Proper care and maintenance is a must for surgical tools like safety scalpels in Baltimore. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.
Correct Use of ophthalmic surgical instruments in Baltimore
Proper maintenance of these instruments are required in Baltimore, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Baltimore. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Baltimore area. Hospitals have proper procedures for disposing off such medical devices as well.
Laprascopy With the Harmonic ScalpelWhere can I locate the history of the surgical scalpel?
Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.
Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.
Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.
A scalpel may appear alarming at first.
This is a useful safety reaction and should mean that you will learn carefully and steadily.
A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.
For fine work with a No 15 blade, hold the scalpel like a pen.
This is the correct way of holding a pen, using a tripod grip.
The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.
Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.
This grip enables the surgeon to:Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.
The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.
The handle rests in the palm of the hand.
The digits and hand are largely on top of the scalpel unlike with the pen grip.
This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the
way as in the pencil grip.
The grip is quite gentle.
For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than
on the side.
This will let you increase the downward pressure of the blade on the tissue.
For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.
The handle does not touch the hand.
Holding the scalpel in the fist or like a dagger is far too clumsy.
DO NOT dissect with the handle of the scalpel.
You will be concentrating on the site of dissection and may accidentally cut your assistant.
DO NOT hold the scalpel in your hand while using another instrument.
You may accidentally cut the patient as you concentrate on the dissection area.
ALWAYS pass the scalpel to someone else handle first.
Preferrably, place the scalpel in a dish for the scrub nurse to pick out.
DO NOT throw the scalpel down onto the bench (or onto the patient.)
The part of the blade that does the cutting is the curve and not the tip.
This means that you need to drag the curve of the blade across the tissue.
Scratching with the tip of the blade is a beginner's error.
A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.
You will feel the curved blade cutting into the tissue.
Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.
Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.
Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.
Use of a Laser Scalpel
Laser surgery is surgery that uses a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L Roberts, III using CO2 lasers in the 1990s. The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis).
Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate.
- Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
- Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
- Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
- Photomechanical effect: used in intraluminal lithotripsy
A range of lasers such as erbium, dye, and CO2 are used to treat various skin conditions including scars, vascular and pigmented lesions, and for photorejuvenation.
Various types of laser surgery are used to treat refractive error:
Lasers are also used to treat non-refractive conditions, such as:
Laser endarterectomy is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastomosis.
Lasers are used to treat several disorders in foot and ankle surgery. They are used to remove benign and malignant tumors, treat bunions, debride ulcers and burns, excise epidermal nevi, blue rubber bleb nevi, and keloids, and the removal of hypertrophic scars and tattoos.
A carbon dioxide laser (CO2) is used in surgery to treat onychocryptosis (ingrown nails), onychauxis (club nails), onychogryposis (rams horn nail), and onychomycosis (fungus nail).
- Peritoneum-Laser is used for adhesiolysis.
- Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
- Coagulation of vascular malformations of stomach, duodenum and colon.
- Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
- Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
- Ablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
- Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.
- Laser-assisted liver resections have been done using carbon dioxide and Nd:YAG lasers.
- Ablation of liver tumors can be achieved by selective photovaporization of the tumor.
- Endoscopic laser lithotripsy is a safer modality compared to electrohydraulic lithotripsy.
The CO2 laser is used in oral and dental surgery for virtually all soft-tissue procedures, such as gingivecomies, vestibuloplasties, frenectomies and operculectomies. The CO2 10,600 nm wavelength is safe around implants as it is reflected by titanium, and thus has been gaining popularity in the field of periodontology. The laser may also be effective in treating peri-implantitis.
Laser spine surgery first began seeing clinical use in the 1980s and was primarily used within discectomy to treat lumbar disc disease under the notion that heating a bulging disc vaporized enough tissue to relieve pressure on the nerves and help alleviate pain.
Since that time, laser spine surgery has become one of the most marketed forms of minimally invasive spine surgery, despite the fact that it has never been studied in a controlled clinical trial to determine its effectiveness apart from disc decompression. Evidence-based data surrounding the use of lasers in spine surgery is limited primarily due to the presence of a number of challenging factors including patient selection, operative indications in the type of laser used in the procedure. As a result, the official Blue Cross of Idaho position on laser disc surgery concluded:
"Evidence on decompression of the intervertebral disc using laser energy consists of observational studies. Given the variable natural history of back pain and the possibility of placebo effects with this treatment, observational studies are insufficient to permit conclusions concerning the effect of this technology on health outcomes."
The CO2 laser is also used in gynecology, genitourinary, general and thoracic surgery, otorhinolaryngology, orthopedic, and neurosurgery.