Post on 17-Jan-2017
BASIC SURGICAL SKILLS COURSE
Purnama Hotel Kuningan
13 th October 2015
dr. Asep Hermana, SpB, FINACS, FICS
AIMS
INSTRUMEN HANDLING
SUTURE MATERIAL
KNOTTING & SUTURING
INCISION
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
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 !
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
.
BASIC SURGICAL SKILLS COURSE
INSTRUMEN HANDLING
PRICIPLES
1 Safety2 Economy of movement3 Relaxed handling4 Avoidance of awkward movement
BASICPRINCEPLE
INSTRUMEN HANDLING
Cutting Instruments:Scalpel
- attachment- detachment- holding - like a table knife
- like a pen- cutting- passing the scalpel in a kidney dish
INSTRUMEN HANDLING
INSTRUMEN HANDLING
INSTRUMEN HANDLING
Cutting Instruments:Scissors (2 types) - holding
- cutting
INSTRUMEN HANDLING
INSTRUMEN HANDLING
Holding Instruments:
• Forceps (toothed and non-toothed) - holding
• Artery Forceps
• Needle Holders
INSTRUMEN HANDLING
INSTRUMEN HANDLING
INSTRUMEN HANDLING
BASIC SURGICAL SKILLS COURSE
KNOTTING
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
KNOTTING PRINCIPLE
MUST
• NOT SAW• NO DAMAGE• NO TEAR TISSUE• NO EXCESSIVE TENSION
NO
• FIRM• SMALL• RIGHT MATERIAL
KNOTTING
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
Square ( Reef ) Knot
KNOTTING
KNOTTING
Surgeon’s knot
KNOTTING
DEEP TIE
KNOTTING
KNOTTING
BASIC SURGICAL SKILLS COURSE
SUTURING
SKIN SUTURE PRINCIPLE
MUST
• NOT TENSION• NO EVERSI• NO INVERSI• NO DEAD SPACE
NO
• EPITEL TO EPITEL• ALL SURFACE• RIGHT MATERIAL
SUTURING
SUTURING
SUTURING
SUTURING
SUTURING
SUTURING
BASIC SURGICAL SKILLS COURSE
SUTURE MATERIAL
Types of Suture MaterialSutures:
Multifilament (twisted, braided)
Monofilament
EyeBodyTip
Needles:CurvedJ-shapedStraight
SyntheticBiologicalNon-absorbableAbsorbable
Types of Suture Material (cont.)
Needles:Curved EyeJ-shaped BodyStraight TipRound BodyTaper - blunt - cutting (forward /reverse)
BASIC SURGICAL SKILLS COURSE
INCISION
X
≥ 3 X
Ellipse
•X• ≥ 3 X
Ellipse