What are Halsted's Principles of Surgery?
1. Gentle tissue handling 2. Meticulous hemostasis 3. Strict aseptic technique 4. Preservation of blood supply 5. Elimination of dead space 6. Minimize tension 7. Careful approximation of tissues 8. Minimize foreign material 9. Sharp anatomic dissection
Tissue damage is proportional to _____ and _____.
In which hand should you hold non-articulating instruments?
In which hand should you hold articulating instruments?
How can hand tremors be minimized?
by decreasing the fulcrum distance
What are the cutting instruments?
scalpel and scissors
What are the grasping instruments?
needle holders, tissue forceps, thumb forceps, towel clamps
Besides cutting and grasping, what are the other general types of instruments?
retracting, orthopedic, miscellaneous
What is the primary cutting instrument?
Scalpel blades have the _____ amount of tissue trauma.
What are the sizes of each blade from left to right? Which one is most commonly used?
#10, #11, #12, #15
#10 is the most common
What should you use to grip your scalpel blade to load it? On what surface should it be gripped?
Use needle holders to grip the non-cutting surface
What is the proper process of loading a scalpel blade onto the handle?
Align slot in handle with hole in the blade and advance the blade until it is locked
What should you use to remove the scalpel blade from the handle and how often?
ALWAYS use a needle holder
How should the scalpel blade/handle be pointed when unloading the blade?
down and away
What are the two grips that can be used to hold the scalpel blade?
Fingertup grip (overhand) and pencil grip
What does your non-dominant hand do when making an incision?
How should the blade be held in relation to the skin when making an incision?
Perpendicular to the skin (held by the dominant hand)
How should an incision be made, in general?
Full thickness with a single pass
What are the motions a scalpel blade can do?
Sliding, pressing, reverse pressing, press cut (stabbing), sawing, and scraping
What is an example of a time when you would use a sawing motion with your scalpel?
removing lung or liver lobe
When would you use a scraping motion with your scalpel?
for very specific reasons
What are the 2 types of tissue dissection?
blunt vs. sharp
What type of grip should be used to hold scissors?
What types of forces can be used with scissors?
Closing, shearing, torque forces
When should you use mayo scissors?
Fascia, linea alba, extending incision
When should you use metzenbaum scissors?
on more delicate tissues (blunt dissection)
When should you use operating (utility, sharp-blunt) scissors?
Cutting inanimate objects
When should operating (utility, sharp-blunt) scissors NOT be used?
Cutting suture in the abdomen because of the sharp end
Identify this instrument.
Bandage scissors (Lister)