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Halsteads Principles
Halsted's principles, also known as Tenets of Halsted, are the basic principles of surgical technique regarding tissue handling. These key points were introduced in the late 19th century by William Stewart Halsted, co-founder of Johns Hopkins Hospital. *Gentle handling of tissue *Meticulous haemostasis *Preservation of blood supply *Strict aseptic technique Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is der ... *Minimum tension on tissues *Accurate tissue apposition *Obliteration of deadspace References Surgery {{surgery-stub ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually span ...
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William Stewart Halsted
William Stewart Halsted, M.D. (September 23, 1852 – September 7, 1922) was an American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several new operations, including the radical mastectomy for breast cancer. Along with William Osler (Professor of Medicine), Howard Atwood Kelly (Professor of Gynecology) and William H. Welch (Professor of Pathology), Halsted was one of the "Big Four" founding professors at the Johns Hopkins Hospital. His operating room at Johns Hopkins Hospital is in Ward G, and was described as a small room where medical discoveries and miracles took place. According to an intern who once worked in Halsted's operating room, Halsted had unique techniques, operated on the patients with great confidence and often had perfect results which astonished the interns. Throughout his professional life, he was addicted to cocaine and later also to morphine, which wer ...
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Johns Hopkins Hospital
The Johns Hopkins Hospital (JHH) is the teaching hospital and biomedical research facility of the Johns Hopkins School of Medicine, located in Baltimore, Maryland, U.S. It was founded in 1889 using money from a bequest of over $7 million (1873 money, worth 163.9 million dollars in 2021) by city merchant, banker/financier, civic leader and philanthropist Johns Hopkins (1795–1873). Johns Hopkins Hospital and its School of Medicine are considered to be the founding institutions of modern American medicine and the birthplace of numerous famous medical traditions including rounds, residents and house staff. Many medical specialties were formed at the hospital including neurosurgery, by Harvey Cushing and Walter Dandy; cardiac surgery by Alfred Blalock; and child psychiatry, by Leo Kanner. Attached to the hospital is the Johns Hopkins Children’s Center which serves infants, children, teens, and young adults aged 0–21. Johns Hopkins Hospital is widely regarded as one of the ...
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Haemostasis
In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulation, which changes blood from a liquid to a gel. Intact blood vessels are central to moderating blood's tendency to form clots. The endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and thrombomodulin, and prevent platelet aggregation with nitric oxide and prostacyclin. When endothelium of a blood vessel is damaged, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand factor, which initiate the maintenance of hemostasis after injury. Hemostasis involves three major steps: * vasoconstriction * temporary blockage of a hole in a damaged blood vessel by a platelet plug * blood coagulation (formation of fibrin clots) These processes seal the injury or hol ...
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Aseptic Technique
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is derived from the older antiseptic techniques, a shift initiated by different individuals in the 19th century who introduced practices such as the sterilizing of surgical tools and the wearing of surgical gloves during operations. The goal of asepsis is to eliminate infection, not to achieve sterility. Ideally, a surgical field is sterile, meaning it is free of all biological contaminants (e.g. fungi, bacteria, viruses), not just those that can cause disease, putrefaction, or fermentation. Even in an aseptic state, a condition of sterile inflammation may develop. The term often refers to those practices used to promote or induce asepsis in an operative field of surgery or medicine to prevent infection. History The modern concept of asepsis ...
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Dead Space (physiology)
Dead space is the volume of air that is inhaled that does not take part in the gas exchange, because it either remains in the conducting airways or reaches alveoli that are not perfused or poorly perfused. It means that not all the air in each breath is available for the exchange of oxygen and carbon dioxide. Mammals breathe in and out of their lungs, wasting that part of the inhalation which remains in the conducting airways where no gas exchange can occur. Components ''Total dead space'' (also known as physiological dead space) is the sum of the anatomical dead space and the alveolar dead space. Benefits do accrue to a seemingly wasteful design for ventilation that includes dead space. #Carbon dioxide is retained, making a bicarbonate-buffered blood and interstitium possible. #Inspired air is brought to body temperature, increasing the affinity of hemoglobin for oxygen, improving O2 uptake. #Particulate matter is trapped on the mucus that lines the conducting airways, a ...
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