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外科手术打结手册.pdf

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BasicPrinciplesof SurgicalKnots LiaAssumpcao Dep.OfSurgery-SOM-JHH SFECourse07/14/08 1 Introduction 2 Introduction „KnotSecurity „Extensibilityrelatestotheway inwhichthesuturewillstretch slightlyduringknottyingand thenrecover 3 TypesofSuture „Multifilament:highcoefficientof frictionandtheknotsremainas theyarelaiddown „Monofilament:lowcoefficientof friction,resultinginagreater tendencyfortheknottoloosen afterithasbeentied,inaddition, possessthepropertyofmemory 4 TypesofKnots „SimpleKnot:incompletebasic unit „SquareKnot:completed commonknot „Surgeon’sorFrictionKnot: completedtensionknot 5 SimpleKnot „Detailsaboutthistopic „Supportinginformationand examples „Howitrelatestoyouraudience 6 SquareKnot „Notsecureasabend.Spillseasily ifoneofthefreeendsispulled outward „Doesnotholdwellifthetwolines arenotthesamethickness 7 SquareKnot:TwoHand Technique „Whitestrandplacedover extendedindexfingeroflefthand actingasbridge,andheldinpalm oflefthand „Purplestrandheldinrighthand „Purplestrandheldinrighthand broughtbetweenleftthumband indexfinger 8 SquareKnot:TwoHand Technique „Lefthandturnedinwardby pronation,andthumbswung underwhitestrandtoformthe firstloop. „Purplestrandcrossedoverwhite andheldbetweenthumband indexfingeroflefthand. 9 SquareKnot:TwoHand Technique „Righthandreleasespurple strand.Thenlefthandsupinated,with thumbandindexfingerstillgrasping purplestrand,tobringpurplestrand throughthewhiteloop.Regrasp purplestrandwithrighthand „Purplestrandreleasedbylefthand andgraspedbyright.Horizontal tensionisappliedwithlefthandtoward andrighthandawayfrom operator.Thiscompletesfirsthalfhitch 10 SquareKnot:TwoHand Technique „Leftindexfingerreleasedfromwhite strandandlefthandagainsupinatedto loopwhitestrandoverleft thumb.Purplestrandheldinrighthand isangledslightlytotheleft. „Purplestrandbroughttowardthe operatorwiththerighthandandplaced betweenleftthumbandindex finger.Purplestrandcrossesoverwhit strand. 11 SquareKnot:TwoHand Tec