Presentation on the topic "Surgery". Presentation on the topic "Surgical Operation
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Mastering anesthesia technology The development of anesthetic technology in 1846. American chemist Jackson and a dentist W. Morton applied inhalation of the vapor of ether when the tooth is removed. Surgeon Warren in 1846 removed the neck tumor under essential anesthesia. In 1847, the English obstetrician J. Simpson for anesthesia applied chloroform and achieved the shutdown of consciousness and loss of sensitivity. Antiseptic - the method of combating an infection English surgeon J. Lister (1827-1912) came to the conclusion that the infection of the wound occurs through the air environment. Therefore, to combat microbes began to spray in operating carbolovic acid. The surgeon's hands before the operation and the operating field were also irrigated by carbolic acid, and at the end of the operation, the wound was covered with gauze impregnated with carbolic acid. Pirogov N.I. (1810-1881) believed that the PNI could contain "enhancing infection" and applied antiseptic substances. In 1885, Russian Surgeon M. S. Subbotin for execution operational interventions produced sterilization of dressing material than and laid the beginning of the Aseptic method. Bleeding F. von Escama (1823-1908) offered a hemostatic harness, which was superimposed on the limb both during a random wound and during amputation. In 1901, Karl Landteyner opened blood groups. In 1907, Ya. Yansky developed a blood transfusion technique.
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Classification of operations
Urgent effects Emergency urgent planned by the volume of interventions of radical Paleative
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According to the multiplicity of execution of simultaneous multiyactive practices of simultaneous typical atypical
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Machining technique Traditional unconventional: endoscopic, microsurgical, endovascular
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Training surgeon to surgery
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Dressing robe on the surgeon
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Dressing gloves
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Patient position on the operating table
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Operational field opening
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Processing of the operating field
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Stages of surgical operation
Surgical Access Surgical Accept Wound Sunning
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Standard conditions for conducting
1. The gentle handling of fabrics - it is impossible to produce a rude compression by tissue tools, cause abstraction and oversight of tissues by manual separation. 2. Careful separation of components of anatomical structures, layer-by-layer crossing organs and tissues. 3. Thorough cessation of bleeding to prevent the development of anemia, secondary bleeding, purulent-inflammatory diseases in the postoperative period. 4. Warning of injury infection is achieved by compliance with the rules of asepsis and antiseptics.
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Pathophysiological changes in the body in the postoperative period
Catabolic phase: lasts 3-7 days; high consumption of energy and plastic materials (proteins, fats and carbohydrates); It is a consequence of the activation of the sympathy adrenal system, hypothalamus and pituitary. Phase reverse development: lasts 4 -6 days; The decay of fats and carbohydrate proteins stops and their active synthesis begins; There is an equilibrium between kata- and anabolic processes. Anabolic phase: lasts 2-5 weeks, on average month; reinforced synthesis of fats and carbohydrate proteins; Activation of the parasympathetic nervous system.
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Highlights of intensive therapy in the postoperative period
1. The fight against narcotic pain (Promedol, Obanopon) and nonarcotic (Droperedol, fentanyl, diclofenac) analgesics. 2. Prevention and treatment of respiratory failure The purpose of the bronchoditics (Eufellin, Papaverin); hydroxiotherapy; respiratory gymnastics; percussian massage chest. 3. Normalization of cardiovascular activity Purpose of cardiac glycosides (Strangefortin, Corglone, Digoxin); metabolites (riboxin); Potassium preparations (potassium chloride); registries (Reopolyglyukin, Kuraltil, Agapurin); Coronarolitics (nitroglycerin, nitrong, slander).
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4. Prevention of exo- and endogenous infection Purpose of synthetic penicillins (ampicillin, oxycyllin); Cephalosporins (Cefzol, Cloofran, Cefazolin, Cefotaxim); ammminoglycosides (gentamicin, sizomycin, dobromycin, methyl issue); Fluoroquinolones (peffersacin, ciprofloxacin). 5. Reducing catabolic processes Purpose of vitamins, anabolics (retabolil). 6. Prevention of thromboembolic complications Purpose of anticoagulants (heparin, fraxipart, cracks). 7. Infusion therapy To cover the functional and pathophysiological losses of fluid hemodynamic blood substitutes (polyglyukin, refooliglucin, gelatin, reform); Disinfecting blood substitutes (hemodez, paradise); protein blood substitutes (amino acids, albumin, protein); Salt and glucosated solutions.
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Monitoring homeostasis
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Blood gas composition monitoring
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Complications of postoperative periodic side
Insolvency of seams Gusts Acute adhesive intestinal obstruction Bleeding in lumen abdominal cavity Bleeding in the lumen of the gastrointestinal abscess of the abdominal cavity
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Localization of abdominal abscesses
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Complications of postoperative periods of respiratory system
bronchial conductivity disorders; Atelectaz; hypostatic pneumonia; pleurisy.
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Complications of postoperative periodic side of the cardiovascular system
acute cardiovascular failure; acute coronary failure; coronary failure; Violation of heart rhythm.
Material prepared biology teacher MOU "SOSH No. 198" of Yapparova Tatyana Vladimirovna
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Stages of surgical treatment: Preparation of a patient for surgery, anesthesia (anesthesia), surgical intervention. Stages of surgery: operational access (skin cut or mucosa), operational treatment of the organ, restoration of the integrity of the tissues disturbed during the operation.
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Classification of operations in nature and goals:
Diagnostic operations allow the surgeon to put a more accurate diagnosis and are, in some cases, the only diagnostically reliable method. Radical operations completely eliminate the pathological process. Palliative operations facilitate the overall state of the patient briefly. Classification of operations in character and goals: Emergency operations require immediate execution (stopping bleeding, tracheotomy, peritonitis, etc.). Urgent operations can be postponed during the clarification of the diagnosis and the preparation of the patient to the operation. Planned operations are performed after a detailed examination of the patient and the necessary preparation for the operation.
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Features of modern surgery
becomes reconstructive surgery, that is, aimed to restore or replace the affected organ: a vessel prosthesis, artificial valve Hearts, strengthening the synthetic grid of the hernial gate, etc.; It becomes minimally invasive, that is, aimed at minimizing the area of \u200b\u200bintervention in the body - mini-access, laparoscopic technique, X-ray endovascular surgery. Areas such as neurosurgery, cardiac surgery, endocrine surgery, traumatology, orthopedics are connected with surgery. plastic surgery, transplantology, ophthalmosurgery, maxillofacial Surgery, urology, andrology, gynecology, etc.
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Historical information
The era of the revival of Ambroaz Pare (1517-1590) - the French surgeon replaced the technique of amputation and dressing of large alms. Paracels (1493-1541) - the Swiss doctor has developed a methodology for the use of binding to improve general status wounded. Garvey (1578-1657) - opened the laws of blood circulation, determined the role of a heart as a pump. In 1667, the French scientist Jean Denis first produced blood transfusion to man. XIX century - a century of large discoveries in surgery received development topographic anatomy and operational surgery. Pirogov N.I. Performed high cross section bladder For 2 minutes, and the shini amputation is 8 minutes. Napoleon I Larray Army Surgeon for one day produced 200 amputations.
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The development of the technology of anesthetic in 1846. American chemist Jackson and Dentist W. Morton applied inhalation of the vapor of ether when the tooth is removed. Surgeon Warren in 1846 removed the neck tumor under essential anesthesia. In 1847, the English obstetrician J. Simpson for anesthesia applied chloroform and achieved the shutdown of consciousness and loss of sensitivity. Antiseptic - the method of combating an infection English surgeon J. Lister (1827-1912) came to the conclusion that the infection of the wound occurs through the air environment. Therefore, to combat microbes began to spray in operating carbolovic acid. The surgeon's hands before the operation and the operating field were also irrigated by carbolic acid, and at the end of the operation, the wound was covered with gauze impregnated with carbolic acid. Pirogov N.I. (1810-1881) believed that the PNI could contain "enhancing infection" and applied antiseptic substances. In 1885, the Russian surgeon M. S. Subbotin for performing operational interventions produced sterilization of the dressing material than and laid the beginning of the Aseptic method. Bleeding F. von Escama (1823-1908) offered a hemostatic harness, which was superimposed on the limb both during a random wound and during amputation. In 1901, Karl Landteyner opened blood groups. In 1907, Ya. Yansky developed a blood transfusion technique.
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Russian Surgery
Surgery in Russia began to develop from 1654, when a decree was issued on the opening of wrestling schools. In 1704, a pharmacy case appeared and the construction of a surgical instrument plant was completed in the same year. Until the XVIII century, there were practically no surgeons in Russia, and hospitals were absent. The 1st Hospital in Moscow is open in 1707. In 1716 and 1719. Two hospitals are commissioned in St. Petersburg.
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