常用外科手術(shù)器械及其使用課件

第六章手術(shù)基本操作技術(shù)手術(shù)種類繁多，范圍、大小和復雜程度不同，但基本操作技術(shù)是相同的手術(shù)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(wěn)、準、巧、輕、快是基本要求。整理課件內(nèi)容提綱第一節(jié)常用外科器械及其使用第二節(jié)顯露第三節(jié)止血第四節(jié)縫合第五節(jié)拆線第六節(jié)打結(jié)第七節(jié)引流整理課件（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(shù)刀，如眼科刀等。高頻電刀。第一節(jié)常用外科器械及其使用一、手術(shù)刀整理課件Sharpscalpelwithdisposable10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號刀柄整理課件Handles整理課件HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理課件DisposableScalpel整理課件Electrosurgicalscalpel整理課件（二）手術(shù)刀的使用裝刀片法取刀片法視頻026整理課件裝刀片整理課件ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理課件Scalpels整理課件Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理課件Thescalpelshouldneverbeusedina"stabbing"motion整理課件二、

surgicalscissors組織剪剪線剪Commonlyusedsurgicalscissors整理課件ClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理課件Alltypescanhaveeitherstraightorcurvedblades整理課件MayoandMetzenbaum整理課件Mayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理課件執(zhí)剪的方法剪線的方法視頻027

整理課件三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理課件Thumbforcepsareheldlikeapencil

整理課件ThumbForcepsarenotheldlikeaknife

整理課件鑷子在手術(shù)中的使用視頻028

整理課件四、止血鉗五、持針鉗HemostaticforcepsNeedleholder整理課件持針鉗在手術(shù)中的應用整理課件ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理課件KellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理課件Mosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理課件Carmalt視頻029

整理課件Mayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理課件Olsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理課件六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理課件七、retractorRibretractorAbdominal~Perineal~整理課件SennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理課件HohmanLeverstissueawayfromboneduringorthopedicprocedures.整理課件WeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理課件GelpiHassinglepointtips.Ratchettoholdtissueapart.整理課件創(chuàng)鉤在手術(shù)中的應用視頻030

整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件八、towelforcep視頻031

整理課件九、tissueforceps整理課件Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理課件RatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理課件AdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理課件Allis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理課件Babcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理課件SpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理課件十、腸鉗整理課件DoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.Usedtotemporarilyoccludelumenofbowel整理課件PayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.整理課件Thethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.整理課件Thisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedintothering整理課件Thisisalsothewrongwaytoholdthescissors.Thetipsofthescissorsshouldbepointingupwards整理課件十一、器械的傳遞手術(shù)剪的傳遞整理課件持針鉗的傳遞整理課件Anacceptablehandsignalforaneedleholderwithsuture

Anacceptablehandsignalfor