█ _ 0 حصريا كتاب principles of general surgery 2024 surgery: by : DR: Kaled Omar 1 PRINCIPLES OF SURGERY MALIHA MALIK ROLL NO 1007 2 CONTENTS • DEVELOPING A SURGICAL DIAGNOSIS BASIC NECESSITIES FOR ASEPTIC TECHNIQUE INCISIONS FLAP DESIGN Prevention flap necrosis dehiscence tearing TISSUE HANDLING HEMOSTASIS Means promoting wound hemostasis Dead space management DECONTAMINATION AND DEBRIDEMENT EDEMA CONTROL PATIENT GENERAL HEALTH NUTRITION 3 Human tissues ,due to their innate properties ,react injury fairly predictably So ,with experience certain set are evolved for optimal healing These called as 4 Important decisions regarding made from Identifying signs and symptoms by 1 Complete thorough history 2 Physical examination Radiographic findings Laboratory investigations Record keeping data in an organized form Differential diagnosis 5 Adequate visibility is based on access m o uth p e ning , s urg ic a l x ure re tra c tio n light Surgical field free excess blood other fluids Assistance 6 It includes minimizing contamination pathogenic microbes through: Medical asepsis asepsis 7 TECHNIQUE(CONTD ) 3 Universal precautions applied prevent sepsis efforts fall under the following headings Instrument sterilization Operatory disinfection staff preparation Hand arm Clean technique Sterile 8 Incisions necessary many OMFS procedures The apply Use sharp blade proper size firm continuous strokes Avoid cutting vital structures Incise perpendicular epithelial surface Intraoral incisions should be properly placed 9 Principles design help prevent: Flap 10 Preventing 4 tip never wider than base unless major artery present at length no more twice width In oral cavity, exceed When possible, include axial supply not twisted, stretched or grabbed with instruments that can interrupt destroy feeding draining 11 Dehiscence (separation) avoided approximate edges over healthy bone, handling gently tension exposes underlying bone leading pain,bone loss, infection scarring 12 Make long enough give adequate one releasing incision if needed 13 Apart careful technique, also uncomplicated Excessive crushing, pulling, extremes temperature, desiccation harsh chemicals damage these Toothed forceps skin hooks preferred crush 14 HANDLING(CONTD excessive pulling forces retract tissue copious irrigation when drilling decrease heat Protect soft frictional direct trauma Wounds allowed desicate Only physiologic substances come contact living 15 loss important Preserving patient’s oxygen carrying capacity Increased To formation hematomas 16 HEMOSTASIS(CONTD MEANS PROMOTING WOUND Assist natural clotting processes applying pressure bleeding vessel hemostat heat(thermal coagulation) Suture ligation vasoconstrictive substances(epinephrine) 5 By procoagulants(commercial thrombin & collagen) 17 DEAD SPACE MANAGEMENT area remains devoid after closure created removing depths reapproximating all planes during usually filled (hematoma) which delays predisposes 18 Can managed ways: Pressure dressing Packing(with antibacterial medication) drains 19 DEBRIDEMENT 20 DEBRIDEMENT(CONTD Debridement sterile saline (large volumes fluid pressure) To remove debris reduce bacteria count minimizes likelihood necrotic, foreign devitalized 21 Results collection serum(fluid)in interstitial spaces due transudation damaged vessels lymphatics obstruction fibrin Variables determining degree postsurgical edema: Tissue Loose connective tissue 22 CONTROL(CONTD Post surgical edema minimized by: Careful gentle Short term steroids(prior surgery) ice packs(controversial) Head kept elevated above rest body few postoperative days 23 NUTRITION PROPER HEALING كتب الطب البشري مجاناً PDF اونلاين هو من أكثر التخصصات التي تفيد المجتمع وأكثرها تواصلاً معه يشارك الطبيب العديد الحملات الصحية التثقيفية والمشاركة البرامج الوقائية وحماية البيئة واستخدام كل وسيلة فعَّآلة لتحقيق ذلك ويساهم أيضاً رفع مستوى الوعي الصحي وتقديم المشورة للمجتمع يحتوي هذا القسم علي مجموعة الكتب المتميزة تشمل: الإلمام الكامل بالأمراض تصيب جسم الإنسان والأعراض المصاحبة لهذه الأمراض وطرق تطوير صحة ويتخصص المجال أطباء يحصلون شهادة MD وهي أول الشهادات يحصل عليها المبتدأ مجال الطب