TREPHINES

Trephines are used to create openings into the cranium for access to the structures within. The burr holes can be used for obtaining biopsy material or for draining a collection of blood or pus.

         Burr holes can also be enlarged or intervening bone between burr holes removed to provide greater access to the brain.

The trephines in use are

Rawbothams

Buchanons

Hudsons burrs

Hudsons Brace

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SCISSORS 2

•       Potts (Fig. 8.38)

•       DeBakey (Fig. 8.39)

•       Microvascular (Fig. 8.40)

•       Satinsky (Fig. 8.41)

            Potts, DeBakey and Microvascular are the scissors used in vascular surgery.

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SCISSORS 1

Mayo
Mcindoe
Nelson
Metzenbaum
Loyd Davies
Abel

Scissors

The choice of surgical scissors is large. They can be long or short, strong or fine blunt or sharp pointed, straight or curved either on the flat side or on the edge.

         More expensive scissors have tungsten edges which are sharp, tough and long lasting.

         The choice will depend on many factors and the surgeon’s preference is perhaps of most importance.

•       For surgical cutting, short scissors are appropriate, and long scissors are used in deep dissection as in thoracic and pelvic surgery.

•       Curved scissors are more popular for dissection because, with the convexity of blades pointing away from the surgeon, structures being cut on both sides of the tip are visible.

         It should be realized that the longer the instruments the more pronounced is the tremor transmitted. The varieties of scissors in use are:

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RIB CUTTERS

Rib cutters are sharp instruments for cutting ribs to gain enterence to thorax
They protect deeper structures from injury
They are required in thoracic surgery
Varieties are :
Vehemerans
Doyans
Gertz

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