Surgery

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Surgery (from Greek: ??????????? cheerobiic? (Consist of ?? "," hand "and" work "), through Latin: chirurgiae , meaning" handwork " ) is a medical specialty that uses manual and operative instrumental techniques in the patient to investigate or treat pathological conditions such as illness or injury, to help improve the function or appearance of the body or to correct undesirable areas.

The act of doing surgery can be called "surgical procedure", "surgery", or just "surgery". In this context, the verb "operates" means carrying out an operation. The adjective "surgery" means relating to surgery; such as surgical instruments or surgical nurses. Patients or subjects in which surgery is performed may be people or animals. A surgeon is a person who performs surgery and a surgeon's assistant is a person who practices surgical help. The surgical team consists of a surgeon, a surgeon's assistant, an anesthesiologist, a circulating nurse, and a surgical technologist. Surgery usually lasts a few minutes to hours, but it is usually not a type of ongoing or periodic treatment. The term "surgery" may also refer to the place where the surgery is performed, or, in English English, only the doctor's office, dentist, or veterinarian.

Video Surgery

Definition

Surgery is a technology that consists of physical intervention in the tissues.

As a general rule, the procedure is considered surgical when it involves cutting a patient's tissue or closing the wound that was previously sustained. Other procedures not always included in this rubric, such as angioplasty or endoscopy, may be considered surgical if involving "general" surgical procedures or arrangements, such as the use of sterile environments, anesthesia, antiseptic conditions, typical surgical instruments, and sutures or stapling. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to excision that does not penetrate the structure of the excised (eg corneal laser ablation) or radiosurgical procedures (eg tumor radiation).

Operation type

Surgical procedures are usually categorized by urgency, type of procedure, system of body involved, level of invasion, and special instrumentation.

• By time: Elective surgery is performed to improve non-life-threatening conditions, and is done at the request of the patient, depending on the surgeon and the availability of the surgical facility. Semi-elective surgery is one that must be done to avoid permanent disability or death, but can be delayed for a short time. Emergency surgery is an operation that must be done immediately to save lives, limbs, or functional capacity.
• By purpose: Exploratory surgery is performed to assist or confirm the diagnosis. Therapeutic surgery treats a previously diagnosed condition. Cosmetic surgery is performed to improve the appearance of the normal structure subjectively.
• By type of procedure: Amputation involves the cutting of body parts, usually limbs or digits; castration is also an example. Resection is the lifting of all internal organs or body parts, or key parts (lung lobes, liver quadrants) of such organs or body parts that have their own name or code marking. Replantation involves the reconnection of disconnected body parts. Reconstructive surgery involves reconstructing injured, truncated, or disabled body parts. Excision is the cutting or removal of only part of the organ, tissue, or other body parts of the patient. Transplant surgery is the replacement of organs or body parts by inserting another from a different human (or animal) to the patient. Removing parts of organs or bodies from humans or live animals for use in transplants is also a type of surgery.
• Based on body parts: When an operation is performed on one system or organ structure, it may be explained by the organ, organ system or tissue involved. Examples include cardiac surgery (performed at the heart), gastrointestinal surgery (performed in the gastrointestinal tract and accessory organs), and orthopedic surgery (performed on bone or muscle).
• Based on the invasive level of surgical procedure: Minimally invasive surgery involves a smaller outer incision to insert a miniature instrument in a body cavity or structure, such as in laparoscopic surgery or angioplasty. In contrast, an open surgical procedure such as laparotomy requires a large incision to access the desired area.
• With the equipment used: Laser surgery involves the use of lasers to cut tissue rather than a scalpel or similar surgical instrument. Micro surgery involves the use of an operating microscope for the surgeon to look at small structures. Robotic surgery using surgical robots, such as Da Vinci or Zeus surgical systems, to control instrumentation under the direction of surgeons.

Terminology

• The excision operation name often begins with a name for the cut organ (cut) and ends with -ektomi .
• Procedures involving cuts to organs or networks end with -otomy . Surgical procedure of cutting the abdominal wall to gain access to the abdominal cavity is laparotomy.
• Minimally invasive procedure involving a small incision in which the endoscope is inserted ends at -copy . For example, such surgery in the abdominal cavity is called laparoscopy.
• Procedures for the formation of permanent or semi-permanent openings called stomas at the ends of the body in -ostomy .
• The reconstruction, plastic or cosmetic operation of the body part begins with a name for the body part to be reconstructed and ends -oplasti . Rhino is used as a prefix for "nose", therefore rinoplasty is a reconstructive or cosmetic surgery for the nose.
• Repair of damaged or congenital abnormal structures ends with -rrafi .
• The re-operation (back to the operating room) refers to returning to the operating room after the initial surgery is performed to re-handle the aspect of patient care best treated by surgery. Reasons for re-surgery include persistent bleeding after surgery, development or persistence of infection.

Maps Surgery

Description of operating procedure

Location

In hospitals, modern surgery is often performed in the operating room using surgical instruments, surgical tables for patients, and other equipment. Among US hospitals for nonnatal and nonneonatal conditions in 2012, more than a quarter of the fixed and half of the hospital costs involved remained including the operating room (OR) procedure. The environment and procedures used in the operation are governed by the principles of aseptic technique: tight separation of "sterile" (free of microorganisms) things from "not sterile" or "contaminated" p. All surgical instruments should be sterilized, and the instrument must be replaced or re-sterilized if contaminated (ie handled in a non-sterile manner, or allowed to touch non-sterile surfaces). Operating room staff should wear sterile clothes (scrubs, scrub hats, sterile surgical gowns, sterile latex gloves or latex gloves and surgical masks), and they should rub their hands and arms with approved disinfecting agents prior to each procedure.

Preoperative treatment

Prior to surgery, patients were given a medical examination, received certain pre-operative tests, and their physical status was assessed according to the ASA physical status classification system. If this result is satisfactory, the patient signs the consent form and is given an operating license. If the procedure is expected to result in significant blood loss, an autologous blood donor may be performed weeks before surgery. If surgery involves the digestive system, the patient may be instructed to prepare the intestine by taking a solution of polyethylene glycol the night before the procedure. Patients were also instructed to abstain from food or drink (NPO orders after midnight on the night before the procedure), to minimize the effects of stomach contents on preoperative drugs and to reduce aspiration risk if the patient vomited during or after the procedure.

Some medical systems have a routine practice of chest X-rays before surgery. The premise behind this practice is that doctors may discover some unknown medical conditions that would complicate surgery, and that after finding this with a chest X-ray, the doctor will adjust the appropriate surgical practice. In fact, professional medical specialist organizations recommend against routine preoperative chest X-rays for patients who have a medical history and are presented with a physical examination that does not show chest x-rays. Routine X-rays are more likely to produce problems such as misdiagnosis, overtreatment, or other negative outcomes than to benefit patients. Likewise, other tests include full blood count, prothrombin time, partial thromboplastin time, basic metabolic panel, and urinalysis should not be performed unless the results of these tests may help evaluate surgical risk.

Staging for operations

In the pre-operative holding area, the patient changes his street clothes and is asked to confirm the details of his operation. A set of vital signs is noted, IV peripheral lines are placed, and preoperative drugs (antibiotics, sedatives, etc.) are given. When the patient enters the operating room, the skin surface to be operated, called the surgical field, is cleaned and prepared by applying antiseptics such as chlorhexidine gluconate or povidone-iodine to reduce the likelihood of infection. If the hair is on the surgical site, the hair is cut before the preparation application. The patient is assisted by an anesthesiologist or resident to make a particular surgical position, then a sterile curtain is used to cover the surgical site or at least a large area around the surgical area; curtains are trimmed to a pair of posts near the head of the bed to form an ether screen, which separates the anesthesia/anesthesiological (non-sterile) work area from the surgical site (sterile).

Anesthesia is given to prevent pain from incision, tissue manipulation and suturing. Under the procedure, anesthesia may be given locally or as a general anesthetic. Spinal anesthesia may be used when the surgical site is too large or deep for local blocks, but general anesthesia may be undesirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient may remain conscious or minimally sedated. In contrast, general anesthesia makes the patient unconscious and paralyzed during surgery. The patient is intubated and placed in a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents. The choice of surgical methods and anesthesia techniques aims to reduce the risk of complications, shorten the time required for recovery and minimize the response of surgical stress.

Surgery

Incisions are made to access the surgical site. Blood vessels can be clamped or burned to prevent bleeding, and retractors may be used to expose the site or make open incisions. Approach to the surgical site may involve multiple layers of incision and dissection, as in abdominal surgery, where the incision must cross the skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, the bone may be cut for further access to the inside of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic surgery (chest) to open the ribs. While in aseptic surgical technique is used to prevent infection or further spread of the disease. The surgeons, wrists, and forearms of the surgeon and assistant are washed for at least 4 minutes to prevent germs from entering the surgery, then sterile gloves placed into their hands. An antiseptic solution is applied to the patient's area of ​​the body to be operated on. Sterile curtains are placed around the operating site. Surgical masks are worn by the surgical team to avoid germs on fluid droplets from their mouth and nose from contaminating the surgery site.

Work to fix the problem in the body then continue. This work may involve:

• excision - cutting off organs, tumors, or other tissues.
• resection - removal of some organs or other body structures.
• reconnection of organs, tissues, etc., especially if disconnected. Resection of organs such as the gut involves reconnection. Internal tailoring or staples can be used. Surgical relationship between blood vessels or other hollow or tubular structures such as intestinal loops is called anastomosis.
• Reduction - movement or rearrangement of body parts to their normal position. eg A fractured nose reduction involves the physical manipulation of bone or cartilage from their displaced state back to its original position to restore normal air flow and aesthetics.
• ligation - binds blood vessels, ducts, or "tubes".
• graft - possibly pieces of tissue cut from the same body or flap (or different) of tissue that is still partially connected to the body but reviewed for rearranging or restructuring the area of ​​the body in question. Although transplantation is often used in cosmetic surgery, it is also used in other surgeries. The graft can be taken from one area of ​​the patient's body and inserted into another body area. An example is a bypass surgery, in which a clogged blood vessel is passed by a graft from another part of the body. Or, the grafts can come from other people, corpses, or animals.
• the insertion of the prosthetic section when necessary. Pin or screws to adjust and hold the bone can be used. Bone parts can be replaced with prosthetic rods or other parts. Sometimes plates are inserted to replace the damaged skull area. Artificial hip replacements have become more common. Pacemakers or valves may be included. Many other types of prostheses are used.
• creation of stoma, permanent or semi permanent opening in body
• In transplant surgery, donor organs (excreted from the donor body) are fed into the recipient's body and reconnected to the recipient by all necessary means (blood vessels, ducts, etc.).
• arthrodesis - an adjacent bone surgery connection so bones can grow together into one. Spinal fusion is an example of a connected vertebra that allows them to grow together into one part.
• modify the digestive tract in bariatric surgery to lose weight.
• repair of fistula, hernia, or prolapse
• other procedures, including:

• cleanse clogged ducts, blood, or other blood vessels
• removal of stones (stone)
• drain collected liquids
• debridemen - removal of dead, damaged, or diseased tissue

Blood or blood developers can be given to compensate for blood loss during surgery. After the procedure is complete, stitches or staples are used to close the incision. After the incision is closed, the anesthetic agent is stopped or reversed, and the patient is removed from ventilation and extubation (if general anesthesia is given).

Post-operative treatment

After surgery, the patient is transferred to the post-anesthesia care unit and closely monitored. When the patient is judged to have recovered from anesthesia, he is transferred to a surgical ward elsewhere in the hospital or home. During the postoperative period, the patient's general function was assessed, the outcome of the procedure was assessed, and the surgical site was examined for signs of infection. There are several risk factors associated with postoperative complications, such as immune deficiency and obesity. Obesity has long been considered a risk factor for adverse postoperative outcomes. It has been linked to many disorders such as the hypoventilation syndrome of obesity, atelectasis and pulmonary embolism, adverse cardiovascular effects, and wound healing complications. If removal of removable skin is used, they are removed after 7 to 10 days postoperatively, or after incisional healing is underway.

It is not uncommon for the surgical channel (see Drain (surgery)) needed to remove blood or fluid from a surgical wound during recovery. Most of these channels stay inside until the volume is smaller, then they are removed. This can become blocked, causing an abscess.

Postoperative therapy may include adjuvant treatments such as chemotherapy, radiation therapy, or drug administration such as anti-rejection drugs for transplantation. Other follow-up or rehabilitation studies may be prescribed during and after the recovery period.

The use of topical antibiotics in surgical wounds to reduce infection rates has been questioned. Antibiotic ointment tends to irritate the skin, slow healing, and may increase the risk of developing contact dermatitis and antibiotic resistance. It has also been suggested that topical antibiotics should only be used when a person shows signs of infection and not as a precaution. A systematic review published by Cochrane (organization) by 2016, though, concludes that topical antibiotics applied to some types of surgical wounds reduce the risk of surgical site infection, when compared with no treatment or use of Antiseptics. The study also found no conclusive evidence suggesting that topical antibiotics increase the risk of local skin reactions or antibiotic resistance.

Through a retrospective analysis of national administrative data, the association between death and elective surgical procedure days indicates a higher risk in procedures performed later in the workweek and at the weekend. The probability of death was 44% and 82% higher respectively when comparing procedures on Friday for weekend procedures. These "weekday effects" have been postulated to come from a number of factors including poorer service availability over the weekend, as well as, reducing the number and extent of experience over the weekend.

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Epidemiology

AS

In 2011, out of 38.6 million inpatients in US hospitals, 29% included at least one operating room procedure. It remains responsible for 48% of the total $ 387 billion hospital fees.

The total number of procedures remained stable from 2001 to 2011. In 2011, more than 15 million surgery procedures were performed in US hospitals.

Data from 2003 to 2011 show that the highest US hospital fees for surgical services; the cost of surgical services was $ 17,600 in 2003 and is projected to be $ 22,500 in 2013. For hospital stays in 2012 in the United States, private insurance has the highest percentage of surgical expenses. in 2012, the average hospital cost in the United States is highest for surgical treatment.

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Custom population

elderly

Older adults have varying physical health. Fatigued parents are at the risk of significant post-surgical complications and the need for continued care. An older patient's assessment before elective surgery can accurately predict the patient's recovery path. One weakness scale uses five items: unintentional weight loss, muscle weakness, fatigue, low physical activity, and slow walking speed. A healthy person gets a score of 0; scores of very weak people 5. Compared with the elderly who are not weak, people with moderate fragile values ​​(2 or 3) are twice as likely to have post-operative complications, spend 50% more time in the hospital, and three times greater will likely be discharged to a skilled treatment facility instead of their own home. Fatigued old patients (scores 4 or 5) had worse outcomes, with the risk of being sent home to nursing homes that were up to twenty times the rate for elderly people who were not weak.

Children

Surgery in children requires unusual consideration in adult surgery. Children and adolescents are still developing physically and mentally making it difficult for them to make decisions and give consent for surgical treatment. Bariatric surgery in youth is one of the controversial topics related to surgery in children.

Vulnerable Population

Doctors perform surgery with patient consent. Some patients may provide better informed consent than others. Populations such as imprisoned persons, people living with dementia, mentally incompetent people, forced people, and others who can not make decisions with the same authority as ordinary patients have special needs when making decisions about their personal health, including operation.

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In low- and middle-income countries

In 2014, the Global Lancet Surgery Commission was launched to examine cases for operations as an integral component of global health care and to provide recommendations on the delivery of surgical and anesthetic services in low- and middle-income countries. Among the conclusions in this study, two main conclusions were reached:

• Five billion people worldwide do not have access to safe, timely, and affordable surgical and anesthetic treatments. Areas where most of the population lack access include Sub-Saharan Africa, Subbenua India, Central Asia and, to a lesser extent, Russia and China. Of the approximately 312.9 million surgical procedures performed worldwide in 2012, only 6.3% is performed in countries comprising 37.3% of the world's poorest citizens.
• 143 million additional surgical procedures are needed each year to prevent unnecessary death and disability.

Globally, there have been several studies comparing the results of operations in different countries income levels, although the evidence shows far worse outcomes than operations performed in lower revenue arrangements. One major prospective study of 10,745 adult patients undergoing emergency stomach surgery from 357 centers in 58 high, middle, and low income countries found that mortality was three times higher than in high HDI countries even when adjusted for prognostic factors.. In this study the overall global mortality rate was 1 Ã, Â · 6 percent at 24 hours (height 1 Ã, Â · 1 percent, medium 1 Ã, Â · 9 percent, low 3 Ã, Â · 4 percent; P & lt ; 0 Ã, Â ° 001), increased to 5 Â · 4 percent per 30 days (high 4 Â ± 5 â € <â €

Taking a similar approach, a unique global study of 1,409 children undergoing emergency stomach surgery from 253 centers in 43 countries shows that mortality adjusted for children after surgery may be as high as 7 times greater in low and middle HDI countries -HDI compared to the high -HDI state, translates to 40 excess deaths per 1000 procedures performed in this setting. Internationally, the most common surgeries are appendix, small bowel resection, pyloromyotomy and intussusception correction. After adjustment for patients and hospital risk factors, child mortality at 30 days was significantly higher in low HDI (OR 3.14 (95% CI 2.52 to 20.23), p <0.01) and medium-HDI (4.42 (1.44-13.56), p = 0.009) countries compared with high HDI countries.

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Human rights

Access to surgical care is increasingly recognized as an integral aspect of health care, and therefore develops into a normative derivation of human rights for health. The ICESCR Articles 12.1 and 12.2 define human rights for health as "the right of everyone to enjoy the highest attainable standard of physical and mental health." In August 2000, the United Nations Committee on Economic, Social and Cultural Rights (CESCR) interpreted this as " the right to enjoy the various facilities, goods, services and conditions necessary for the highest attainable health realization ". Surgical treatment can be viewed as a positive right - the right to protective health care.

The weave through the Human Rights and International Health literature is the right to be free of surgical disease. The 1966 ICESCR Article 12.2a illustrates the need for "the provision for the reduction of the stillbirth and infant mortality rate and for the healthy development of children" which is then interpreted as "requiring measures to improve... emergency obstetric services". Article 12.2d of the ICESCR sets out the need for "the creation of conditions which would guarantee all medical services and medical attention in the event of an illness", and interpreted in a 2000 comment to include timely access to "basic prevention, curative services... for injury care and proper disability. ". Obstetric care has a close relationship with reproductive rights, which includes access to reproductive health.

Surgeons and public health advocates, such as Kelly McQueen, have described operations as "Integral to the right to health". This was reflected in the establishment of the WHO Global Initiative for Emergency Care and Essential Surgery in 2005, the establishment of the Lancet Commission for Global Surgery, World Bank 2015 Publishing Volume 1 of the Priority of Disease Control "Essential Surgery", and the World Health Assembly 2015, 68.15 submitted Resolution for the Enhancement of Emergency and Essential Surgical Treatments and Anesthesia as Universal Healthcare Components. The Lancet Commission for Global Operations describes the need for access to "available, affordable, timely and safe" surgical and anesthetic treatments; parallel dimensions in ICESCR General Comment. 14, which also outlines the need for available, accessible, affordable and timely health care.

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History

Ancient Egyptian

Surgical treatment dates back to prehistoric era. The oldest where there is evidence is trepanation, where holes are drilled or scraped into the skull, thus exposing the dura mater to treat health problems associated with intracranial pressure and other diseases. Prehistoric surgical techniques are seen in Ancient Egypt, where mandibular dates around 2650 BC show two perforations just below the root of the first molar, indicating abscessed dental dryness. The surgical texts from ancient Egypt originated some 3500 years ago. Surgical operations performed by priests, specializing in medical treatments similar to today, and using stitches to seal wounds. Infection is treated with honey.

India and China

The remainder of the early Harappan period of the Indus Valley Civilization (c 3300 BC) shows evidence of a tooth that has been drilled since 9,000 years ago. Susruta is an ancient Indian surgeon who is generally regarded as the author of the treatise Sushruta Samhita. He is dubbed the "father of surgery" and the period is usually placed between the period 1200-600 BC. One of the earliest known mention of names is from the Bower Manuscript where Sushruta is listed as one of the ten rishis in the Himalayas. The text also shows that he studied operations in Kasi of Lord Dhanvantari, the god of medicine in Hindu mythology. This is one of the oldest known surgical texts and describes in detail the examination, diagnosis, treatment, and prognosis of various diseases, as well as procedures for performing various forms of cosmetic surgery, plastic surgery and nose surgery.

Surgical instruments have also been found at the archaeological site of the Chinese Bronze Age dating from the Shang Dynasty, along with seeds that may be used for herbal medicine.

Ancient Greek

In ancient Greece, temples dedicated to the god of healing Asclepius, known as Asclepieia (Greek: ?????????? , singing. Asclepieion ?????????? ), serves as a center for medical advice, prognosis, and healing. In Asclepieion of Epidaurus, some registered surgical medications, such as abdominal abscess opening or removal of a traumatic foreign material, are quite realistic to occur. The Greek Galen was one of the greatest surgeons in the ancient world and performed many bold operations - including brain and eye surgery - that had not been tried for nearly two millennia.

In the Middle East, operations are developed to a high level in the Islamic world. Abulcasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi), an Andalusian-Arab physician and scientist practicing on the outskirts of Zahra, CÃÆ'³rdoba, wrote a medical text affecting European surgical procedures.

early modern Europe

In Europe, growing demand for surgeons to formally learn for years before practicing; Universities such as Montpellier, Padua and Bologna are well known. In the 12th century, Rogerus Salernitanus compiled his book Chirurgia , laying the foundation for a modern Western surgical handbook. Barbers - surgeons generally have a bad reputation that does not improve until the development of academic surgery as a medical specialty, not an accessory field. The basic surgical principle for asepsis etc., is known as the Halsteads principle.

There have been several important advances in the art of operation during this period. Professor of anatomy at the University of Padua, Andreas Vesalius, is an important figure in the Renaissance transition from classical medicine and anatomy based on Galen's works, to the empirical approach of 'direct' dissection. In his anatomical treatise, De humani corporis fabrica , he reveals many anatomical errors in Galen and suggests that all surgeons should practice by engaging in the practical surgery itself.

The second important figure in this era was Ambroise ParÃÆ'Â © (sometimes spelled "Ambrose"), a French army surgeon from the 1530s until his death in 1590. Exercises to burn battlefield wounds were using oil boiling; a very dangerous and painful procedure. ParÃÆ'Â © started using a less irritating emollient, made from egg yolks, rose oil, and turpentine. He also explained a more efficient technique for effective ligation of blood vessels during amputation.

Modern surgery

Operational discipline was put on a sound scientific footing during the Enlightenment in Europe. An important figure in this regard is Scottish surgical scientist, John Hunter, generally regarded as the father of modern scientific surgery. He brings an empirical and experimental approach to science and is well known throughout Europe for the quality of his research and his papers. Hunter reconstructs surgical knowledge from the beginning; refusing to rely on the testimony of others, he conducted his own surgical experiment to determine the truth of the matter. To help with comparative analysis, he built a collection of over 13,000 specimens of separate organ systems, from the simplest plants and animals to humans.

He fully understands venereal disease and introduces many new surgical techniques, including new methods to repair damage to the Achilles tendon and a more effective method for applying arterial binding in the case of aneurysms. He was also one of the first to understand the importance of pathology, the danger of spreading the infection and how wound inflammatory problems, bone lesions and even tuberculosis often loosen whatever benefits are derived from the intervention. He consequently adopted the position that all surgical procedures should be used only as a last resort.

Leading surgeons of the late 18th and early 19th centuries included Percival Pott (1713-1788) describing tuberculosis in the spine and first showing that the cancer could be caused by environmental carcinogens (he saw a connection between exposure to the smokestack and soot high incidence of scrotum cancer). Astley Paston Cooper (1768-1841) first performed a successful ligation in the abdominal aorta, and James Syme (1799-1870) pioneered Symes amputation for the ankle joint and successfully performed the first pelvic disarticulation.

Control of modern pain through anesthesia was discovered in the mid-19th century. Before the onset of anesthesia, surgery is a painful, traumatic procedure and the surgeon is encouraged to as soon as possible to minimize the suffering of the patient. This also means that operations are largely confined to amputations and removal of external growth. Beginning in the 1840s, operations began to change dramatically in character with the discovery of an effective and practical anesthetic chemicals such as ether, first used by American Crawford Long surgeons, and chloroform, discovered by Scottish obstetrician James Young Simpson and later spearheaded by John Snow. , doctor for Queen Victoria. In addition to relieving the suffering of patients, anesthesia allows more complicated surgery in the internal areas of the human body. In addition, the discovery of muscle relaxants such as curare is allowed for safer applications.

Infection and antisepsis

Unfortunately, the introduction of anesthesia encourages more operations, which inadvertently lead to more dangerous post-operative infections of patients. The concept of infection is not known until relatively modern time. The first advance in the fight against infection was made in 1847 by Hungarian physician Ignaz Semmelweis who noticed that medical students who had recovered from the surgery room caused excessive maternal mortality compared to midwives. Semmelweis, though ridiculed and contested, introduced mandatory hand washing for all those entering the maternity ward and was rewarded with maternal and fetal deaths, but the Royal Society rejected his suggestion.

Until the pioneering work of British surgeon Joseph Lister in the 1860s, most medical men believed that chemical damage from exposure to bad air (see "miasma") was responsible for wound infections, and facilities for washing hands or wounds were not available.. Lister becomes aware of the work of the French chemist Louis Pasteur, which suggests that decay and fermentation can occur under anaerobic conditions if micro-organisms are present. Pasteur suggests three methods for removing the microorganisms responsible for gangrene: filtration, heat exposure, or exposure to chemical solutions. Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop an antiseptic technique for wounds. Since the first two methods suggested by Pasteur are unsuitable for human tissue care, Lister experimented with the third, spraying carbolic acid on the instrument. He found that this greatly reduced the gangrene incident and he published the results on The Lancet . Then, on August 9, 1867, he read a paper before the British Medical Association in Dublin on the Surgical Practice Antiseptic Principles, reprinted in The British Medical Journal. His work is groundbreaking and lays the groundwork for rapid advancement in infection control that sees the theater of modern antiseptic surgery widely used in 50 years.

Lister continues to develop methods of increasing antisepsis and asepsis when he realizes that infection can be avoided better by preventing bacteria from getting into the wound in the first place. This leads to the emergence of sterile surgery. Lister introduced Steam Steriliser to sterilize the equipment, institute careful handwashing and then apply rubber gloves. These three important advances - the adoption of a scientific methodology for surgical operations, the use of anesthesia and the introduction of sterilized equipment - laid the groundwork for today's modern invasive surgical techniques.

The use of X-rays as an important medical diagnostic tool began with their discovery in 1895 by the German physicist Wilhelm RÃÆ'¶ntgen. He noticed that these rays could penetrate the skin, allowing skeletal structures to be captured on specially treated photographic plates.

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Specialization surgery

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National community

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See also

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Notes and references

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External links

Source of the article : Wikipedia