第六章手術基本操作技術手術種類繁多，范圍、大小和復雜程度不同，但基本操作技術是相同的手術順利完成，一定意義上取決于基本操作的熟練程度及其理論的掌握理論指導下的不斷實踐，是唯一的正確途徑。穩、準、巧、輕、快是基本要求。整理ppt內容提綱第一節常用外科器械及其使用第二節顯露第三節止血第四節縫合第五節拆線第六節打結第七節引流整理ppt（一）種類4、6、8號刀柄配19~24號刀片。3、5、7號刀柄配10、11、12、15號刀片專用手術刀，如眼科刀等。高頻電刀。第一節常用外科器械及其使用一、手術刀整理pptSharpscalpelwithdisposable10號小圓刃11號角形尖刃12號號彎形尖刃15號小圓刃3號刀柄8號刀柄整理pptHandles整理pptHandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理pptDisposableScalpel整理pptElectrosurgicalscalpel整理ppt（二）手術刀的使用裝刀片法取刀片法視頻026整理ppt裝刀片整理pptThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理pptScalpels整理pptThescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理pptThescalpelshouldneverbeusedina"stabbing"motion整理ppt二、

surgicalscissors組織剪剪線剪Commonlyusedsurgicalscissors整理pptClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理pptAlltypescanhaveeitherstraightorcurvedblades整理pptMayoandMetzenbaum整理pptMayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理ppt執剪的方法剪線的方法視頻027

整理ppt三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理pptThumbforcepsareheldlikeapencil

整理pptThumbForcepsarenotheldlikeaknife

整理ppt鑷子在手術中的使用視頻028

整理ppt四、止血鉗五、持針鉗HemostaticforcepsNeedleholder整理ppt持針鉗在手術中的應用整理pptClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理pptKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理pptMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理pptCarmalt視頻029

整理pptMayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理pptOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理ppt六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理ppt七、retractorRibretractorAbdominal~Perineal~整理pptSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理pptHohmanLeverstissueawayfromboneduringorthopedicprocedures.整理pptWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理pptGelpiHassinglepointtips.Ratchettoholdtissueapart.整理ppt創鉤在手術中的應用視頻030

整理ppt創鉤的使用整理ppt創鉤的使用整理ppt創鉤的使用整理ppt八、towelforcep視頻031

整理ppt九、tissueforceps整理pptForceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理pptRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理pptAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理pptAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理pptBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理pptSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理ppt十、腸鉗整理pptDoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.Usedtotemporarilyoccludelumenofbowel整理pptPayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.整理pptThethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.整理pptThisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedintothering整理pptThisisalsothewrongwaytoholdthescissors.Thetipsofthescissorsshouldbepointingupwards整理ppt十一、器械的傳遞手術剪的傳遞整理ppt持針鉗的傳遞整理pptAnacceptablehandsignalforaneedleholderwithsuture

Anacceptablehandsignalfor