EXAM 1: Lecture 7 - principles of tissue handling Flashcards
what are the 3 types of heuristics in sx
cognitive, perceptual, and motor
what is heuristics
the element of a skill
what does cognitive heuristics mean
planning movements
what does perceptual heuristics mean
recognizing tissues
what does motor heuristics mean
handling of tissues
T/F: Tissue handling is a trade off between speed and accuracy
true!
what are some things that are important with surgical technique
meticulous techniques, hemostasis, local anesthetics, and patient care
what are the 6 principles attributed to Halsted
- handle tissue gently
- control hemorrhage meticulously
- observe strict aseptic technique
- preserve blood supply to tissues
- eliminate dead space
- appose tissues accurately with minimal tension
what are the 6 things we need to know to have safe and efficient surgical techniques
- instrument handling
- tissue dissection and manipulation
- suturing
- knot tying
- hemostasis
- wound closure
what does correct selection/use of instruments protect the tissues from
crushing, drying, heat loss, hemorrhage, and loss of vascular supply
what are the 4 motions of the scalpel
- sliding
- pressing
- sawing
- scraping`
how should the scalpel blade be orientated to the skin
perpendicular with a single sweep to cut the tissue
what type of grip is this
pencil grip, “pressing”
what type of scalpel grip is this
fingertip grip, “sliding”
what are scissors used for
cutting or dissection, cutting inanimate objects
what are the benefit of curved scissors
greater maneuverability and visibility
what are the advatanges of straight scissors
greater mechanical advantage for cutting dense tissue
what happens with inefficient use of the needle holders
it accounts for more wasted time than poor technique with any other surgical instrument
what are disadvantages of non-crushing-type tissue forceps
may still damage the tissue depending on length of application
What type of forceps are crushing type tissue forceps
Allis and babcock forceps
what are hemostatic forceps good for
isolation of bleeders and blunt dissection
what are the benefits of thumb forceps with tissue handling
speed suturing time with appropriate use and avoids unnecessary tissue trauma
what is important to remember with towel clamps
you need to know what you are penetrating under the drape
what should we remember during the placement of retractors
avoid sensitive structures (vessels or nerves) and avoid excess opening
when do you use poole tip suction
body cavities
when do you use yankauer suction tip
oral cavity
when do you use frazier suction tip
neurosurgery or bulla osteotomy
what should we remember with tissue dissection and manipulation
use caution and do deliberate dissection, dissect along tissue planes, pay attention to lines of tension, and limit tissue manipulation
what is important for suturing with tissue handling
- use the right suture pattern
- use the right needle
- minimize tissue handling when placing sutures
- dont over tighten!!
what should we remember about knot tying
secure the knots, make sure they are appropriately buried, and absorbable is only absorbable when it is buried in tissue!
What is important to know about hemostasis
it is one of the surgical skills which results in safe, efficient, and reproducible surgical technique
what is important to remember about wound closure
it is one of the surgical skills which results in safe, efficient, and reproducible surgical technique
what is an aberdeen knot
alternative to the square knot at the end of a continuous line
what is the volume and holding capacity of aberdeen knots compared to square knots
volume - 32-56%
holding - 24% greater
what kind of knot is this
aberdeen knot
