Biomedical subjects
Publications and source records attributed to Emilio Illana Esteban.
Instruments to cut and make incisions are used to cut and section tissues as well as to desiccate and extract organs or masses. They are used during the first phases of any surgical activity such as an incision, an exploration, to take a sample or to make pathological findings.
In a surgeon's tool chest there are a variety of incision-making tools, some of frequent, common use in general or specialized surgery such as scalpels or scissors. There also exists an abundant quantity of instruments considered to pertain exclusively to determined surgical specialties.
Cutting tools used on bones fulfill different actions: we distinguish between those which cut bone tissue (dissection of an exostosis, extraction of bone tumors, to remove pieces of bone in order to have access to other body parts, etc.); and those which are used on tendinous structures, cartilage, and more frequently on soft tissues.
The scalpel is the best known cutting tool; surgery techniques image par excellence is the scalpel. Its use to incise an opening in surgery is well-known, although the use of a scalpel in surgery is much wider than commonly thought to be. Throughout this and other articles, up until now unedited, the author plans to review the characteristics of different models; the keys to identify and associate scalpels according to their use and purposes shall be presented. These articles should be of interest as a means to define the contents of tool kits to all those professionals who wish to widen their theoretical and technical development.
In its current version, a scalpel is the best known cutting tool. It comes with a versatile metallic handle, available in a variety of models having differentiated characteristics. With a few simple movements, all models enable you to articulate and extract multiple cutting blades.
The blades of a scalpel form an extensive set of stainless steel cutting sheets which have a fenestration where they link to a scalpel's handle comfortably; these handles can be small, number 3 or large, number 4.
In surgical wards, the variety and increasing complexity of techniques used, together with the high number of materials and instruments employed, demands that professionals who join these wards have a specific professional development related to instruments and techniques. In this short series of articles, the author shall present distinct manners to gain knowledge about instruments in such a way that at the end of this series, professionals who are interested will have a guide to help them acquire a deep understanding of surgical instruments, their common usage and their specialized characteristics. A bibliography will be included with the last article.
In clinical practice, there are many diverse ways to name each instrument. Some names consist of local terms related to the shape or the use of an instrument; others have their origin in confusing references; few of these names tend to be related to known nomenclature. This causes a serious inconvenience for someone who wishes to learn about the intra-surgical medium in an organized manner. Undoubtedly this is an inconvenience for the untrained person who discovers he/she is incapable of retaining an enormous volume of names, often presented without any logic whatsoever This also causes an inconvenience for the trained professional; it is difficult to understand terms since, depending on which surgical ward one refers to, the name for the same instrument changes.
In order to help professionals learn, understand and especially to remember the qualities of surgical instruments, in this article the author presents a study based on the physical traits of surgical instruments.
In this last article in a series about surgical instruments, the author continues explaining his classification system according to the degree, branches, cut and consistency instruments have. A bibliography for the entire series of articles accompanies this article.
Pneumatic tourniquets have proven to be a great help in surgery on limbs, on a wide range of operations involving bone surfaces or in delicate operations on hands and feet. Their correct use reduces the amount of tissue exposed, lowers the doses of anaesthetics required, limits the administration of blood products, but their use is not always possible. The author describes the evolution of these devices, highlighting their application and aspects related to patient care.
Surgical washing is the process which removes habitual bacterial flora from the surface of the skin on hands and forearms. This technique centers on the mechanical action of water and a sterile surgical brush combined with the antiseptic action of chemical agents. Its practice is not limited to, as its name appears to indicate, professionals related to sterile wards and surgical rooms, but pertains to delivery rooms, pain clinics, etc., in which the diagnostic and therapeutic procedures require a strict control over the quality of the environment.