Principles of Tissue Handling (7) Flashcards
Dr. Thompson
What are the 3 types of heuristics in surgery?
- cognitive
- perceptual
- motor
Who can we attribute many surgical principles to?
Halsted
What did Halsted focus on?
- meticulous techniques
- hemostasis
- local anesthetics
- patient care
How should a scalpel blade be oriented?
perpendicular to the skin
What are the four motions of the scalpel?
- sliding
- pressing
- sawing
- scraping
What are the benefits of curved scissors?
greater maneuverability and visibility
What are the benefits of straight scissors?
greater mechanical advantage for cutting dense tissue
How can you dissect with scissors?
- blunt
- sharp
Correct selection and use of instruments helps the surgeon protect tissues from _____
- crushing
- drying
- heat loss
- hemorrhage
- loss of vascular supply
What does inefficient use of the needle holder account for?
more wasted time than poor technique with an other surgical instrument
What are the characteristics of non-crushing-type tissue forceps?
- may damage tissue depending upon the length of application (Doyen forceps)
- digital intestinal occlusion may be a less traumatic alternative
What are the drawbacks to Crushing-type tissue forceps?
Allis and Babcock forceps have a crushing effect on tissue and should not be used on tissue slated to remain in the patient
How do you use grasping instruments?
When should you not use thumb forceps?
on intestine when performing anastomosis
When should you use grasping instruments?
- know what you are penetrating under the drape
- may be used to assist in closing wounds under tension
- consider substituting non-penetrating clamps in the overdrape
When are retractors used?
improve exposure and speed surgical time
avoid sensitive structures, excessive opening
When do you use suction?
choose appropriate tip
poole: body cavities
yankeur: oral
Frazier: neurosurgery
caution
How should you dissect and manipulate tissue?
How should you suture tissue?
What do hemostasis and wound closure result in?
safe, efficient, reproducible surgical technique
What is the Aberdeen knot?
an alternative to the square knot at the end of a continuous line - left with a loop and a free end
