第讲microsurgery.pptVIP

显微外科临床应用有哪些方面？ 1. 骨科及整形外科：断肢再植；足趾移植再造手（指）；周围神经损伤修复； （肌）皮瓣移植；神经移植；骨（膜）移植；关节移植 2. 其他领域：扩大手术范围，提高手术质量。 * * MICROSURGERICAL TECHNIQUES 一、Concept Microsurgery is a kind of surgical techniquues, operating on tiny structures under the microscope with sutures that are barely visible. It is a important advancement in the modern surgery. History 1921, Carl-Olof Nylen and Holmgen in Sweden first used the operating microscope for treatment of otosclersis. They are the founders of microsurgery. Lab stage: in 1960, Jacobson and Suarez Clinical stage: From 70s, microsurgery was rapidly developed, it have been used in all branches of surgery. Broad applications have involved:example: replantation surgery; micro vascular free transfer of flaps, omentum, toes, bones and muscles; microlymphatic surgery and so on. 二、Conditions of Microsurgery Suitable magnification Appropriately instrument and sutures Training to acquire hand-eye-coordination through the microscope （一）surgical magnifying loupes and operating microscope 1.Loupes: single used be heads magnifying from 2~4times, even to 6 times working distance 20~25cm working view 2~5cm It is commonly used for micro-dissection and obtaining a free flap, but the surgeon feels easily tired with using it. 2. Operating Microscope: optical system Lighting Support Supplementary installation Single -headed -binocular warm lighting on table camera double-headed-binocular cold lighting standing movie-camera double-headed-binocular hanged video +observation tube Requisite: Magnifying 10~40 times Working distance 20cm Enough brighter Record syste