energy sources used in surgery, including electrosurgery, cryotherapy, infrared coagulation, ultrasound, lasers, and ultrasonic knives. It provides details on how each method works, such as how electrosurgery uses radiofrequency energy to cut and coagulate tissue, cryotherapy uses freezing to ablate tissue, and lasers emit coherent light that can be used for cutting and coagulation. The document also discusses advantages and disadvantages of different energy sources as well as complications that can occur.
The document discusses different types of suture materials and techniques. It describes the properties of ideal suture materials and categorizes them as absorbable or non-absorbable. Common natural and synthetic materials are listed, along with their characteristics. Absorbable materials like catgut and polyglycolide are degraded over time in the body. Non-absorbable materials like silk require later removal. The document also covers suturing instruments, needles, and interrupted versus continuous suturing techniques.
Basic surgical skills^j by dr mehraj ud deen kulooMehraj Din
The document provides an overview of basic surgical skills, including principles of asepsis such as hand washing, gowning, and gloving. It discusses skin preparation and draping, and handling of common surgical instruments such as scalpels, scissors, forceps, and retractors. Guidelines are provided for skin incisions, wound closure techniques including suturing methods and knots, and alternatives to sutures. The document also covers surgical needles and their classification. The overall aim is to understand principles for maintaining sterility and performing common surgical procedures.
The origins of surgery can be traced back many centuries, with practitioners using various materials and techniques for closing wounds. Ancient methods included using ants or thorns to close wounds. In more modern times, catgut made from sheep intestine was used. Post-World War II, sutures were developed with needles attached to reduce tissue trauma. Sutures are classified based on material and absorbability, and appropriate suture selection depends on factors like the tissue and wound characteristics.
Electrosurgery uses high-frequency alternating electrical current to cut, coagulate, or vaporize tissue. It allows for precise cuts with limited blood loss. The current is delivered via an electrosurgery generator to an active electrode and returns through the patient to a neutral electrode. Different waveforms and modes, such as cut, coagulate, and blend, are used depending on the desired tissue effect. Safety features monitor for excess heat buildup and electrode detachment to prevent patient injury.
Laparoscopic surgery provides several advantages over traditional open surgery such as less pain, shorter hospital stays, faster recovery times, and smaller incisions resulting in less scarring. Key aspects of laparoscopic surgery include creating pneumoperitoneum using CO2 gas insufflation to provide working space, performing surgery using long instruments inserted through small incisions, and relying on camera systems to provide indirect visualization. Common basic laparoscopic procedures include cholecystectomy and appendicectomy, while more advanced procedures involve organs in the abdomen, pelvis, chest and for hernia repairs. Risks include potential complications from the pneumoperitoneum such as gas embolism, organ injury, bleeding, infection and hernia formation.
HARMONIC SYNERGY® Blades use high-frequency mechanical vibration to simultaneously cut and coagulate at the same time, sealing vessels at lower temperatures than electrosurgery:
Precise: Minimal lateral thermal tissue damage for safer dissection near vital structures
Reliable: Seals and divides vessels <= 2mm, as well as lymphatics
Versatile: Cuts, coagulates and dissects, reducing instrument exchanges
Laparoscopy involves using small incisions and a camera to perform surgery in the abdomen or pelvis. It requires specialized instruments including trocars for instrument insertion, graspers and forceps for tissue manipulation, scissors and staplers for cutting and sealing, and electrosurgical devices. Key components of laparoscopy are insufflation of carbon dioxide gas, optical devices for visualization, and various instruments tailored for intra-abdominal use and manipulation of delicate tissues during minimally invasive procedures.
This document provides an overview of suturing techniques and knot tying. It discusses the history of suturing dating back to ancient Egypt, different suture materials and needles, wound healing processes, and various suturing techniques like simple interrupted, vertical mattress, and subcuticular stitches. It emphasizes the importance of mastering suturing skills like tying secure square knots using proper two-handed techniques to aid in wound healing and produce good cosmetic results.
This PPT is oriented mainly towards sutures / needles & knots. Their types, uses and techniques of using it. Mainly for MBBS students as well as other medically oriented people.
Thermal cauterization uses electromagnetic currents to generate heat in body tissues. It can be used physically to treat deeper lesions or surgically to cauterize blood vessels and destroy abnormal growths. The process involves an electrosurgical generator, active electrode, patient return electrode, and forming an electrical circuit. Different frequencies are used for different applications like nerve stimulation or electrosurgery. Bipolar cauterization involves both electrodes at the surgical site while monopolar uses one active electrode and a patient return elsewhere. Settings like waveform, power, and time determine cutting versus coagulation effects. Safety involves avoiding interference with devices and preventing burns.
This document provides an overview of basic surgical skills including objectives, incision techniques, suturing, wound closure methods, suture materials, staples, clips, tissue glues, needles, and knot tying. The key points covered are skin incision using scalpels, gaping wound edges for swelling, interrupted versus continuous suturing, absorbable versus non-absorbable suture materials, and tying secure knots using instruments to avoid injury.
The passage discusses the importance of teaching children about money at a young age through age-appropriate activities like allowances, savings jars, and helping with family shopping. Learning good financial habits early can set kids up for financial success as adults by developing an understanding of earning, spending, saving and the value of a dollar. Hands-on learning about money through real world activities can instill lifelong skills for managing personal finances responsibly.
This document discusses electrosurgery, which uses high frequency electrical current to cut, coagulate, desiccate, or fulgurate tissue. It explains how electrosurgical units work and some of the risks of electrosurgery, such as electrical burns and transmission of infection. Safety measures are outlined like using the lowest power setting, intermittent activation, and avoiding activation near other instruments to prevent complications.
This document provides an overview of day care or ambulatory surgery. It discusses the history and development of day care surgery. Key points include that day care surgery aims to have patients discharged on the same day of surgery. Patient selection involves assessing medical, social and surgical factors to identify appropriate candidates. The document also outlines common procedures performed in day care settings and considerations for anesthesia, analgesia, and post-operative recovery and discharge criteria. The overall goal of day care surgery is to provide surgical care without an overnight hospital stay when possible.
Presentation describing the modes of diathermy used in modern day surgery, its working principles, complications associated with diathermy use, precautions to be taken while using diathermy. Valuable for undergraduate students and post graduate residents of general surgery.
Surgical retractors are instruments used to separate the edges of an incision and hold back underlying tissues, allowing access to body parts. There are two main types - hand retractors which must be held manually, and self-retaining retractors which use mechanisms like screws or clamps to hold tissues independently. Common hand retractors include Senn, Army-Navy, Ribbon, Hohmann, Farabeuf, Meyerding, Deaver, and Richardson retractors used in various procedures. Examples of self-retaining retractors are Weitlaner, Balfour Abdominal, Finochietto Rib, Hip, Gelpi, Joll, and Omni-Tract Wishbone retract
Electro-surgery uses high frequency electric current to cut, coagulate, desiccate, or fulgurate tissue. The generator converts electricity to high frequency waveforms over 30,000 cycles per second. Tissue effects are regulated by current, power, modulation level, electrode shape and condition, cutting speed, and tissue properties. Monopolar electro-surgery uses an active electrode at the surgical site and a return electrode elsewhere to complete the circuit. Bipolar electro-surgery contains active and return electrodes within the instrument to limit current flow. Proper use and maintenance of equipment, along with correct patient positioning and electrode application, are necessary to avoid risks like unintended burns.
This document introduces common surgical instruments used in oral and maxillofacial surgery. It describes scalpel blades, periosteal elevators, retractors, forceps for grasping tissue and controlling hemorrhage, bone cutting instruments like rongeurs and chisels, instruments for removing soft tissue from bone, suturing tools like needle holders and suture materials, dental extraction instruments like elevators and forceps, and various trays used in oral surgery procedures. The purpose is to familiarize residents with the basic instrumentation required to perform routine dental extractions and other oral surgical operations.
Dr. Ashly Alexander is an ear, nose and throat physician practicing at Gandhi Medical College in Bhopal. The CUSA console provides ultrasonic energy to the handpiece which contains a piezoelectric transducer that converts it to mechanical vibrations conducted to the surgical tip. This allows for tissue fragmentation, irrigation and aspiration during ENT procedures.
Instruments in major oral and maxillofacial surgeryDrKamini Dadsena
A surgical instrument is a specially designed tool or device for performing specific actions and carrying out desired effects during surgery or operations.
Surgical instruments are specially designed tools used to modify tissue or provide access during surgery. Common instruments include scalpels, forceps, scissors, needles, and retractors. Proper handling is important for safety, efficiency of movement, and to prevent damage to tissues and instruments. Scalpels should be held like a pen for precise cuts. Needles should be held two-thirds from the tip. Scissors and forceps are held with fingers in the rings. Hemostats are used gently to clamp vessels. Electrocautery uses a pen grip with the index finger as a trigger. Proper handling allows surgery to be facilitated with minimal tissue damage.
This document provides information on suture materials and techniques. It discusses the anatomy of skin, definitions of suturing terms, goals of suturing, ideal suture requirements, suturing armamentarium including needles and needle holders. It also covers various suture materials like catgut, silk, nylon, linen; their properties, manufacturing process, sterilization methods and uses. Principles of suture selection and different suturing techniques are also explained.
Electrosurgery uses high-frequency alternating electrical current to cut, coagulate, or vaporize tissue. It allows for precise cuts with limited blood loss. The current is delivered via an electrosurgery generator to an active electrode and returns through the patient to a neutral electrode. Different waveforms and modes, such as cut, coagulate, and blend, are used depending on the desired tissue effect. Safety features monitor for excess heat buildup and electrode detachment to prevent patient injury.
Laparoscopic surgery provides several advantages over traditional open surgery such as less pain, shorter hospital stays, faster recovery times, and smaller incisions resulting in less scarring. Key aspects of laparoscopic surgery include creating pneumoperitoneum using CO2 gas insufflation to provide working space, performing surgery using long instruments inserted through small incisions, and relying on camera systems to provide indirect visualization. Common basic laparoscopic procedures include cholecystectomy and appendicectomy, while more advanced procedures involve organs in the abdomen, pelvis, chest and for hernia repairs. Risks include potential complications from the pneumoperitoneum such as gas embolism, organ injury, bleeding, infection and hernia formation.
HARMONIC SYNERGY® Blades use high-frequency mechanical vibration to simultaneously cut and coagulate at the same time, sealing vessels at lower temperatures than electrosurgery:
Precise: Minimal lateral thermal tissue damage for safer dissection near vital structures
Reliable: Seals and divides vessels <= 2mm, as well as lymphatics
Versatile: Cuts, coagulates and dissects, reducing instrument exchanges
Laparoscopy involves using small incisions and a camera to perform surgery in the abdomen or pelvis. It requires specialized instruments including trocars for instrument insertion, graspers and forceps for tissue manipulation, scissors and staplers for cutting and sealing, and electrosurgical devices. Key components of laparoscopy are insufflation of carbon dioxide gas, optical devices for visualization, and various instruments tailored for intra-abdominal use and manipulation of delicate tissues during minimally invasive procedures.
This document provides an overview of suturing techniques and knot tying. It discusses the history of suturing dating back to ancient Egypt, different suture materials and needles, wound healing processes, and various suturing techniques like simple interrupted, vertical mattress, and subcuticular stitches. It emphasizes the importance of mastering suturing skills like tying secure square knots using proper two-handed techniques to aid in wound healing and produce good cosmetic results.
This PPT is oriented mainly towards sutures / needles & knots. Their types, uses and techniques of using it. Mainly for MBBS students as well as other medically oriented people.
Thermal cauterization uses electromagnetic currents to generate heat in body tissues. It can be used physically to treat deeper lesions or surgically to cauterize blood vessels and destroy abnormal growths. The process involves an electrosurgical generator, active electrode, patient return electrode, and forming an electrical circuit. Different frequencies are used for different applications like nerve stimulation or electrosurgery. Bipolar cauterization involves both electrodes at the surgical site while monopolar uses one active electrode and a patient return elsewhere. Settings like waveform, power, and time determine cutting versus coagulation effects. Safety involves avoiding interference with devices and preventing burns.
This document provides an overview of basic surgical skills including objectives, incision techniques, suturing, wound closure methods, suture materials, staples, clips, tissue glues, needles, and knot tying. The key points covered are skin incision using scalpels, gaping wound edges for swelling, interrupted versus continuous suturing, absorbable versus non-absorbable suture materials, and tying secure knots using instruments to avoid injury.
The passage discusses the importance of teaching children about money at a young age through age-appropriate activities like allowances, savings jars, and helping with family shopping. Learning good financial habits early can set kids up for financial success as adults by developing an understanding of earning, spending, saving and the value of a dollar. Hands-on learning about money through real world activities can instill lifelong skills for managing personal finances responsibly.
This document discusses electrosurgery, which uses high frequency electrical current to cut, coagulate, desiccate, or fulgurate tissue. It explains how electrosurgical units work and some of the risks of electrosurgery, such as electrical burns and transmission of infection. Safety measures are outlined like using the lowest power setting, intermittent activation, and avoiding activation near other instruments to prevent complications.
This document provides an overview of day care or ambulatory surgery. It discusses the history and development of day care surgery. Key points include that day care surgery aims to have patients discharged on the same day of surgery. Patient selection involves assessing medical, social and surgical factors to identify appropriate candidates. The document also outlines common procedures performed in day care settings and considerations for anesthesia, analgesia, and post-operative recovery and discharge criteria. The overall goal of day care surgery is to provide surgical care without an overnight hospital stay when possible.
Presentation describing the modes of diathermy used in modern day surgery, its working principles, complications associated with diathermy use, precautions to be taken while using diathermy. Valuable for undergraduate students and post graduate residents of general surgery.
Surgical retractors are instruments used to separate the edges of an incision and hold back underlying tissues, allowing access to body parts. There are two main types - hand retractors which must be held manually, and self-retaining retractors which use mechanisms like screws or clamps to hold tissues independently. Common hand retractors include Senn, Army-Navy, Ribbon, Hohmann, Farabeuf, Meyerding, Deaver, and Richardson retractors used in various procedures. Examples of self-retaining retractors are Weitlaner, Balfour Abdominal, Finochietto Rib, Hip, Gelpi, Joll, and Omni-Tract Wishbone retract
Electro-surgery uses high frequency electric current to cut, coagulate, desiccate, or fulgurate tissue. The generator converts electricity to high frequency waveforms over 30,000 cycles per second. Tissue effects are regulated by current, power, modulation level, electrode shape and condition, cutting speed, and tissue properties. Monopolar electro-surgery uses an active electrode at the surgical site and a return electrode elsewhere to complete the circuit. Bipolar electro-surgery contains active and return electrodes within the instrument to limit current flow. Proper use and maintenance of equipment, along with correct patient positioning and electrode application, are necessary to avoid risks like unintended burns.
This document introduces common surgical instruments used in oral and maxillofacial surgery. It describes scalpel blades, periosteal elevators, retractors, forceps for grasping tissue and controlling hemorrhage, bone cutting instruments like rongeurs and chisels, instruments for removing soft tissue from bone, suturing tools like needle holders and suture materials, dental extraction instruments like elevators and forceps, and various trays used in oral surgery procedures. The purpose is to familiarize residents with the basic instrumentation required to perform routine dental extractions and other oral surgical operations.
Dr. Ashly Alexander is an ear, nose and throat physician practicing at Gandhi Medical College in Bhopal. The CUSA console provides ultrasonic energy to the handpiece which contains a piezoelectric transducer that converts it to mechanical vibrations conducted to the surgical tip. This allows for tissue fragmentation, irrigation and aspiration during ENT procedures.
Instruments in major oral and maxillofacial surgeryDrKamini Dadsena
A surgical instrument is a specially designed tool or device for performing specific actions and carrying out desired effects during surgery or operations.
Surgical instruments are specially designed tools used to modify tissue or provide access during surgery. Common instruments include scalpels, forceps, scissors, needles, and retractors. Proper handling is important for safety, efficiency of movement, and to prevent damage to tissues and instruments. Scalpels should be held like a pen for precise cuts. Needles should be held two-thirds from the tip. Scissors and forceps are held with fingers in the rings. Hemostats are used gently to clamp vessels. Electrocautery uses a pen grip with the index finger as a trigger. Proper handling allows surgery to be facilitated with minimal tissue damage.
This document provides information on suture materials and techniques. It discusses the anatomy of skin, definitions of suturing terms, goals of suturing, ideal suture requirements, suturing armamentarium including needles and needle holders. It also covers various suture materials like catgut, silk, nylon, linen; their properties, manufacturing process, sterilization methods and uses. Principles of suture selection and different suturing techniques are also explained.
This document describes various types of surgical instruments used for clamping and occluding, specifically focusing on clamping instruments. It defines crushing clamps that are designed to crush tissue versus non-crushing clamps used to occlude tissue temporarily. The document outlines different types of haemostatic clamps including mosquito haemostats, Kelly haemostats, and right angle haemostats. It also discusses atraumatic non-crushing clamps and bulldog clamps. The anatomy of instruments is defined including joints, shanks, ratchets, finger rings, and jaws. Methods for passing instruments to surgeons are provided.
general surgery Instruments-Revision copy.pptxm7sd4y47jv
This document describes various common surgical instruments and their uses. It discusses the parts of instruments like finger bows and shafts. It provides details on specific instruments like sponge holding forceps, towel clips, Bard Parker handles, surgical blades, Allis forceps, dissection forceps, artery forceps, needle holders, scissors, retractors, and Desjardins forceps. The key functions and applications of each instrument are outlined.
The document discusses various knot tying techniques, suture materials, and methods for performing intestinal anastomoses. Key topics include types of knots (square knot, surgeon's knot), suture characteristics (absorbability, strength), intestinal anastomosis techniques (Lembert, Senn), and principles such as adequate exposure and a tension-free anastomosis. Suture materials are typically absorbable polymers mounted on atraumatic needles."
Sutures are medical devices used to close wounds and help healing. There are two main types - absorbable and non-absorbable. Absorbable sutures dissolve in the body over time and don't require removal, while non-absorbable sutures are permanent and must be removed later. Sutures come in a variety of materials like catgut, silk, and nylon, and are chosen based on factors like wound location and depth. Surgical needles also vary in shape, size, and point type to best facilitate suturing different tissues with minimal trauma.
Instrumentation for Basic Oral Surgery Dr.Ali Mohammed AbuTrabAli Mohammed AbuTrab
This document describes various instruments used in oral surgery. It discusses scalpels and blades for incising tissue, periosteal elevators for reflecting tissue, retractors for providing access and visibility, forceps for grasping and removing tissue, rongeurs and burs for removing bone, curettes for removing pathological tissue, suture needles and materials for closing wounds. The key instruments and their uses are outlined for each surgical step and tissue management task.
The document discusses surgical dressings and bandages. It defines a surgical dressing as a sterile pad or compress applied to a wound to promote healing, while a bandage is material used to support, cover, immobilize, or exert pressure on part of the body. The document outlines the purpose of bandaging, considerations before bandaging such as the type and patient comfort, different types of bandages based on material and structure, proper bandaging techniques including different turns, important site-specific bandages, and bandage removal.
This document provides an overview of basic orthopedic surgical instruments. It describes the main categories of instruments used in orthopedic surgeries, including forceps, scissors, retractors, periosteal elevators, rongeurs, nerve hooks, curettes, and dissectors/probes. For each category, it provides details on specific instrument types, including their names, parts, uses, and images. The summary focuses on the instrument categories and does not include details on specific instrument names or uses.
Classification of surgical instruments.pptxahsanashfaq19
This document summarizes different types of surgical instruments used in procedures. It describes retracting instruments like Deaver and Richardson retractors which are used to hold back tissues. Cutting instruments include scalpels with different blade and handle combinations for various tissues. Scissors like Mayo and Metzenbaum are used for cutting sutures, heavy tissues, and delicate tissues. Bone cutters come in unpowered, reciprocating, sonic, and specialized forms like costotomes and are used for cutting and reshaping bones. Grasping instruments are also discussed.
This document provides information on the manufacturing process and types of surgical instruments. It discusses the materials used, key parts of instruments like jaws and handles. Different categories of instruments are outlined including cutting instruments, grasping instruments, hemostatic instruments, and retractors. Specific instruments are described in detail like scalpels, scissors, forceps, needle holders. Fine vascular instruments for microsurgery are also covered. The document aims to educate on the variety of instruments used in surgery and their functions.
Dr. T.C. Singel discusses various dissection techniques and the instruments used. He defines different types of dissections like comprehensive study dissection, composite study dissection, and unistructural dissection. He describes the proper use and parts of various instruments for dissection including scalpels, forceps, scissors, saws, bone cutters, and needles. Safety measures for the dissection lab are also outlined such as using protective clothing and ensuring proper ventilation.
This document discusses sutures and needles used in surgery. It defines sutures as stitches used to hold tissues together during healing. It classifies sutures as absorbable or non-absorbable and discusses common materials. Sutures must be strong, non-toxic, and flexible. The document also describes different needle shapes and types, including atraumatic needles permanently attached to sutures for ease of use with less tissue trauma. Proper selection, storage, and care of sutures and needles is important for effective wound closure and patient safety.
Sutures and suturing are used to approximate wound edges and promote healing. The goals of suturing include wound closure with adequate tension to prevent dead space but not cause ischemia, maintain hemostasis, permit primary intention healing, reduce pain, and provide support until tissue has healed. An ideal suture material is easy to use, has good knot security, causes minimal tissue reaction, resists bacteria, is strong but small, and affordable. Suture materials are categorized as absorbable or non-absorbable, natural or synthetic, and monofilament or multifilament. Common suture techniques include simple interrupted stitches, mattress stitches, and subcuticular stitches.
The document describes various surgical instruments including forceps, scissors, needle holders, and scalpels. It provides details on their uses, parts, and sizes. Some key instruments summarized are:
1. Sponge holding forceps which are long and straight with round fenestrated ends used to hold antiseptic materials.
2. Cheatle forceps which are large and heavy with serrated blades used to safely transport sterile items between trays.
3. Needle holders which have serrated tips and a box lock close to the tip for grasping needles during suturing.
4. Scalpel handles which come in different sizes to attach interchangeable surgical blades for cutting tasks.
This document provides an overview of suture materials and basic orthopaedic instruments used in surgery. It discusses the ideal properties of suture materials and classifications of sutures as absorbable or non-absorbable. Specific suture types are described such as polyglycolic acid, polyglactin 910, surgical gut, polydioxanone and polypropylene. Basic orthopaedic instruments include retractors, forceps, bone levers and scissors. Common retractors discussed are Mayo, Beckman, Charnley and Volkmann. Forceps aid in holding, positioning and compressing bone.
The document summarizes suture materials used in surgery. It discusses the history of sutures and how they have evolved from materials like hair, cotton and silk to modern synthetic absorbable and non-absorbable materials. The key phases of wound healing and factors influencing suture selection are outlined. Different types of surgical needles and their uses are described. Absorbable sutures like catgut and synthetic materials like Vicryl and PDS are explained in terms of their composition and absorption time. Characteristics of suture materials including strength, tensile behavior and biological response are highlighted.
This document defines various terms related to maintaining surgical instruments and apparatus. It describes the different types of instruments used for tasks like cutting, dissecting, grasping tissues, clamping blood vessels, retracting tissues, and improving visualization. It provides examples of specific instruments that fall into each category, such as scalpels, scissors, forceps, retractors, and hemostats. It also outlines the key parts of instruments like blades, handles, jaws, and locks. Maintaining efficiency and preventing failure of these tools is important for ensuring safe and effective surgical procedures.
Similar to Basics of instrument and tissue handling.pptx (20)
Hypertrophic pyloric stenosis is a condition in infants where the pyloric muscle thickens, causing projectile vomiting. It is usually diagnosed between 4-8 weeks of age when vomiting becomes frequent and forceful. On physical exam, doctors may feel an olive-sized pyloric tumor. Ultrasound confirms the diagnosis by showing thickened pyloric muscles. The standard treatment is Ramstedt pyloromyotomy surgery to cut the thickened pyloric muscle. After resuscitation from dehydration, the surgery cures the condition and babies can resume feedings within a day.
Nutritional support is important for surgical patients to prevent complications. Three key aspects of nutritional support discussed are:
1) Enteral nutrition is preferred over parenteral nutrition when possible, with a hierarchy of feeding methods from oral to tube feeding to be followed.
2) Malnutrition increases surgical risk, so nutritional screening and optimization of intake, including supplementation, is important pre-and post-operatively.
3) Close monitoring of caloric and protein intake as well as electrolytes and glucose is needed for patients receiving enteral or parenteral nutrition support.
This document discusses fluid and electrolyte management. It covers fluid compartments in the body, reasons for fluid prescription including resuscitation, maintenance and replacement. It describes different types of intravenous fluids including crystalloids like normal saline and Hartmann's solution, and colloids. Factors to consider when prescribing fluids like daily requirements, fluid status assessment, correcting deficits and replacing ongoing losses are outlined. Close monitoring of fluid balance is emphasized.
This document provides an overview of concussion including:
- Definitions of concussion and its symptoms and signs in the acute phase.
- Risk factors, assessment tools like SCAT3, and typical findings.
- Management including return to play guidelines in a 5-step progression and treatment of post-concussion syndrome.
- Rare and serious conditions like second impact syndrome and chronic traumatic encephalopathy are also discussed.
This document provides an overview of chronic subdural hematoma (CSDH), including its definition, epidemiology, risk factors, pathophysiology, clinical presentation, management, and outcomes. CSDH is defined as an abnormal collection of liquefied blood underneath the dura matter that can compress brain tissue and cause neurological symptoms, typically occurring 21 or more days after injury. Risk factors include advanced age, coagulopathies, head trauma, alcohol abuse, and conditions increasing falls risk. Treatment involves surgical evacuation of the hematoma using various burr hole or craniotomy techniques, with the goal of relieving pressure and allowing brain re-expansion to improve symptoms.
Ascariasis is caused by the roundworm Ascaris and is one of the most common parasitic infections worldwide. It is transmitted through ingestion of Ascaris eggs from contaminated soil or food. The worms mature in the intestines and females can produce hundreds of thousands of eggs daily that are passed in feces. While often asymptomatic, ascariasis can cause abdominal pain and complications when worms migrate to other organs. Diagnosis is made by identifying eggs in stool samples under microscopy. Treatment involves anthelmintic medications while prevention relies on improved sanitation and hygiene. A study in Rwanda found 18% of ascariasis cases led to surgical complications like bowel obstruction and perforation requiring interventions like enterotomy.
This document discusses cellular neurotransmitters, receptors, and pharmacology of drugs used to treat neurological disorders. It provides background on the history of neuroscience research from ancient times through the 20th century, when scientists discovered that neurons communicate by releasing chemical neurotransmitters. Over 100 neurotransmitters have been identified. Neurotransmitters act on receptors, which are proteins on receiving cells that detect neurotransmitters. There are two main types of receptors: ionotropic receptors which are ligand-gated ion channels, and metabotropic receptors which are G-protein coupled receptors. The document also discusses the process of neurotransmission, receptor pharmacology, and consequences of neurotransmitter imbalances in the brain.
CT scans are useful for evaluating paranasal sinuses. Key anatomical structures include the ostiomeatal complex, ethmoid air cells, and thin bones surrounding the sinuses. A systematic approach is needed to identify variations that increase surgical risk, such as a dehiscent lamina papyracea or Onodi cell extending to the optic nerve. Interpreting CT scans is important for surgical planning to safely treat sinusitis, trauma, or tumors while avoiding sensitive structures like the carotid artery and optic nerve.
1. The document discusses higher cortical functions including language, vision, object recognition, and awareness, which are carried out by the association cortex.
2. It describes several cortical areas including the primary motor cortex, premotor cortex, motor eye fields, Broca's area, prefrontal cortex, sensory areas, auditory cortex, visual cortex, and language areas.
3. For each area, the location, blood supply, function, and effects of lesions are outlined. The processing of written and spoken language is also summarized.
The skull contains 22 bones that form the cranium and protect the brain, sensory organs, and entrances to the respiratory and digestive systems. The cranium contains flat bones that form the calvaria and irregular bones that form the cranial base. Several cranial bones contain air spaces that lighten the skull. The brain is divided into five main divisions - the telencephalon, diencephalon, mesencephalon, metencephalon, and myelencephalon. The telencephalon contains the cerebral hemispheres and basal ganglia. Each hemisphere is divided into four main lobes - frontal, parietal, temporal, and occipital.
Myelomeningocele is a congenital defect where the vertebral arches fail to close, resulting in a sac extending from the spinal column containing neural tissue and cerebrospinal fluid. It occurs in approximately 1-2 per 1000 live births. Risk factors include low maternal folic acid, certain genetic factors, and exposure to environmental toxins. Clinical features depend on the level of spinal cord involvement and may include paralysis, bladder and bowel dysfunction. Diagnosis is typically made via prenatal ultrasound or MRI. Treatment involves surgical repair shortly after birth to prevent further neurological damage and lifelong multidisciplinary management. Prevention focuses on women consuming adequate folic acid before and during early pregnancy.
This document discusses spinal nerve root entrapment and spinal cord compression. It begins by describing the anatomy of the spinal cord and roots. It then discusses various causes of spinal cord compression including traumatic, inflammatory, neoplastic, degenerative, and vascular etiologies. Signs and symptoms of spinal cord compression include pain, progressive motor weakness, sensory disturbance, and sphincteric disturbance. Radiological investigations and treatments are also summarized. Spinal nerve root entrapment can result from disk herniation, trauma, or degeneration and causes radicular pain. Diagnosis involves tests like straight leg raise and imaging modalities like MRI. Treatment focuses on conservative measures like medication, physical therapy, and injections.
Traumatic brain injury (TBI) is caused by external force to the head resulting in brain dysfunction. Globally there are millions of TBI cases annually. The leading causes are road traffic incidents, falls, and assaults. In Rwanda, a study found an incidence of 234 TBIs per 100,000 people in Kigali, with the majority being mild TBIs from traffic accidents. Primary injuries occur at impact and secondary injuries can develop from factors like hypoxia and raised intracranial pressure. Imaging helps classify injuries as focal like fractures or contusions, or diffuse like diffuse axonal injury. The main clinical challenges are managing raised ICP and treating hematomas surgically if needed to prevent herniation.
This document discusses testicular cancer and Wilms tumor.
For testicular cancer, it defines the condition, discusses epidemiology such as affecting men aged 15-35 most commonly, and covers anatomy, arterial supply, venous drainage, lymphatic drainage, predisposing factors, types like seminoma, spread patterns, clinical features, diagnostic modalities like blood tests and imaging, clinical staging, and management including surgery and chemotherapy.
For Wilms tumor, it defines the condition, discusses epidemiology such as affecting children under 5 most commonly, etiology involving genetic factors, clinical features like abdominal mass, diagnostic evaluation using imaging and labs, staging depending on tumor extent, and multimodal management with surgery, radiation, and
- Electrosurgery, also known as diathermy, uses high frequency alternating current to cut and coagulate tissue during surgical operations. It was first developed in the 1920s and has since become widely used, though it also carries risks if not used properly.
- The key components of an electrosurgical system are the generator, handpiece, cables, electrodes, dispersive pad, and foot pedal. It works by converting normal frequency current to high frequency current, which allows ion exchange and heat generation to cut and coagulate tissue.
- Monopolar electrosurgery uses the patient's body as part of the circuit, while bipolar focuses the current between instrument tips. Risks include burns
Lung contusion is when, as a result of chest trauma, there is direct or indirect damage of the parenchyma of the lung that leads to oedema or alveolar haematoma and loss of physiological structure and function of the lung.
Acute respiratory distress syndrome (ARDS) is an acute, diffuse, inflammatory form of lung injury that is associated with a variety of etiologies.
Adult intussusception is rare, accounting for 1% of small bowel obstructions. It is usually caused by an underlying pathological lead point like a tumor. CT imaging is the most sensitive test for diagnosis and can identify potential lead points. Presenting symptoms are nonspecific like abdominal pain but complications from delay in diagnosis or treatment include bowel ischemia, perforation and sepsis. Surgical intervention is usually required for definitive treatment and pathology diagnosis given the high incidence of malignancy as the lead point.
Management of neck masses! This topic was presented by Rutayisire François Xavier during his rotation in ENT department at Kigali university teaching hospital (CHUK)of the university of Rwanda.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Basics of instrument and tissue handling.pptx
1. Basics of instrument and tissue handling
1. Principles of superficial and subcutaneous tissues incision and
closure
2.Safe use of surgical diathermy
Dr. RUTAYISIRE François Xavier
PGY1
Basic Surgical Skills Course
University of Rwanda
2. Introduction
• Surgical instrument
A specially designed tool or device for performing specific actions of carrying out desired
effects during a surgery
• 1. Modifying biological tissue
2. Provide access for viewing
3.
4. Nomenclature
1. Action it performs
• scalpel, hemostat
2. Inventor(s) name
• Kocher forceps
3. Compound scientific name related to type of surgery
• Osteotome - tool used to perform osteotomy
5. Actions: Hemostatic Forceps
e.g: Clamps, artery forceps, hemostats
• Purpose - to achieve hemostasis
• Available in different lengths, curved and straight, serrated jaws or toothed ends
• Examples - Mosquito, Kelly, Kocher
7. Actions: Soft Tissue Forceps
Similar to hemostats
• Purpose – holding and retracting soft tissue for longer periods
• Characteristics include fine teeth or ridges on the jaws to provide a more delicate grip without trauma
to tissue
• Examples –Allis Intestinal, Babcock Intestinal, Kocher Artery, Right Angle, Forester sponge forceps
8.
9. Actions: Thumb Forceps
• Do not have box locks or ring handles but rather have spring handles
• Held closed by the thumb and finger pressure
FORCEPS IS HOLD LIKE A PEN
10. Thumb Forceps
Toothed Forceps
• Toothed forceps are useful for atraumatic tissue
handling.
• USUALLY FOR HANDLING SKIN.
• NOT SUITABLE FOR GRIPPING NEEDLES.
• Only a small area of tissue is held in the jaws
• Tissue must be handled very gently to avoid
unwanted damage
Non-toothed forceps
• THEY HAVE SERRATIONS TO HELP GRIP
NEEDLES, SUTURE MATERIALS AND
ALIKE.
• Non-toothed forceps spread the force of the grip
over a larger area
• They are used when handling delicate tissue such
as bowel or vessels
11.
12. Actions: Needle Holders
• Similar to hemostats but with smaller, shorter and thicker jaws
• Available in a variety of lengths and styles and may be curved or straight
• Needle holders have inserts in the jaw to prevent excessive wear of the instrument
tungsten carbide granules in a cobalt or other metallic paste
Needle holders with tungsten carbide inserts have gold plated handles
• The inserts can be replaced which prolongs the life of the needle holder and reduce the
replacement
13. Instrument handling
• After opening the suture pack, the needle is presented ready for mounting in the
needle holder.
• Grasp the needle with the tip of the needle holder, two thirds along the shaft
from the needle tip.
• When removing the suture from the pack, it is often useful to use your little
finger to take up the slack in the suture.
14. Instrument Handling
• It is important that the needle is grasped at the tip of the jaws of the
needle holder
• The needle can either be held two thirds away from the tip and
perpendicular to the needle holder or, when using a half curved
needle, it can be held half way along the shaft at a slight angle.
• Use forceps to manipulate the needle in the holder
15. Instrument Handling
• When grasping the needle, only one click is required on the ratchet.
• Putting too much force on the handles will damage the hinged area of the needle holder.
16. Instrument Handling
• It is important that the needle is not handled at the tip or the swaged area.
17. Actions:Scissors
• Curved scissors – used to cut and dissect tissue
• Straight scissors - used for cutting sutures and any tissue when a smooth, straight cut is desired,
such as a damaged nerve or blood vessel
• Scissors can be used for probing, dissecting, and spreading tissue
• Should never be used to cut paper or tubing - bandage scissors may be utilized for this purpose
Scissors may also have tungsten carbide cutting edges which provide finer cutting with longer
lasting wear
• Scissors with tungsten carbide inserts are identified by gold plated ring handles
• Examples - Mayo scissors, Metzenbaum (Metz) scissors, Iris (dissecting) scissors
18. Instrument Handling
• The tips of the scissors should be used for dissection and division of structures.
19.
20. Instrument Handling
• When using instruments with finger loop handles, it is important to use the correct grip
21. Actions: Retractors
• Purpose - used for holding the incision open to provide exposure to the surgical site
• The use of specific retractors depend on the type of surgical procedure being performed
• Smaller types - held by fingers or hand retract skin and subcutaneous tissue in shallow
surgical areas
• Larger, heavier types - retract muscle tissue and organs in deeper surgical sites
• Some retractors are held in place by an assistant
• Self-retaining retractors require no assistant - held open by their own action and may be
used in conjunction with the hand held retractors
24. Scalpel instrument handling
The scalpel pack should be opened carefully
The needle holder must always be used to pick up the
blade, never the fingers.
25. Instrument handling
The blade must be slid carefully into place, lining up the
central opening with the notch on the handle.
The blade is removed by gently lifting the proximal end and
then withdrawing the scalpel handle (note that
in this manoeuvre the blunt handle is moved but the sharp
blade remains still). Blades are placed in sharps
bins for disposal.
27. Instrument handling
Scalpel should be held with the
handle in the anatomical snuffbox
(like holding a pen)
• Allows short, fine, precise incisions
• Skin is stabilized by exerting
tension with the opposite hand
• Thumb is placed on one side of
the cut with the other fingers
placed on the opposite side
29. Instrument handling
• Handle with great care as blades are very sharp
• Practise attaching and detaching the blade using a haemostat - Never handle the blade
directly!
• Always pass the scalpel in a kidney dish
- Never pass the scalpel point first across the table
30. Suturing
• Sutures
An ideal suture should exhibit the following characteristics:
easy to tie/secure;
elicits very little tissue reaction;
maintains its tensile strength for the period required for it to hold
the tissue together while it heals.
• Most suture material is now synthetic.
• Sutures can be absorbable or non-absorbable, and may be braided
or monofilament in construction.
• Each type has its own properties, which are largely concerned with
memory and with tensile strength.
31. Suture properties
Memory
• The extent to which the suture tries to stay in
its original shape.
• Memory can lead to difficulty tying a knot as
the suture may unravel as it tries to return to
its original shape (e.g. when it was stored in
the suture packet).
• This is more of a problem with larger
monofilament sutures.
Tensile Strength
• The amount of force required to snap a suture is
related to its tensile strength, which
diminishes with time.
• The length of time over which this occurs is
dependent upon the type of suture.
•
The measurement of tensile strength is expressed as
the time taken for the suture to lose half of its original
strength.
• For example, the 50% tensile strength of Polydiaxone
(e.g. PDS) is 28 days, whereas that of Polyglactin
(e.g.Vicryl) is 18 days.
32. Comparison of sutures
Advantages of Braided Sutures
• Tie more securely
• Retain less memory than
monofilament sutures
• Less risk of the suture
“fracturing” when handled with
forceps
Advantages of Monofilament Sutures
• Less tissue reaction
• Less incidence of micro-abscess
formation in the tissue
33. Comparison of sutures
Advantages of Absorbable Sutures
• Not being required to be
removed
• Are not present after wound
healing has been achieved
Advantages of Non-Absorbable Sutures
•Offer long-term support
•Less tissue reaction
34. • Different suture types are suitable for different situations.
• Eg: most surgeons will close the skin layer by using either a subcuticular
absorbable suture, or an interrupted monofilament suture.
• For a continuous suture, most prefer a monofilament suture, which
slides through the tissues more easily, and reduces the chances of the
tissue “bunching”.
• For areas where wound healing takes longer, it is important to use a
suture that has a longer 50% tensile strength and absorption rate – e.g.
polydiaxone may be used to close the linea alba.
35. Size of Sutures
• Vary in size, depending on the job for which they are required.
• They are sized using the USP (United States Pharmacopoeia) system.
• Some examples of sizes and diameters are shown below:
6/0 = 0.07 mm
4/0 = 0.15 mm
3/0 = 0.2 mm
2/0 = 0.3 mm
0 = 0.35 mm
1 = 0.4 mm
2 = 0.5 mm
36. Tensile strengths and absorption times
• Giving an indication as to what situation you may wish to use
certain sutures 50% Tensile Strength Absorption Time
Polyglactin (vicryl) 18 days 28 days
Coated polyglactin (vicryl
rapide)
6 days 10 days
Polydiaxone (PDS) 28 days 180 days
Polyglycolic acid (Dexon
II)
16 days 60-90 days
37. Needles
• Needles may vary in size, and type.
• The shape of the needle is determined by the access to the tissue that requires to be sutured – normally
the tighter the operative space is, the greater the curvature of the needle is that is required. The basic
shapes used are: ¼, 3/8, ½, 5/8 Circle, J shape compound curved needle (used to close the sheath in
laparoscopic ports)
• Previously a straight needle was available for closing skin in a subcuticular fashion, but this is no longer
used as they are more prone to needle stick injuries
39. • “Electrosurgery” is generally used to describe operations that utilize
an alternating current to cut and coagulate tissue.
40. Introduction
• “Electrosurgery at least permits us today to remove certain
brain tumors from situations and under circumstances which a
year ago – indeed six months ago – I would not have thought
possible.” Dr. Harvey Cushing, 1926.
• More recent quotes give a different impression:
• “Most hazardous device used on a daily basis” “Causes more
patient injury than any other electro-medical device used in the
operating theatre”
41. History
• Development of the first commercial electrosurgical device is credited
to William T. Bovie, who developed the first electrosurgical device
while employed at Harvard University.
• The first use of an electrosurgical generator in an operating room
occurred on October 1, 1926 at Peter Bent Brigham Hospital in
Boston, Massachusetts.
• The operation—removal of a mass from a patient’s head—was
performed by Harvey Cushing.
42. What is an electrosurgical system?
• Electrosurgical system as the combination of components that enable
a physician to perform electrosurgery.
• Six components of an electrosurgical system: the generator, the
handpiece, the cables, the electrode, and the dispersive pad/return
electrode, the foot pedal/control.
43. • Electrosurgical devices are frequently used during surgical operations
helping to prevent blood loss in hospital operating rooms or in
outpatient procedures
44. • Principle: Convert normal frequency alternating current (50 Hz) to
high frequency alternating current (50 kHz)
• Ion Exchange is not possible at such a rapid rate of change of current
no stimulation
• Modern electrosurgical units can produce currents in the range of
200–300 kHz.
• High frequency AC to a small area raised temperature & coagulation.
45. 45
• Monopolar:
• Patient's body forms part of circuit
• Used for cutting and coagulating
• Bipolar:
• Current passes between tips of forceps, not through patient
• Used for fine coagulation
Diathermy may be:
46. 46
• The plate contact is crucial
• Current ( heat) is focused at the point of the
instrument and dissipated over the area of the plate
(10 000x larger)
Monopolar Diathermy
47. 47
• May earth if body comes into contact with metal or if
plate is not in full contact
Monopolar diathermy (cont.)
X
49. Principle
•Whenever current is concentrated in a small
area heat is generated.
•This heat can be used for coagulating and cutting
tissue.
50. 50
• Pacemaker malfunction
• Arcing to metal instruments and implants
• Burns if used with spirit-based skin
preparations
• Burns from shorting or improper application
of plate
Risks when using diathermy:
51. • Electrocautery Smoke contains:
– Toluene, benzene, hydrogen cyanide, formaldhyde
– Potential carcinogens
– Avoid inhalation using Inline filters, effective evacuation systems,
improved masks
• Avoid using diathermy inside bowel as it contains flammable gases:
hydrogen, methane