basic surgical skills course
TRANSCRIPT
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BASIC SURGICAL SKILLS COURSE
Purnama Hotel Kuningan
13 th October 2015
dr. Asep Hermana, SpB, FINACS, FICS
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AIMS
INSTRUMEN HANDLING
SUTURE MATERIAL
KNOTTING & SUTURING
INCISION
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AIMS
To learn one safe way to do a surgical procedure.
The course should instructive educational AND enjoyable
Acquire good habits earlier – it is difficult to unlearn bad habits
SAFE ENJOYHABITS
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Pass sharps in a kidney dish to your assistant / nurseSafety of all is responsibility of operating surgeon
NEVER DIRECTLY HANDLE SHARPS WITH YOUR FINGERS (i.e. blades or needles).
SAFETY FIRST !
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SAFETY FIRST !
Always dispose of sharps in a sharps bin −not on patient or
operating table!In case of injury
assess the injuryassess patient status
.
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BASIC SURGICAL SKILLS COURSE
INSTRUMEN HANDLING
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PRICIPLES
1 Safety2 Economy of movement3 Relaxed handling4 Avoidance of awkward movement
BASICPRINCEPLE
INSTRUMEN HANDLING
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Cutting Instruments:Scalpel
- attachment- detachment- holding - like a table knife
- like a pen- cutting- passing the scalpel in a kidney dish
INSTRUMEN HANDLING
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INSTRUMEN HANDLING
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INSTRUMEN HANDLING
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Cutting Instruments:Scissors (2 types) - holding
- cutting
INSTRUMEN HANDLING
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INSTRUMEN HANDLING
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Holding Instruments:
• Forceps (toothed and non-toothed) - holding
• Artery Forceps
• Needle Holders
INSTRUMEN HANDLING
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INSTRUMEN HANDLING
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INSTRUMEN HANDLING
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BASIC SURGICAL SKILLS COURSE
KNOTTING
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Knotting• Knot-tying is a fundamental technique in
surgery, and is often performed badly
• Take time to perfect your knotting technique
• Uses of knots:− Tying sutures− Ligation (tying vessels)
KNOTTING
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KNOTTING PRINCIPLE
MUST
• NOT SAW• NO DAMAGE• NO TEAR TISSUE• NO EXCESSIVE TENSION
NO
• FIRM• SMALL• RIGHT MATERIAL
KNOTTING
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Types of Knots• Reef / Square Knot - one hand
- two hands- instrument tie
• Surgeon’s Knot - one hand- two hands- instrument tie
• Slip Knot - must always be followed by a reef knot
KNOTTING
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Square ( Reef ) Knot
KNOTTING
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KNOTTING
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Surgeon’s knot
KNOTTING
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DEEP TIE
KNOTTING
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KNOTTING
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BASIC SURGICAL SKILLS COURSE
SUTURING
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SKIN SUTURE PRINCIPLE
MUST
• NOT TENSION• NO EVERSI• NO INVERSI• NO DEAD SPACE
NO
• EPITEL TO EPITEL• ALL SURFACE• RIGHT MATERIAL
SUTURING
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SUTURING
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SUTURING
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SUTURING
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SUTURING
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SUTURING
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BASIC SURGICAL SKILLS COURSE
SUTURE MATERIAL
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Types of Suture MaterialSutures:
Multifilament (twisted, braided)
Monofilament
EyeBodyTip
Needles:CurvedJ-shapedStraight
SyntheticBiologicalNon-absorbableAbsorbable
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Types of Suture Material (cont.)
Needles:Curved EyeJ-shaped BodyStraight TipRound BodyTaper - blunt - cutting (forward /reverse)
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BASIC SURGICAL SKILLS COURSE
INCISION
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X
≥ 3 X
Ellipse
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•X• ≥ 3 X
Ellipse