基础手术指切口缝合教学课件

1、基础手术技巧之消毒铺巾打结切开缝合2021/7/91简介刀：持弓式、持笔式；垂直进刀刀：运用刀腹；装刀卸刀持针器：正确握持、正确夹针持针器：旋转手腕、打外科结线剪：双手稳定、沿线下滑线剪：旋转显露、线尾长度缝合原则：二分之一、垂直进针缝合原则：不留死腔、皮缘外翻2021/7/92垂直下刀，利用刀腹2021/7/93持弓式2021/7/94持笔式2021/7/95垂直进刀，利用刀腹2021/7/96装卸刀片2021/7/97持针器：握法、手腕2021/7/98夹针：角度、位置2021/7/99器械打结2021/7/9109、 人的价值，在招收诱惑的一瞬间被决定。2022/7/142022/7/1

2、4Thursday, July 14, 202210、低头要有勇气，抬头要有低气。2022/7/142022/7/142022/7/147/14/2022 9:21:58 PM11、人总是珍惜为得到。2022/7/142022/7/142022/7/14Jul-2214-Jul-2212、人乱于心，不宽余请。2022/7/142022/7/142022/7/14Thursday, July 14, 202213、生气是拿别人做错的事来惩罚自己。2022/7/142022/7/142022/7/142022/7/147/14/202214、抱最大的希望，作最大的努力。14 七月 20222022

3、/7/142022/7/142022/7/1415、一个人炫耀什么，说明他内心缺少什么。七月 222022/7/142022/7/142022/7/147/14/202216、业余生活要有意义，不要越轨。2022/7/142022/7/1414 July 202217、一个人即使已登上顶峰，也仍要自强不息。2022/7/142022/7/142022/7/142022/7/142021/7/911线剪：双手稳定、沿线下滑、旋转显露2021/7/912不留线尾：深部打结；丝线留线尾：缝皮；可吸收线2021/7/913缝合：二分之一原则2021/7/914二分之一原则沿鼻唇沟2021/7/915缝

4、合原则：垂直进针、顺针弧度、不留死腔2021/7/916垂直进针顺针弧度皮缘外翻2021/7/917垂直进针，皮缘外翻：愈合快、瘢痕小2021/7/918调整线结，精确对合2021/7/919总结刀：持弓式、持笔式；垂直进刀刀：运用刀腹；装刀卸刀持针器：正确握持、正确夹针持针器：旋转手腕、打外科结线剪：双手稳定、沿线下滑线剪：旋转显露、线尾长度缝合原则：二分之一、垂直进针缝合原则：不留死腔、皮缘外翻2021/7/920总结刀：持弓式、持笔式；垂直进刀刀：运用刀腹；装刀卸刀持针器：正确握持、正确夹针持针器：旋转手腕、打外科结线剪：双手稳定、沿线下滑线剪：旋转显露、线尾长度缝合原则：二分之一、垂直

5、进针缝合原则：不留死腔、皮缘外翻2021/7/921参考文献1. 杨学颖编译，基础外科技巧，合记国书出版社（清华）2. Essential Surgical Skills, Elsevier3. Color atlas of cutaneous excisions and repairs. New York: Cambridge, 2008（协和）4. Adrian M. Richards. Key notes on plastic surgery. London: Blackwell, 2002 2021/7/922Practice makes perfect!2021/7/923Pract

6、ice makes perfect!2021/7/924Thank you for your attention!Lets practice!2021/7/925提高课程设计切口：皮肤张力松弛线、梭形切除比例减小张力：皮下缝合、皮下游离缝合方法：垂直褥式、水平褥式、皮内缝合特殊情况：三角/四角缝合、两边高度不一致缝线的特点：可吸收缝线、不可吸收缝线2021/7/926设计切口：皮肤张力松弛线2021/7/927梭形切除理想比例2021/7/928减小张力：皮下游离2021/7/929减小张力：皮下缝合2021/7/930减小张力：皮下缝合2021/7/931减小张力：皮下缝合二分之一原则沿鼻唇

7、沟2021/7/932垂直褥式2021/7/933水平褥式2021/7/934 皮内缝合2021/7/935两边不一样平2021/7/936三角/四角缝合2021/7/937SuturesAbsorbable vs. non-absorbableSynthetic vs. naturalBraided vs. monofilament2021/7/938不可吸收缝线的特点2021/7/939可吸收缝线的特点2021/7/940Catgut羊肠线Catgut is derived from the submucosal layer of sheep intestine.It elicits a

8、significant inflammatory response.Its absorption is unpredictable.It loses its strength by 89 days.It is absorbed by 1 month.A decreased rate of absorption occurs if the suture is chromatized (chromic catgut).Clinically catgut is usually used as:A mucosal sutureA dermal suture in the faceA skin sutu

9、re in children.2021/7/941Polyglycolic acid聚羟乙酸Dexon is a synthetic suture composed of polyglycolic acid.It is degraded by hydrolization.It loses its strength by 21 days and is absorbed by 90 days.2021/7/942Polyglactin 910 聚糖乳酸910Vicryl （薇乔）is a braided synthetic suture composed of polyglactin 910.It

10、 loses its strength by 21 days and is absorbed by 90 days.Its braided nature may make it more prone to bacterial colonization than monofilament alternatives. (Vicryl Plus)It may provoke a significant inflammatory reaction and some recommend that it is not used as a dermal suture in the face.2021/7/9

11、43Poliglecaprone 25 聚糖乙内酰胺Monocryl （单乔/玻璃丝）is a monofilament synthetic suture composed of poliglecaprone 25.It has similar absorption characteristics to vicryl.Its monofilament composition may make it less prone to bacterial colonization2021/7/944Polydioxanone 聚二氧六环酰胺PDS（普迪思） is a monofilament synth

12、etic suture composed of polydioxone.It is absorbed more slowly than either vicryl, monocryl or dexon.It loses its strength by 3 months and is absorbed by 6 months.It is primarily used as a dermal suture in areas prone to developing stretched scars.2021/7/945Non-absorbable suturesCutaneous stitches w

13、hich will need to be removed.Deep stitches to provide permanent tissue fixation.2021/7/946Non-absorbable suturesNaturalSilk丝线SyntheticPolyamideNylon尼龙线So-named because it was developed jointly in New York and LONdonPolypropylene (Prolene)聚丙烯（普理灵）Stainless steel不锈钢丝2021/7/947Thank you for your attent

14、ion!Lets practice!2021/7/948Practice makes perfect!Lets make it better!2021/7/9499、 人的价值，在招收诱惑的一瞬间被决定。14-7月-2214-7月-22Thursday, July 14, 202210、低头要有勇气，抬头要有低气。*7/14/2022 9:21:58 PM11、人总是珍惜为得到。14-7月-22*Jul-2214-Jul-2212、人乱于心，不宽余请。*Thursday, July 14, 202213、生气是拿别人做错的事来惩罚自己。14-7月-2214-7月-22*14 July 2022

15、14、抱最大的希望，作最大的努力。14 七月 2022*14-7月-2215、一个人炫耀什么，说明他内心缺少什么。七月 22*14-7月-22*14 July 202216、业余生活要有意义，不要越轨。*7/14/202217、一个人即使已登上顶峰，也仍要自强不息。*14-7月-22谢谢大家2021/7/9509、 人的价值，在招收诱惑的一瞬间被决定。2022/7/142022/7/14Thursday, July 14, 202210、低头要有勇气，抬头要有低气。2022/7/142022/7/142022/7/147/14/2022 9:21:58 PM11、人总是珍惜为得到。2022/7/142022/7/142022/7/14Jul-2214-Jul-2212、人乱于心，不宽余请。2022/7/142022/7/142022/7/14Thursday, July 14, 202213、生气是拿别人做错的事来惩罚自己。2022/7/142022/7/142022/7/142022/7/14