Yumuşak Doku Enstrümanları ve Süturleri

Yazarlar

Derya Abeş
https://orcid.org/0000-0002-3675-3181

Özet

Fasiyal estetik cerrahide başarının sağlanması; doğru tanı, cerrahın bilgi birikimi ve uygun enstrüman seçimiyle doğrudan ilişkilidir. İncelenen metinde, cerrahi süreçleri kolaylaştıran temel yumuşak doku aletleri ve sütur materyalleri kapsamlı bir şekilde kategorize edilmiştir. Bistüriler, kullanım alanlarına göre 10'dan 67 numaraya kadar çeşitlilik gösterirken, fasyal cerrahide en sık 15 numara tercih edilmektedir. Dokuların anatomik yapısına uygun olarak tasarlanan Hartmann, Cottle ve Killian tip spekulumlar muayene ve operasyon süreçlerinde nazal yapıları değerlendirmek için kullanılır. İris, Metzenbaum ve Stevens-tenotomy gibi makaslar keskinlik, eğrilik ve uzunluklarına göre hassas diseksiyonlarda veya kalın dokularda yapısal avantajlar sunar. Dokunun minimum travmayla stabilize edilmesi amacıyla Adson gibi dişli veya tırtıklı forsepsler, cerrahi alanın genişletilmesi için ise çeşitli kanca ve ekartörler kullanılır. İğne yapısına uygun portegülerin ve Cottle gibi elevatörlerin kullanımı doku bütünlüğünün korunması açısından kritiktir. Rinoplastide kemik şekillendirme için keski, osteotom, törpü ve çekiçlerden yararlanılır. Yara iyileşmesinde kritik rol oynayan sütur materyalleri ise emilebilen (Vicryl, PDS, Monocryl) ve emilemeyen (İpek, Naylon, Prolene) olarak ikiye ayrılmakta; monofilaman ya da örgülü yapılarına göre doku reaksiyonu ve gerilim kuvveti açısından farklı avantajlar barındırmaktadır.

Achieving success in facial aesthetic surgery is directly related to accurate diagnosis, the surgeon's knowledge, and the correct selection of instruments. In the analyzed text, essential soft tissue instruments and suture materials that facilitate surgical procedures are comprehensively categorized. Scalpels vary from number 10 to 64 based on their application areas, with number 15 being the most frequently preferred in facial surgery. Designed in accordance with anatomical structures, Hartmann, Cottle, and Killian type speculums are utilized to evaluate nasal structures during examination and operative processes. Scissors such as Iris, Metzenbaum, and Stevens-tenotomy offer structural advantages in delicate dissections or thick tissues depending on their sharpness, curvature, and length. Forceps like Adson, either toothed or serrated, are used to stabilize tissue with minimal trauma, while various hooks and retractors are employed to expand the surgical field. The use of needle holders suitable for the needle structure and elevators like Cottle is critical for preserving tissue integrity. In rhinoplasty, chisels, osteotomes, rasps, and mallets are utilized for bone shaping. Suture materials, which play a critical role in wound healing, are divided into absorbable (Vicryl, PDS, Monocryl) and non-absorbable (Silk, Nylon, Prolene); they offer different advantages regarding tissue reaction and tensile strength based on their monofilament or braided structures.

Referanslar

Huizing, H. E., de Groot, A. J. (2004). Functional reconstructive nasal surgery.

Sataloff, RT. Volume ed. Sclafani AP. (2016) Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery: Facial Plastic and Reconstructive Surgery (Vol. 3). JP Medical Ltd.

Hochberg, J., Meyer, K. M., & Marion, M. D. (2009). Suture choice and other methods of skin closure. Surgical Clinics, 89(3), 627-641.

Bernstein, G. (1995). Choosing the correct surgical instruments. Advances in dermatology, 10, 245-83.

Ethicon, Inc. coated VIcRYL (polyglactin 910) Suture. Available at http://www.ethicon.com/healthcare-profes- sionals/products/wound-closure/absorbable-sutures/coated-vicryl-polyglactin-910-suture#!description-and-specs.

Ethicon,Inc.PDSII(polydioxanone)Suture.Availableathttp://www.ethicon.com/healthcare-professionals/prod- ucts/wound-closure/absorbable-sutures/pds-two-polydioxanone#!description-and-specs.

Ethicon, Inc. MONOcRYL (poliglecaprone 25) Suture. Available at http://www.ethicon.com/healthcare-profes- sionals/products/wound-closure/absorbable-sutures/monocryl-poliglecaprone-25#!description-and-specs.

Ethicon,Inc.PERMA-HANDSilkSuture.Availableathttp://www.ethicon.com/healthcare-professionals/products/ wound-closure/non-absorbable-sutures/perma-hand-silk#!overview.

Ethicon,Inc.SurgicalStainlessSteelSuture.Availableathttp://www.ethicon.com/healthcare-professionals/prod- ucts/wound-closure/non-absorbable-sutures/surgical-stainless-steel#!overview.

Ethicon, Inc. ETHILON Nylon Suture. Available at http://www.ethicon.com/healthcare-professionals/products/ wound-closure/non-absorbable-sutures/ethilon-nylon.

Ethicon, Inc. PROLENE Polypropylene Suture. Available at http://www.ethicon.com/healthcare-professionals/ products/wound-closure/non-absorbable-sutures/prolene-polypropylene.

Ethicon, Inc. MERSILENE Polyester Fiber Suture. Available at http://www.ethicon.com/healthcare-professionals/ products/wound-closure/non-absorbable-sutures/mersilene-polyester-fiber.

Ethicon,Inc.ETHIbONDEXcELPolyesterSuture.Availableathttp://www.ethicon.com/healthcare-professionals/ products/wound-closure/non-absorbable-sutures/ethibond-excel-polyester.

Cheney, M. L., & Hadlock, T. A. (Eds.). (2014). Facial surgery: plastic and reconstructive. CRC Press.

Gelecek

12 Ekim 2022

Lisans

Lisans