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BASIC SURGICAL SKILLS

COURSE

dr. Asep Hermana, SpB,


FINACS, FICS

Purnama Hotel
Kuningan
13 th October

AIMS

INSTRUMEN
HANDLING
SUTURE MATERIAL
KNOTTING &
SUTURING
INCISION

AIMS

To learn one
safe way
to do a
surgical
procedure
.
E
F
SA

The course
should
instructive
education
al AND
enjoyable
Y
O
J
EN

Acquire good
habits
earlier it
is difficult
to unlearn
bad habits
S
T
I
B
HA

SAFETY FIRST !
NEVER DIRECTLY
HANDLE SHARPS
WITH YOUR FINGERS
(i.e. blades or
needles)
.Pass sharps in a
kidney dish to your
assistant / nurse
Safety of all is
responsibility of
operating surgeon

SAFETY FIRST !

Always dispose
of sharps in a
sharps bin
not on
patient or
operating
table!
In case of injury
assess the
injury
assess
patient
status

BASIC SURGICAL SKILLS


COURSE

INSTRUMEN HANDLING

INSTRUMEN HANDLING

BASIC
PRINCEP
LE

PRICIPLES
1 Safety
2 Economy of movement
3 Relaxed handling
4 Avoidance of awkward
movement

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

BASIC SURGICAL SKILLS


COURSE

KNOTTING

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
FIRM
SMALL
RIGHT MATERIAL

NO

MUST

NOT SAW
NO DAMAGE
NO TEAR TISSUE
NO EXCESSIVE
TENSION

KNOTTING

Types of Knots
Reef / Square Knot - one hand
- two hands
- instrument tie
Surgeons Knot - one hand
- two hands
- instrument tie
Slip Knot - must always be followed by
a
reef knot

KNOTTING

Square ( Reef ) Knot

KNOTTING

KNOTTING

Surgeons knot

KNOTTING

DEEP TIE

KNOTTING

BASIC SURGICAL SKILLS


COURSE

SUTURING

SUTURING

SKIN SUTURE PRINCIPLE


EPITEL TO EPITEL
ALL SURFACE
RIGHT MATERIAL

NO

MUST

NOT TENSION
NO EVERSI
NO INVERSI
NO DEAD SPACE

SUTURING

SUTURING

SUTURING

SUTURING

SUTURING

SUTURING

BASIC SURGICAL SKILLS


COURSE

SUTURE MATERIAL

Types of Suture Material


Sutures:
Absorbable
Biological
Monofilament
Needles:
Curved
J-shaped
Straight

Non-absorbable
Synthetic
Multifilament
(twisted,
braided)
Eye
Body
Tip

Types of Suture Material (cont.)


Needles:
Curved
Eye
J-shaped
Body
Straight
Tip
Round Body
Taper
- blunt
- cutting (forward /reverse)

BASIC SURGICAL SKILLS


COURSE

INCISION

Ellipse

3X

Ellipse

X
3
X