Sx_equiqment. and Tissue handling techniques Flashcards
Hasted’s principles
l) gentle tissue handling
2) meticulous hemeostasis
3) strict aseptic technique
4) preservation of blood supply to tissued
5) eliminate dead space
6) accurate tissue apposition with min tension
types of cutting instruments
scalpel
scissors
rongeurs
periosteal elevator
scalpel
3, 3L, 7- #10-15
primarily used
less trauma than scissors
beaver-special blades
making a skin incision
centet of blade
penpendicular to skin
full thickness cut
four ways to hold a scalpel
fingertip grip
pencil grip
reverse press cut
press cut
scissors classification
point type
blade shape
cutting edge
what influences our selection of type of scissors?
straight tips-greater mechanical advantage, inanimate objects
curved tips-greater versatility, enable improve visibility
serrated cutting edge prevent slippage on lax or dense tissie
metzenbaum
thin, delicate blades about 1\4 of overal length
used on delicate tissues
sq tissue
mayo
thick blades about 1/3 of overall length
used on denser tissue
fascia
utility or operating scissors
straight blades with sharp-blunt tips
reserved for inanimate objects
ronguers
forceps with cupped jaws and blunted or tapered tips
uses: remove bone, prepare bone for graftong, recontour bone ends
periosteal elevators
double ended-freer, sayre
single-ended-langenbeck
neuro and ortho procedures
chisel
cuts bone
beveled on one side
osteotome
bone cutting
double beveled
saw
manual vs power
hobby saw
gilgi wire
bone cutting forceps
single vs double action
paired chisel like tips for cutting bones
curettes
various sizes and shapes
harvesting bone grafts
beveled cupped end used to remove bone from restricted sites
trephines
cylindrical cutting blades and central stylet
bone bx, entry into bone cavities
needle holders
most equipped with ratchet, some have suture-cutting ability
jaw are short and frequently have grooves that are cross-hatched on surface
various sizes and lengths
textures tungsten carbide jaw inserts
tissue forcepts
various sizes and shapes for various tasks: tissue grasping, dissection
Cross serrations vs longitudinal serrations
Crushing tissue forceps
apposing tipcs with a hinge +/- ratchet lock
Allis and Ochsner-Kocher have teeth at their tips
Babcock and Allis grasp tissue at right angles to tesion that is applied
to minimize tissue trauma, crushing forcepts should only be used on tissue being excised
noncrushing tissue forceps
Doyen intestinal forceps-thin, slightly bowed jaws with fine longitudinal grooves of various lengths which may be straight or curved
peripheral vascular clamps-straight or angled jaws
partial occlusion forceps-used when incising large vessels, restrict bloodflow through only portion of vessel
hemostatic forceps
various sizes, orientations, partial vs complete serrations, straight vs curved jaw tip
tip clamping-Vessels-Halsted mosquito, Kelly, Crile
Jaw-clamping-ovarian pedicle-Rochester-Carmalt
Thumb forceps
usually straight, serrated shafts for secure grasping
constructed with or without teeth at tips
Brown-Adson, Adson, DeBakey
towel clamps
Secure towels or quarter drapes to skin of patient
penetrating vs non-penetrating
bone holding forceps
manipulate bone fragments or grip bone during fracture repair
classified by shape and locking mechanism-ratchet or speedlock
retractors
used to deflect tissue away from area of interest in surgical field
hand-held or self retaining
suction tips
accurate suction/small fluid volume-Frazier
large cavities/fluid volumes-Poole
Yankauer for intermediate volumes
