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Selecting Dissecting Instruments for General Zoology

The purchase of a set of dissecting instruments becomes essential when the student approaches his first year of university work in zoology. This is the time when a little care and thought will lead to the selection of a limited number of instruments which with few additions will serve adequately for many years whether the student continues in zoology or goes on to veterinary science, home science, dentistry, medicine, agriculture, etc.
A minimum of good quality instruments of suitable shapes and sizes, kept in good condition and correctly used, are a prime essential to the aret of dissection, and will prove an economy of time, energy and money. The work of the first year in zoology will include the dissection of animals ranging in size and nature from the small soft-bodied earthworm to the large hard-skinned shark, and other animals such as the frog, and a mammal which might be a rabbit, a white rat or a guinea-pig. A limited number of simple instruments will prove adequate for all this work and for the work of other courses in later years.
It is extremely difficult to describe all the characteristics which enable an experienced person to distinguish instruments of good quality from those which are poor in design, made of cheap materials and with faulty workmanship. Scalpels come in all grades from cheap, case-hardened, all-metal scalpels which are brittle and most difficult to sharpen, to forged scalpels with finely-tempered, high-quality steel blades which sharpen readily to a perfect cutting edge. Avoid stainless steel scalpels which do not take or keep an edge, and those which fail to ring sharply when the scalpel is held lightly by the end of the handle and the tip of the blade is clicked with the thumbnail or tapped on a hard surface such as glass. Avoid scissors which are unduly heavy, thick in the blades or handles, and which fail to cut cleanly at the tip. If you have the opportunity, check a variety of scalpels, forceps, scissors, etc., and try to develop a sense of balance in these instruments. A good all-metal scalpel balances at the middle of the total length; well-designed scissors balance about two-thirds of the length from the tip. Well-made forceps balance at about the mid-point in their length. The double thickness at the hinge in well-designed forceps is thinner than the mid-portion of the arm, and the portion between the hinge and the modelled arm will be the narrowest and the PAGE 100thinnest part of the arm (see detail, Fig. E), even thinner than the portion used to form the hinge since it is by thinning and narrowing this region that the designer creates a pair of forceps with a really light spring action.
Most dissection instruments are plated. Good plating is smooth, without pits, cracks or ripples, uniformly and brightly reflective. Chrome plating has a bluish tinge, an oily appearance and a long life in ordinary usage. Nickel plating is silvery and with proper care has a reasonably long life but tends to peel when it breaks. Chrome-plated instruments are preferable but usually somewhat more costly than nickel-plated instruments of similar quality. Even when the plating is worn, a good instrument is fully usable provided it is not allowed to rust.
An adequate dissecting set will include one scalpel; fine and heavy scissors; fine and coarse forceps; two dissecting needles; a probe; a six-inch ruler; dividers; pencil; rubber. Hooks and chains and the blowpipe are described because they are still supplied in many kits which persuades students that these items are necessary, but this is not correct. Hand-lens, pipettes, pins, slides and cover-slips, corded hooks, and other items used from time to time throughout the year are not included here as part of the dissecting kit since these and a sharpening stone are generally supplied to the student in the laboratory as required.

INSTRUMENT CASE

This is a first requirement. Dissection instruments are sharp tools. Edges and points blunt and damage if the instruments are kept loose in a box. Expensive sets are supplied with wooden boxes fitted with racks, but soft cases with pockets or loops for each instrument are less costly and fully satisfactory. Equally suitable is the instrument roll made of heavy linen with pockets or loops and a turn-in flap, much to the pattern of a carpenter's wood-bit roll. A roll can be easily made to the pattern illustrated in Fig. H.
The most costly case or the simplest home-made roll is useless unless instruments are kept in it and in their proper places when not required.

SCALPEL

This is much more than an ordinary knife. A good scalpel has a strong sharp point to the blade so that the blade will pass easily in between two sheets of tissue or between other structures. It has a strong dull back to

A, scalpel and cross-section through blade; B, heavy dissection scissors; C, light dissection scissors; D, fine dissection forceps; E, heavy dissection forceps, and side view of detail of hinge-end; F, detail of interlocking ridges on tips of forceps; G, german-silver wire probe; H, plan layout for instrument roll;. Note: Scale for Figs. A to G, 2 in. Plate prepared by Mr. J. A. F. Garrick.
the blade and this is freely used. By moving the back of the point or of the whole blade between sheets of tissue, or two muscles, these structures can be separated readily, avoiding cuts and other damage which happen if the sharp edge is used. The blunt edge tends to follow anatomical pathways between the structures which are being exposed. The handle is usually flat because the scalpel is best held by the tips of the fingers and the thumb and not grasped hard in the palm of the hand since holding in this manner restricts the range of application and dulls the sense of touch. The sense of touch gained by holding the handle with the finger-tips gives information on the nature of the structures over which the blade is working. In a well-designed dissecting scalpel, the end of the handle is square or preferably slightly curved, and has an obtuse edge. This is a valuable part of the scalpel. It is used for coarser, heavier work than can be conveniently managed by the back of the blade, work such as separating the skin of a dogfish from the underlying muscles.
The sharp edge of the blade should be used only to do the work which the other parts of the scalpel will not perform. This keeps the edge of the blade sharp and saves sharpening. A scalpel with a straight edge is designed for cutting down through thick layers or across solid structures and has little value in general dissection because only a small part of the edge can be used. If the sharp edge is convex there is a greater length of usable edge and as one portion dulls, a change in the angle of attack will allow another portion of the edge to come into use. Keep the edge sharp. Heavy cutting pressure with a dull scalpel can lead to accidents and damage to the dissection or to yourself.
From the above account of the use of a scalpel it can be seen that a single scalpel suitable for a wide range of general work should have a convex blade about l½ in. long by at least ½ in. at its greatest depth. The handle should be at least 4½ in. long so that the scalpel can be reversed and the end of the handle used in dissection without danger to the fingers from the cutting edge.
A good scalpel has a blade which is an acute-angled triangle in section. A deeply hollow-ground blade sharpens easily for light work but will be found too weak for heavy tasks.
Sharpen the scalpel on a fine grade india stone wet with water. Lay the blade flat. Rub the blade lengthwise. Then reverse and rub the other side an equal amount. Take out nicks by using a coarser grade of stone.
Avoid scalpels with replaceable blades. These were not originally designed for general dissection, are too fragile for much heavy work, cannot be sharpened, and usually provide only a short cutting edge.

SCISSORS

If anything, these are more generally useful cutting instruments than is the scalpel; but it requires some experience before scissors are freely and properly employed in dissection.
Two types of scissors are required. One is a smaller pair with sharp-PAGE 103Dissecting Instruments for Zoology pointed blades from 1 in. to 1 ½ in. in length, and the whole instrument of at least 4 in. total length; the other, a larger pair of scissors about 6 in. in total length with strong blades 2 in. long and preferably one blade tapering and sharp-pointed, the other blade being almost parallel-edged and rounded at the end. Obviously, the smaller are used for finer dissection, the larger for heavier work. Scissors with curved blades are of little general use and are employed for trimming away loose strands or edges of sheets of tissue.
It is most important in scissors that they cut to the very tips of the blades when used. Good scissors cut cleanly a piece of paper even less than 1 mm. from the tip, and scissors should be tested this way before purchase.
Dissection of the frog provides a good opportunity for the diversified use of scissors. A scalpel is used in this dissection only when removing the bones forming the roof of the skull. The skin on the frog is divided, as required, by picking up a small fold of the skin in fine forceps, cutting it across just sufficiently to allow entry of the tip of the small scissors and then cutting lengthwise using the greater length of the blade of the scissors. The same scissors are used to cut through the septa which attach the skin to the muscular body-wall. The same technique is used in opening the body cavity; but the heavy scissors are used with the blunt blade within the animal to cut through the pectoral girdle. The blunt end of the blade tends to force aside soft structures with little damage. A sharp pointed blade used in the same way may pierce a structure so that it will be cut or otherwise damaged. Forceps and scissors are used again in dissecting the leg to expose the sciatic nerve passing to the gastrocnemius muscle. Scissors are used to open the pericardium to expose the heart, and to open the heart to examine the chambers and valves.

FORCEPS

These are used as an extension of the fingers. They permit the hand to be kept out of the immediate field of the dissection and are used for the grasping of small or large items often for considerable periods of time such as when a structure is kept under tension to assist its dissection, as in exposing a nerve or a blood-vessel passing through connective tissues. Typically a pair of forceps consists of two parallel metal blades or arms fastened permanently at one end as a spring-hinge and ending at the other with a tip of various forms, straight or curved, blunt or sharp.
For general dissection, two pairs of forceps are required, a pointed pair for finer work, a blunt pair for heavy work. In both cases select only forceps which close under light pressure. Forceps having a strong spring hinge rapidly tire the hand. The pressure to close good forceps is so little that it can hardly be appreciated, yet on release the tips spring wide apart, 3/4 in. or more. Good forceps of all sizes have a guide-pin, a small tapering pin mounted on the inner face of one arm and passing through an opening on the opposite arm when the forceps are closed. This small pin should be sturdy since it lines up the tips when closed. It makes the tips meet accurately even under heavy pressure. The inner face of each tip should PAGE 104be ridged cross-wise for at least 1/4 in. to ½ in. The ridges should fit into one another when the tips are closed. This adds greatly to the grip. (Toothed forceps are unsuitable in the dissection of smaller animals with delicate tissues.) The blades or arms should not be too narrow or sharp-edged, or otherwise uncomfortable to hold for any length of time.
Pointed forceps for fine work are held between the thumb and forefinger, or grasped in the hand and so can be used at many angles. For this reason straight forceps are preferred. Forceps with curved tips are more restricted in use and less satisfactory also, because unless a very expensive, well-built pair is obtained, the points tend to separate or twist apart under pressure.
Blunt forceps should be really sturdy, but still only lightly sprung so that when held between thumb and forefinger or grasped in the hand they close easily and open readily to at least 1 in. between the tips. They should be straight, plain enough to be comfortable to hold but with some modelling to fit the hand so that they will not tend to slip if wet and greasy. Some well-built heavy forceps have a low flat-topped stop on the inner face of one arm in addition to the guide-pin. This stop prevents the tips from separating under heavy pressure, but if the stop is placed near the middle of the arm or nearer the tip than the hinge, it is useless.
Because forceps primarily enable the hand to be kept clear from the field of dissection and forceps are used in a variety of positions, both fine and blunt forceps should be at least five to six inches in length.
Avoid forceps which have a strong spring; in which the tips close under light pressure but open at the tips when full pressure is applied; which lack guide-pins; in which the ridging of the tips does not interlock.

NEEDLES

Dissection needles are steel needles mounted in the ends of rounded wooden handles. These instruments are more neglected and abused than any other. Simple as these instruments are, they are worthy of respect. They take the place of fine forceps and a scalpel in the minutest dissection such as under the hand-lens. Experienced workers use only a pair of needles to carry out dissections by hand even under the low power of the ordinary microscope.
The needles are used, one in either hand, held between thumb and forefinger and supported on the index finger. One needle is pressed down on to a specimen to hold it in place. The sharp tip of the other needle is pressed lightly on to and drawn along the specimen as though it were a scalpel, and properly used it will cut into the specimen. This is the best way to remove the wings and legs of a small insect such as a fly or a mosquito, to free internal organs in a weta to expose the nervous system, to dissect the head of a preserved small tadpole which is a simpler and clearer dissection than the head of a frog, etc.
Good dissecting needles are less than a millimetre in diameter, sold for ordinary sewing as size 5/9. A needle 1 ½ in. long is of a convenient length. Needles of this size are sufficiently rigid and yet flexible enough to be PAGE 105useful when pressed on to a specimen to hold it down. They are flexible enough for sharpening. This is done by holding the handle against the tips of the fingers with the thumb so that the handle can be rotated by rolling it with the thumb. The needle is pressed on to a fine stone so that about ½ in. of the needle is in contact with the stone. By a combination of rubbing the needle lengthwise and rotating it on the stone, a long, tapering, extremely sharp point can be formed. Needles usually supplied for dissection are too rigid for proper sharpening. A well-sharpened needle can hardly be felt if it is pushed into the finger.

PROBE OR SEEKER

In its best form, this is nothing but a piece of german-silver or silver wire about 6 in. long, a good millimetre in diameter, straight or curved as shown (Fig. G), and bluntly rounded at each end. It should be semi-soft, soft enough that it can be pushed gently inside a blood-vessel or duct, and tend to follow the path of the structure. The probe then acts as a guide for scissors which can be used to open the length of the vessel. This is almost a forgotten technique in ordinary dissection and yet it is the simplest way to locate and follow structures such as the anterior cardinal vein in the dogfish, or the ureters in a fatty rat, etc.
The hard-drawn blunt steel wire mounted in a round wooden handle is of little practical use. The instrument in this form has discouraged the use of the probe in dissection; but a good probe is a most useful aid in many dissections.

BLOWPIPE

This was a common instrument in former years when dissections were carried out on fresh material. The blowpipe consisted of a metal tube tapering to about 2 mm. in diameter. This narrow end could be passed into the bladder, into the intestine or other hollow organs and ducts, which could then be inflated to display form and connections. Since most larger dissections are now performed on preserved material, the blowpipe has dropped from use.

HOOKS AND CHAINS

These are seen in the large complete dissecting sets such as contain a variety of scalpels, forceps, etc. There is usually a pair in a set. Each consists of three pieces of light chain about 6 in. long joined to a ring and the free ends armed each with a strong sharp hook. They were used in the dissection of large animals, animals of sufficient size that two of the hooks could be separated and driven into the flesh of the animal as anchors for the third hook which could be used to hold an organ or an edge of a flap of body wall, etc., clear from the dissecting field. They are not sufficiently adaptable for use on small animals since they cannot be conveniently PAGE 106shortened as required and it is for this reason they are not suitable for anchoring a small animal to the dissecting board. Purchase of hooks and chains is not worth while until a student begins dissection of large animals when they may be found really usable.

RULER, DIVIDERS, PENCIL AND RUBBER

These can hardly be termed dissecting instruments but they have a proper place in any dissecting kit since there is no better way to study a dissection than to prepare a well-proportioned and detailed drawing of the work that has been done. The simplest way to do this is by a mechanical transfer of the proportions of major structures from the dissection to paper. Decide a size for the drawing, a reduction or magnification such as will allow all detail to be conveniently represented. Then take the length and breadth of the various major structures item by item, using the dividers, measuring each on the ruler, reducing or enlarging each according to the scale, and mark out the dimensions in their relative positions on the drawing before attempting the outlines. Outlines should be lightly dotted in first and corrected until a good representation has been obtained. This may appear tedious, but it is the most accurate and the fastest way to obtain a good drawing.
A 6 in. rule is all that is needed; celluloid and plastic are preferable to wood, but wood is adequate. The dividers should have legs at least 6 in. long, the hinge should be firm and capable of being tightened if necessary. A good pencil, kept sharp, is needed. HB or softer grades are unsatisfactory because the drawings rub when assembled into a book or folder, and drawings made with soft pencils smear even to the extent of becoming illegible. Use a 2F or 2H pencil.
Before you buy your rubber, check to see that it does not leave a mark on the paper. A good grade of soft red rubber is adequate.

GUIDING RULES

(1)Instruments loose on the bench are dangerous. Place instruments in the case when not in use. This keeps instruments in the best condition.
(2)Do not abuse your instruments. The scalpel was not made for sharpening pencils. Fine forceps and needles are used for dissection, not for playing darts.
(3)Sharpen your instruments before they become dull. This means better dissection, easier sharpening, and a longer life for the instrument.
(4)Do not let instruments get rusty. Rust rapidly destroys sharp points and cutting edges. Clean and dry each time before putting instruments away. This is extremely important after using them in or near salt water.
(5)Do not use fine grade instruments for coarse dissection.

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General practitioner is a medical profession that encompasses a wider range and covers all the systems in the human body, so it just touches the superficial area in the treatment process. Nevertheless, the role of general practitioners itself is quite important because the primary positions in health services in the community, which is why a general practitioner must have knowledge and skills appropriate action in accordance with the overall competence. One of the most important skills mastered in everyday practice is minor surgery. This is because the number of cases that require this action is quite high in the community. Experience the authors found that of 10 patients who came for treatment, there are 3 cases that require this action procedures. Generally complication of this case is not so much, but if not handled properly can end up to death, especially for cases with large enough bleeding or incomplete disinfection cases.
In an article published by the British Medical Association (BMA), said that in the UK, had minor surgery procedures are often performed by general practitioners and are quite popular among patients and has a fairly high cost. Based Health Authority (1990), general practitioners have the authority to perform minor surgery and get a payment from this action. Even in 2004, general practitioners in the UK to improve and expand their minor surgical competence by way of paying a commission to the manager Addition pelayananan (Directed Enhance Service-DES). In Indonesia, minor surgical care coverage that can be performed by a general practitioner is quite diverse, ranging from action hecting open wound, incision, excision, extraction, cauterization and so forth. This action is generally performed with local anesthesia with anesthetic techniques appropriate to the case at hand.
Implementation of minor surgical procedures require a general practitioner to know some basic knowledge about these actions. Basic knowledge in the form of minor surgical instruments, materials and sewing techniques of disinfection and tissue engineering. This article is only bounded on the introduction of minor surgical instrument which is the basis of the first knowledge that must be possessed by a doctor to perform this action. For more knowledge will be explained in a different article.
Basic instruments minor surgery is divided into four by function, ie the function of cutting instrument (scalpel blade + handle and various types of scissors), an instrument with grasping function (anatomical tweezers, forceps and clamps cirrhurgis network), an instrument with a function to stop the bleeding (arterial clamp straight and clamps mosquito), as well as instruments to function sewing (needle holder, suture and needle).  
Minor surgery Tools Complete
Figure 1: Basic Surgical Instruments Minor
All of these instruments are described in detail as follows:
A.    Instruments With Cutting Function
1.      Scalpel blades + Handbook
A small scalpel blade is used with the handle. This tool is useful in skin menginsisi and sharply cut tissue. In addition, it is also a useful tool to remove tissue / foreign matter from the inside of the skin. Each blade scalpel has two different ends, one sharp-pointed as the other parts of cutting and blunt-tipped hollow as the attachment of a scalpel handle. Installation means: holding area with a blunt knife needle-holder and plug holes in the area of the tongue handle until it locks (you hear). How to release: hold the knife edge with a needle-holder and release the grip of the tongue, then dispose in the trash. The handle scalpel is often used is the size 3 that can be used with scalpel blades in a variety of sizes. While the scalpel blade that is often used is the size no.15. No.11 size used for incision of perianal abscess and hematoma. Scalpel is used like a pen grip with maximum control when cutting is done. In daily practice, scalpel handles are usually ignored that only using a scalpel blade. This could be accepted with the knife still in a state consideration sterile (new package) and should be used with good control so as not to cause tissue damage when cutting.
2.      Scissors
It basically combines the action of scissors slicing and shaving. Shaving requires smooth action conflicting pressures between the thumb and other fingers child. Movement is usually done by shaving the dominant hand which is not recognized and based on instinct. We recommend using the thumb and ring finger on the second hole of scissors. This will cause the index finger when cutting instruments support so that we can cut to the right. In addition, the use of the thumb and index finger on the hole is usually the controlling scissors reduced. The types of objects based on his scissors, shears the network (surgical), yarn scissors, bandages and scissors iris scissors.
a.         Network scissors (surgical)
Scissors tissue (surgical) consists of two forms. First, form a blunt end and bent-shaped ends. Scissors with blunt ends be used to make up the field of tissue or soft tissue, which can also be cut sharply. Scissors with curved ends made ​​by experts on a flat metal carefully. Cutting with scissors is done in the case of lipoma or cyst. Usually done by mengusuri borderline lesions with scissors. It must be ensured that the cuts do not cross the line because the lesions can cause damage.
b.        Scissors Yarn (dressing scissors)
Scissors are designed to cut threads thread. The scissor-shaped straight and sharp-pointed. Use only for cutting threads, not to the network. This scissor lift is also used when the wound yarn on techniques that have been dried with a thread cutting inserts and should use the tip of the scissors. Be careful in cutting the stitches. If the tip protruding suture scissors, cut the risk of other structures there.
c.         Bandage Scissors
Bandage scissors angle is tipped scissors with a blunt tip. These scissors have a small head on a useful tip for ease in cutting bandages. This type consists of a pair of scissors knowles and lister. The base of this scissors is longer and very easy to use in cutting bandages. Blunt tip designed to prevent accidents when done remove bandages. In addition to forming and cutting bandages just before closing the wound, is also safe to use scissors for cutting bandages when the bandage was placed over the wound. (Wikipedia)
d.        Iris Scissors
Iris scissors are scissors with sharp edges and small about 3-4 inches. Normally used in surgery ophtalmicus especially iris. In minor surgery, iris scissors used to cut threads because the tip is small enough to slip when done remove the thread. (Online dictionary)  
B.    Instruments With Hold Function
3.      Tweezers Anatomy
Anatomy has a blunt tip tweezers smooth. In general, tweezers used by the thumb and two or three other fingers in one hand. Spring pressure occurs when the fingers pressed together in the opposite direction and generates grasping ability. This tool can grasp small objects or tissue quickly and easily, as well as move and issued a variety of tissues with pressure. Anatomy tweezers is also used when stitching is done, a network exploration and form a stitch patterns without involving the fingers. (Wikipedia)
4.      Tweezers Chirurgis
Tweezers Chirurgis usually has a 1x2 arrangement of teeth (two teeth on the field). This toothed tweezers used on the network; must be the exact calculation, because it may damage tissue when compared with anatomical tweezers (can be used with smooth grip). This tool has the same functionality as the anatomical tweezers to form a stitch pattern, removing sutures, and other functions. (Wikipedia)
5.      Clamps Network
Tissue clamps shaped like pincers with two interconnected springs on her toes. The size and shape of these tools varies, there are long and short, and there are those that are scalloped and there is not. This tool is useful for holding tissues appropriately. Usually held by the dominant hand, while his other hand to cut, or sew. How pemegangannya: clamp held in a relaxed state such as holding a pen with a position in the middle of the hand. Many people who hold these clamps with one, which forces the arm in full pronation position and cause the hands to become tense. In use, careful tissue damage. Hold the clamp gently as possible, try to limit the depth of mobile networks should be. Clamps toothed network has small teeth on the end that is used to hold the tissue firmly and with accurate control. Be careful, clumsiness when using these tools can damage the tissue. Then, not toothed clamps also have the risk of tissue damage if left too long tongs, as the clamp has a strong pressure in grasping tissue.  
C.    Instruments With Bleeding Stop Function
6.      Artery Clamps
In principle, artery clamps useful for stopping bleeding of small blood vessels and other tissues with a proper grip without causing unnecessary damage. In general, artery clamps and needle-holders have the same shape. The difference in the structure of the jaws (figure 2), which clamps the artery, the clip structure in the form of parallel lines on the surface and the length of the pattern of the clips to the handle slightly longer than the needle-holder. This tool is also available in two forms namely straight and curved forms (mosquito). However, bent shape (mosquito) is more suitable for use in minor surgery.
How to use: arterial clamps have a ratchet on the handles. Ratchet is what causes the arterial clamp position in a state terututup (locked). Ratchet generally have three degrees, which at the time of closure do not directly use the final degree because it will bind automatically and is difficult to remove. The release of the clamp is done by first must be pressed into the handles, then separated, opening the handles of both. We recommend using the thumb and ring finger as this will cause the index finger so that it can support the instruments work properly position the grappling.
Artery clamp smooth-shaped clamps with parallel latitude lines that form a circle when the instrument channel is closed. These are relatively long tongs to grip handled that allow finer network without destruction. Grappling with the tip bent (mosquito) function to assist the binding of blood vessels. Do not use these clamps to sew, and therefore does not support the structure of the clip holding the needle.
D.    Instruments With Function Tailoring
7.      Needle Holder
Needle holder is useful for holding suture needle insertion is done. Overall between the needle holder and clamp the artery of the same form. Handled and ends the clip may be either straight or curved. However, the most important is the difference in the structure of the clip (Figure 2). The structure of the needle holder jaws shaped criss-cross on its surface and has handled a longer size of the clip, to prisoners who are strong in holding the needle. Therefore, do not grasp tissue with a needle holder because it will cause serious tissue damage.
How to use: how to shut down and remove the ratchet similar to the method that has been presented on the use of artery clamps above. Needle is held at a distance of 2/3 of the end of the hollow needle, and is at the tip of the needle-holder jaws. This will facilitate network puncture at the time of stitching done. In addition, holding the needle in an area close to the needle holder hinge will cause the needle to bend. Then, steered needle slightly toward the front of the instrument jaws as it will be adjusted to the natural direction of the hand when insertion is done and hands will feel more comfortable. Failure to deflect the needle will cause the needle to bend.
Sewing techniques: keep the ring finger and the thumb hole settled on the handle while sewing done that restrict the movement of the hand and arm. Hold the needle holder with the palm of the hand will give good control. Constantly, do not remove the finger from the hole handled because it can damage the sewing rhythm. Consider use your thumb on the hole which settled handled, but the manipulation of the other hole with the ring finger and little finger.
Graphic1
Figure 2. Clamps Difference Between Network Structure clamp, clamp the artery and Needle Holder
8.      Suture
Can be absorbable suture and non-absorbable. Absorbable thread that is usually used for the network layer, binding to blood vessels and sometimes used in minor surgery. Non-absorbable thread is usually used for a particular network and should diremove. In addition, there is also the suture are natural and synthetic. The thread can be monofilament (Ethilon or prolene) or braid (black silk). Generally, minor surgical wound on closed using non-absorbable thread. However, stitching subkutikuler should use this type of absorbable threads.
Black silk yarns are braided non-absorbable nature of the most widely used. Even so, this thread can cause tissue reaction, and produces a rather large wound. This type of thread should be avoided, because today has many alternative synthetic yarn that gives better results. Sores on the scalp is bounded is an exception, because of the use of this type of thread is more satisfying.
Abosrbable non-synthetic yarn consists of prolene and ethilon (trade name). This form of monofilament yarn which is best thread. This type of yarn is quite smooth and flexible and produces little tissue reaction. However, it is more difficult types of yarn tied on silk so often leads to open seams. This problem can be solved by using special techniques like the thread while stitching is done by adding or tying yarn winding. Prolene (polypropylene monofilament) sutures can improve security and easier diremove compared with Ethilon (polyamide monofilament).
Catgut is the best example of a natural absorbable threads in the group. Type of monofilament yarn is made ​​from the gut biology sheep and cattle. There are two kinds of catgut, plain catgut and chromic catgut. Plain catgut has the power for 7-10 days. While chromic catgut have power for 28 days. However, both types of yarns can produce tissue reaction.
Absorbable synthetic yarn consisting of vicryl (polygactin) and Dexon (polyclycalic acid) which is a multifilament yarn. This thread is longer than catgut and have little tissue reaction. Its primary use is to stitch diremove subkutikuler unnecessary. In addition, it can also be used to suture the wound closure and binding on blood vessel (hemostasis).
There are two systems in regulating thickening of the thread, which is the metric system and the traditional system. The numbering system in accordance with the metric thread diameter in tenths of a millimeter. For example, a thread with a size of 2 means has a diameter of 0.2 mm. Traditional system is not rational, but many are using it. The thickness of the thread mentioned using a zero value for example 3/0, 4/0, 6/0 and so on. Most of its value, the smaller the thickness. 6/0 is most delicate numbers diameter thick as hair, are used on the face and the kids. 3/0 is the measure most commonly used in thick mostly minor surgery. Particularly harsh for the skin (skin shoulder). 4/0 is the middle value is also frequently used.
In a suture package, there is all the information about the threads and the full needlenya in the cover package. Each package has two outer seam, the first made ​​of stronger paper that bind to the transparent cover. The suture package secured in a sterile state until the cover is open. Therefore, when opening the package, save it into a sterile container. The second part of the envelope is made ​​of paper soaked in silver on one side. This facilitates suture package Basahan separated from the paper. Then by using a needle-holder, lift the needle of the windings and align carefully. Then, use for sewing action.
Recommendations that can be used suture material is monofilament prolene or Ethilon 1.5 metric (4/0) for interrupted sutures on all parts. Monofilament prolene or ethilon 2 metric (3/0) to a non-absorbable sutures subkutikuler. It can also be used for interrupted sutures on the skin, for example on the hard shoulder. Vicryl 2 metric (3/0) used in the absorbable sutures and suture subkutikuler in hemostasis. Vicryl 1.5 metric (4/0) is used for soft tissue or sutures subkutikuler stitches in. prolene or Ethilon 0.7 (6/0) for smooth stitching on the face and in children.
9.      Surgical Needle
When this form of surgical needle used by most people is the kind of atraumatic consisting of a hole in the end which is where the thread insertion. Thread will follow the path of the needle without causing tissue damage (trauma). In the old model has eye needle and thread loop on that can cause trauma. Needle has the same basic parts, despite these varied shapes. Each section has a tip, which is part of the body and the insertion hole threads. Most of needle-shaped curve with a size of ¼, 5/8, ½ and 3/8 circle. This causes the needle has to meet with a range of other needed stitches. There are also forms a straight needle, but rarely used in minor surgery. Needle flat semicircular used to facilitate its use with the needle holder.
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