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a common surgical tool for cutting or dissecting tproblems.provided to reduced loose tconcerns, the chisels stabilize the tworries during cuttingprovides exceptionally good control of depth and direction of cutting. even more traumatic than scalpel because they crush in the time of cutting.

Goal

contolled use of tworry scissors throughout scissor cutting, press cutting and also blunt dissection

Skills to Practice

wide-based tripod gripprecise scissor cuttingcontrolled push cuttingaccurate, reliable blunt dissection 


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scissors are classified according totips (sharp-sharp, blunt-blunt, sharp-blunt)blade shape (straight or curved)cutting edge (normal or serrated)blunt-blunt tips with a normal cutting edge are typically usedright scissors carry out more mechanical advantage for cutting thick or tough tissuecurved scissors permit better maneuvercapacity and visibility

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scissors come in a variety of sizes and also deindicators relying on their intfinished usefrequently offered fundamental forms include:

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sturdy designsupplied to cut heavier tconcerns (eg. linea alba, thick fascia)< memory tip: “short” name” → “short” handle>

Metzenbaum scissors

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reasonably finer designprovided for fine tworries and blunt dissection (eg. subcutaneous and light fascia)< memory tip: “long” name”  → “long” handle>

General function ("suture") scissors

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relatively shorter and also bigger bladesfrequently lower high quality (cheaper) so can be commonly reput as become dull or damagedsupplied to reduced sutures and also various other products, NOT tissuespreserves the sharpness of the tproblem scissors

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many effective holdthumb and ring finger through the ringsmiddle finger is put on top of the finger ringstop placing fingers as well far right into rings as borders maneuverability and comfort (stay over initially knuckle)avoid putting index or middle finger though ring as decreases stcapacity and also efficiencyleft-handed surgeons: a lot of adapt to using scissors via right hand yet left handed scissors are available

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generally used for cutting from left to right (much less awkward)thumb and also middle finger with the rings through take care of relaxing on 3rd and also fourth fingers
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deserve to be modified when cutting fowards bodythumb and index finger through the ringseven more comfortable reliable and controlled
more traumatic than scalpel but gives terrific control

Technique:

chisels partially closed over tissue and elevated slightly (stabilizes tissues)tips closed to cut the tissuejust usage the tipseven more crushing trauma and jagged edges if whole blade used

When continuing an incision

tips are not closed completelychisels are re-opened, tips progressed and more tworry cutproceeds for whole incision lengthstays clear of creating a collection of jagged cut


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effective cutting methodused for much longer incisions in light fascia

Technique:

begins with a scissor knives partly closed (tip still open)proceed by pushing the almost closed blade forward via the tissuetworry is cut in one continuous motion without additionally opening/closing of the bladesscissors should development conveniently without tearing the tconcern or approach is abandoned

provided to separate fine tconcern attachments in between anatomic tworry planes and also isolate fragile structures

nice for separating muscles, fat and fine fascial planesmore traumatic than sharp dissection (scalpel or scissor)creates even more dead spacenot for splitting strong fascial attachments

Technique

closed tips of the scissors are put into tissueblades are opened separating (tearing) loose tworry connectionsscissors tips are rerelocated without cshedding the chisels to proccasion unregulated cuttingthe process is recurring as needed

Blunt dissection