Lecture № 1
The subject of the problem of topographic
anatomy and operative surgery
primary treatment of wounds
Closure of skin defects
• Topographic anatomy - the study of the
morphological structure of the different regions
of the human body.
• TOPOS - the place and the GRAPH - I write.
Hence - topographic, ie Regional (regional)
anatomy.
1) Layered topography - ie successive layers outcrop area, from the
skin.
2) Golotopiya - position of authority in relation to the human body.
The liver, for example, is golotopicheski at right hypochondrium
and epigastric abdominal cavity and the heart - in the anterior
mediastinum and thoracic cavity, etc.
3) syntopy - the ratio of the body to the surrounding organs and
tissues. Thus, behind the stomach adherent pancreas, bottom poperechnoobodochnaya intestine, stomach in front of the front
abdominal wall, etc. Relationships are described and with n t o p u
and body.
4) Skeletopiya body, its relation to the level of the skeleton. Thus,
renal pedicle skeletotopicheski located at the level II of the lumbar
vertebrae, pylorus - XII breast etc.
5) A typical anatomy, design a school professor. V.N.Shevkunenko
studying the variants of the structure of organs and their extreme
morphological types in connection with a wide variety of shapes
and positions.
• 6) Age anatomy - the process of identifying age
differences in the location of bodies.
7) Xirurgicheskaya studying anatomy and
morphology of the body surrounding
anatomical structures in pathological conditions.
Method for studying topographic
anatomy
•
Dissection - allocation body, followed by a
study.
Method cuts Pirogov ("Pirogov slices") to the
frozen corpse.
The method of "ice sculpture" Pirogov is the
design on the frozen corpse of a separate
body, by removing all excess tissue using chisel
and hammer.
Method injections or cordials vessels.
SUBJECT of Surgery
• Operative Surgery - is the study of surgical
operations, addressed the development and
study of techniques and good practice surgery.
In surgery distinguish two main
points: on-line access and
operational techniques.
• 0perativnym access is the part of the operation,
the surgeon ensures outcrop body.
The operative technique is called the main part
of the operation on the organ.
ANESTEZIYA
• 1) local anesthesia,
2) nerve block,
3) spinal anesthesia,
4) epidural anesthesia.
Surgical instruments: Divided
into 5 groups
•
to disconnect the tissues - scalpels, knives, scissors, saws,
chisels, osteotomes, pliers, etc.
•
to stop the bleeding - hemostat? Kocher, Billroth, Halstead,
Mikulic, etc. and ligature needles Cooper and Deschamps.
•
fixation tools (enhance and support)? tweezers anatomical,
surgical, web-footed, blunt and sharp hooks, probes, and large
extensions (mirrors), bone fixation forceps.
•
for tissue - needle holders with sharps needles, instruments for
bone joint.
•
special tools used for ophthalmology, ENT, neurosurgery,
cardiology, pulmonology, gynecology and urology.
Classification of transactions
• radical
• palliative
By due date
Emergency
urgent
routine
healing
diagnostic
PRIMARY TREATMENT OF
WOUNDS
• I) wide incision wounds
2) deprived of food and excision of
contaminated sites
3) stop the bleeding,
4) removal of free-lying foreign bodies and
bone fragments devoid of periosteum,
5) wide drainage of the wound,
6) immobilization of the affected limb.
Types of surgical sutures
• Primary - Where the operation menee than 6-12
hours after the injury, and if it was possible to
excise the wound;
Initially delayed - in the case of late avivement 24 hours after the injury - the wound is
recommended to flash, but do not leave seams
tied, sutures tied in 4-5 days if there are no signs
of inflammation in the wound;
Secondary - after days, the wound is festering
like after treatment stitches.
Distinguish 5 types of plastic
surgery on the skin
• Plastic local tissues,
plastic skin graft to pedicle,
Free transplantation of skin grafts.
the use of cultured allofibroblastov.
temporary closure of a biological defect.
Виды кожной пластики местными
тканями.
I и II— по Ю. К. Шимановскому; III — по А. А. Лимбергу; IV —
индийский метод; V — итальянский метод (вариант метода).
Способы выкраивания кожного
стебля по В. П. Филатову.
Пластика мигрирующим стеблем
по В. П. Филатову
Разновидности кожной пластики
итальянским методом
Взятие расщепленного лоскута
кожи
Некоторые виды пластики
местными тканями
1 — применение послабляющих разрезов; 2 —
перемещение прямоугольных лоскутов; 3 — пластика
встречными треугольниками
Этапы создания стебля по Л. Р.
Балону.
THANK YOU FOR YOUR
ATTENTION