Erstellt von serenacutbill
vor mehr als 11 Jahre
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Frage | Antworten |
Examples of Schedule 3 Procedures | Wound closures/stitch ups Skin mass removal, biopsies Dental scaling and polishing (digital extraction) Tx of abscesses, aural haematomas Dew claw removal, tail amputation |
Towel Clips (Crossover & Backhaus) | Tips placed downwards towards tissue One tip placed on each corner overlying both drapes Tips pushed onto underlying skin & closed Handles tucked under drapes, no repositioning |
Scalpel and handle | Scapel blade incises skin Scalpel handle used to hold blade Held in pencil grip, fingertrip grip or (rarely) a palm grip Hold positively, firmly with controlled pressure Used to make a stab incision into abscess Used needleholders to remove |
Thumb Forceps (Rat tooth & Atraumatic) | Held in a pencil grip and balanced across hand Should be used as gently and infrequently as poss |
Tissue Forceps | Traumatic to tissues Useful for holding tissue going to be excised Also for holding skin edges but should be applied to dermis rather than skin surface |
Scissors (Mayo and Metzenbaum) Curved or straight | Used to cut skin and suture material Used for cutting or blunt dissection Held in right hand with thumb and ring finger (to first joint) Index finger rests along blade for stability, middle finger wraps around ring |
Haemaostats artery forceps | To occlude blood vessels (after 2min) Choose smalles appropriate size Applied to vessels before cut or once incised when bleeding seen (tips) Tied off with 2/3m suture or clamping/twisting/pulling small vessels |
Needle Holders (Mayo, MacPhail, Olsen-Hager, Gillies) | Some combine needle holder and suture scissors Held with thumb and fourth finger (MacPhails held in palm) |
Common suture patterns | Simple interrupted Horizontal mattress pattern Cruciate mattress pattern Vertical mattress pattern Simple continuous suture Ford interlocking suture Subcuticular closure |
Suture needles Attachment: | Oblong eye Square eye French eye Swaged |
Suture needles Tissue trauma: | Swaged needle creates a tunnel same size for suture material to follow through Eyed needle causes more drag on tissues because double thickness thread being pulled through |
Suture needles Tissue trauma 2: | A eyed needle with material double threaded causes the most tissue damage due to a large know being dragged through small tunnel made by needle. Should never be done! |
Suture needles Parts of needle/needle shapes: | Point - mostly sharp to penetrate tissues, also blunt Body - 6main types. Choose most appropriate one Shank - eye at end or material swaged on |
Suture needles Parts of needle/needle shapes: | Hold body of needle with needle holders for control as passed through tissues Needle holders should grip body of needle close to shank |
Suture needles Parts of needle/needle shapes: | Needles come in a variety of shapes. Swaged needles are usually 1/2 circles |
Suture needles Taperpoint: | Atraumatic, designed to pierce and spread tissues not cut them For intestines, bladder, s/c tissue and fascia where you need minimum trauma for quick healing |
Tapercut: | Similar to taperpoint but combines a reverse cutting edge tip Slightly more traumatic as have cutting element For tendons & dense fibrous tissue |
Regular cutting: | 3 cutting edges Apex of triangle towards inside of needle To cut through tough tissues - muscle and skin |
Reverse cutting: | 3 cutting edges Apex of triangle is towards outside of needle Also cut through tough tissue but cutting point is away from tension line - use for wounds likely to be under tension |
Spatula point: | Flattened body with cutting tip Designed to penetrate between tissue layers For opthalmic procedures |
Blunt point: | Needles have round, blunted point Designed to dissect or penetrate through friable tissue without cutting it For liver, kidney |
Alternatives to suturing: | Sterile stapes - internal and external use Tissue adhesive - variable setting time, sterile individual packaged vial, for rabbits |
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