Essential Surgical Skills with CD-ROM, 2nd Edition

Essential Surgical Skills with CD-ROM

2nd Edition

By David A. Sherris, MD, Associate Professor and Interim Chair of Otolaryngology, University at Buffalo, State University of New York, Buffalo, New York; Former Associate Professor and Chair Division of Facial Plastic Surgery, Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota; and Eugene B. Kern, MD, Emeritus Endicott Professor of Medicine, Mayo Foundation, Emeritus Professor of Rhinology and Facial Plastic Surgery, Division of Facial Plastic Surgery, Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota


A. THE OPERATING ROOM

B. THE WOUND

1. Tissue Injury?Wounding
Inflammation ?Proliferation of collagen and scar formation? Scar maturation

2. Wound Classification
Clean wounds ? Clean contaminated wounds Contaminated wounds ? Infected wounds

3. Factors That Affect Wound Healing
Age ? Weight ? Nutrition ?Dehydration ? Blood supply ? Immune responses ? Chronic illness ? Drugs and radiation therapy ? Smoking

4. Healing
Primary intention ? Secondary intention ? Tertiary intention ? Complications

C. BASIC PRINCIPLES IN SURGERY

1. Hemostasis

2. Handling of the Tissues

3. Incision Planning

4. Relaxed Skin Tension Lines

5. Undennining

6. Choice of Suture Materials

7. Closing With Sufficient Tension

8. Tissue Moisture

9. Debriding Necrotic Tissue

10. Dead Spaces

11. Postoperative Wound Stress

D. LOCAL ANESTHETICS

1. Anesthetics

2. Injection Technique

E. SCRUBBING

1. Washing Your Hands

2. Gowning

3. Gloving

F. SURGICAL INSTRUMENTS

1. Scalpel

2. Tissue Scissors

3. Forceps

4. Skin Hooks

5. Retractor

6. Needle Holder

7. Hemostat

8. Suction

9. Cautery

10. Suture Scissors

11. Towel Clip

12. Staple Gun

Quiz

G. SUTURES AND KNOTS

1. Introduction

2. Suture Materials

3. Needle Types

4. Knot Tying
- Two-Hand Tie ? Square Knot ? Comparison Between Surgeon's Knot and Square Knot ? Surgeon's Knot ? Instrument Tie

H. OBTAINING HEMOSTASIS

1. Free Vessel Ligature

2. Figure-of-8 Stick Tie

3. Electrocautery

4. Bone Wax

I. WOUND CLOSURE

1. Principles of Halving

2. Subcutaneous Closure

3. Subcuticular Closure

4. Skin Closure
- Simple Interrupted Suture ? Vertical Mattress Suture ? Horizontal Mattress Suture ? Running Closure (Baseball Stitch) ? Running-Lock Closure ? Running Intracuticular Closure? Staples ? Skin Adhesive Closure ? Purse String Suture ?Drains

J. SKIN FLAPS

1. Introduction

2. Fusiform (Elliptical) Excision

3. Advancement Flap

4. Rotation Flap

5. Z-Plasty

K. POSTOPERATIVE WOUND

1. Local Wound Care

2. Steri-Strips

3. Suture Removal

4. Staple Removal

5. Drain Removal

L. QUIZ QUESTIONS

M. GLOSSARY OF TERMS

N. QUIZ ANSWERS 145

0. MAIN MENU FOR CD ROM

1. Scrubbing?washing hands

2. Gowning and Gloving

3. Surgical Instruments

4. Knot Tying

5. Laboratory Preparations (Pigs' Feet)

6. Laboratory Exercises (Surgical Techniques)

Quiz