El documento describe diferentes tipos de instrumental quirúrgico. Explica que el instrumental debe estar diseñado específicamente para su propósito quirúrgico y debe ser de materiales resistentes a la corrosión. Además, clasifica el instrumental en general, especializado, de diéresis, prehensión y hemostasia; e indica precauciones para el manejo seguro de los instrumentos cortantes.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
More than Just Lines on a Map: Best Practices for U.S Bike Routes
This session highlights best practices and lessons learned for U.S. Bike Route System designation, as well as how and why these routes should be integrated into bicycle planning at the local and regional level.
Presenters:
Presenter: Kevin Luecke Toole Design Group
Co-Presenter: Virginia Sullivan Adventure Cycling Association
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...DevGAMM Conference
Has your project been caught in a storm of deadlines, clashing requirements, and the need to change course halfway through? If yes, then check out how the administration team navigated through all of this, relocating 160 people from 3 countries and opening 2 offices during the most turbulent time in the last 20 years. Belka Games’ Chief Administrative Officer, Katerina Rudko, will share universal approaches and life hacks that can help your project survive unstable periods when there seem to be too many tasks and a lack of time and people.
This presentation was designed to provide strategic recommendations for a brand in decline. The deck also incorporates a situational assessment, including a brand identity, positioning, architecture, and portfolio strategy for the Brand.
Presentation originally created for NYU Stern's Brand Strategy course. Design by Erica Santiago & Chris Alexander.
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
More than Just Lines on a Map: Best Practices for U.S Bike Routes
This session highlights best practices and lessons learned for U.S. Bike Route System designation, as well as how and why these routes should be integrated into bicycle planning at the local and regional level.
Presenters:
Presenter: Kevin Luecke Toole Design Group
Co-Presenter: Virginia Sullivan Adventure Cycling Association
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...DevGAMM Conference
Has your project been caught in a storm of deadlines, clashing requirements, and the need to change course halfway through? If yes, then check out how the administration team navigated through all of this, relocating 160 people from 3 countries and opening 2 offices during the most turbulent time in the last 20 years. Belka Games’ Chief Administrative Officer, Katerina Rudko, will share universal approaches and life hacks that can help your project survive unstable periods when there seem to be too many tasks and a lack of time and people.
This presentation was designed to provide strategic recommendations for a brand in decline. The deck also incorporates a situational assessment, including a brand identity, positioning, architecture, and portfolio strategy for the Brand.
Presentation originally created for NYU Stern's Brand Strategy course. Design by Erica Santiago & Chris Alexander.
1. HIPOCRATES
“Es menester que todos los
INSTRUMENTAL BASICO instrumentos sean propios para el
propósito que se persigue, esto es
propó
respecto a su tamaño, peso y
tamañ
Lic. Silvia Garcia precisión”.
precisió
INSTRUMENTAL QUIRUGICO
Propiedades
CONCEPTO El titanio, baquelita y acrílico parecido
acrí
Es el objeto de acero inoxidable diseñado
diseñ plástico se manejan como desechable.
plá
técnica y científicamente para el desarrollo
cientí Las aleaciones que se utilizan deben tener
del acto quirúrgico y de acuerdo al tiempo
quirú propiedades específicas para hacerlos
especí
quirúrgico y a la especialidad.
quirú resistentes a la corrosión cuando se
corrosió
exponen a sangre y líquidos corporales,
lí
soluciones de limpieza, esterilización y a la
esterilizació
atmósfera.
atm ó
CLASIFICACION Y USO DEL
INSTRUMENTAL
Acero inoxidable: Están diseñados con el fin de proporcionar al
Está diseñ
Es una aleación de hierro, cromo y carbón;
aleació carbó cirujano las herramientas que le permiten
también puede contener níquel, manganeso,
tambié ní realizar las maniobras específicas en cada
especí
silicón, molibdeno, azufre y otros elementos con
silicó
el fin de prevenir la corrosión o añadir fuerza.
corrosió añ intervención.
intervenció
Otros metales: Algunos instrumentos pueden Existen maniobras básicas comunes a las
bá
ser fabricados de cobre, plata, aluminio. diferentes intervenciones quirúrgicas.
quirú
El carburo de tungsteno es un metal Según su función pueden ser pequeños o
Segú funció pequeñ
excepcionalmente duro que se utiliza para
laminar algunas hojas de corte, parte de puntas grandes, cortos o largos, rectos o curvos, filosos
funcionales o ramas de algún instrumento.
algú o romos
1
2. Se clasifica de acuerdo a su
utilidad en:
en:
GENERAL Instrumental general; es aquel que va
general;
estar presente en todas las cirugías.
cirugí
ESPECIALIDAD Instrumental especial: Es aquel para
especial:
un procedimiento especifico
Instrumental quirúrgico
quirú
Clasificación según Finochietto
Clasificació segú propiamente dicho
Instrumental quirúrgico propiamente
quirú Instrumental para la confección del campo
confecció
dicho.
I. para diéresis
dié
I. para la iluminación del campo
iluminació
operatorio. I. de prehensión
prehensió
I. de aspiración.
aspiració I. de hemostasia
I. para anestesia local. I. de separación
separació
I. para radiología intraoperatoria.
radiologí I. de síntesis
sí
I. adaptado a la cirugía especializada.
cirugí
I. de tiempos especiales
Instrumental para confección
confecció Pinzas de campo
del campo
Pinzas de primer campo Kirmisson
- Kirmisson
- Backaus
Pinzas de segundo campo Backaus
- Doyen
2
3. Pinza de Campo o Backus
Instrumental de diéresis
dié
El cirujano debe tener visibilidad adecuada Se denomina diéresis a la sección de los tejidos.
dié secció
del campo, para tomar y sostener los
tejidos en tal forma de no dañar otras
dañ Bisturíes
Bisturí
estructuras cercanas.
Tijeras: Doyen, Mayo, Metzembaum,
Doyen, Metzembaum,
PRECAUCIONES
Instrumental de diéresis
dié
El instrumento de corte tiene bordes filosos, se Se debe considerar los bordes filosos los
usa para: cortar, separar o extirpar tejido. que se protegen durante la limpieza,
Poseen superficie cortante ya sea una hoja o esterilización y almacenamiento,
esterilizació
una punta, puede ser considerado una guardándolos separados de otros y con un
guardá
herramienta de corte o disección.
disecció
manejo cuidadoso, en la manipulación.
manipulació
Tijeras, escalpelos, osteótomos, curetas,
osteó tomos,
sierras, taladros, escoplos, cincel para biopsia,
agujas, etc.
BISTURIS Consideraciones en su uso:
Instrumental de corte, básico en cualquier set
bá La hoja se fija al mango resbalando la hendidura
de instrumental quirúrgico.
quirú dentro de las muescas del mango
Fabricado en una sola pieza o en dos (mango y Al fijar o sacar la hoja del mango nunca utilizar
hoja). los dedos, todo por medio de pinza
El tipo de bisturí más frecuente tiene un mango
bisturí Las hojas difieren en tamaño y forma
tamañ
reutilizable con una hoja desechable. Las hojas Nº20, 21, 23 tienen la misma forma y
20,
Casi todos los mangos son de cobre y las hojas distinto tamaño, se utilizan con el mango Nº4 y
tamañ
de carbón acerado.
carbó 3
3
4. Los mangos difieren en cuanto a
longitud y ancho Hojas de bisturí
IQ-098 Nº12
IQ-099 Nº10
IQ-099A Nº11
IQ-099B Nº15
IQ-099C Nº20
IQ-099D Nº21
IQ-100 Nº22
Bisturí eléctrico 100 W.
IQ-105 Nº22A
IQ-110 Nº23
IQ-110A Nº24
Mango de bisturí
plegable
TIJERAS Tijera de disección
disecció
Tijeras: La hojas de las tijeras varían
varí El tipo y localización del tejido a cortar
localizació
según su objetivo, rectas, en ángulo o
segú determina la tijera a usar; puede ser
curvas y con las puntas romas o grande para tejidos duros, con ángulo
puntiagudas. Los mangos pueden ser para alcanzar estructuras, con mangos
cortos o largos largos para cavidades corporales
profundas y con hojas filosas.
Tijeras de hilo Tijeras de apósitos
apó
Tienen puntas romas para no cortar las Se utilizan para cortar drenajes y apósitos
apó
estructuras cercanas a la sutura y también
tambié y para abrir artículos como paquetes de
artí
sirven para preparar material de sutura plástico
plá
por parte de la quirúrgica
quirú
4
5. Tijeras
De hilos
Tijera de 14 cm.
aguda/aguda, curva
aguda/aguda,
Mayo
Metzenbaum
Instrumental de prehensión
prehensió
Instrumentos destinados a traccionar los tejidos,
sostenerlos, movilizarlos en el campo operatorio.
De ángulo recto
Pinzas de prehensión elástica.
prehensió elá
Pinzas de prehensión contínua.
prehensió contí
Potts
Prehensión elástica
Prehensió elá PINZAS DE DISECCIÓN
DISECCIÓ
Pinzas de disección
disecció
Tienen dos ramas unidas en un extremo y
Pinza de diente de ratón
rató cogidos entre el pulgar y los dedos sirve
para levantar o presentar porciones de
Pinza de Brown Finochietto tejido
Pinza de Von Ott
Pinza en roseta.
5
6. Ejemplo: Pinzas simples, c/d y s/d, Disección. Cushing c/d - s/d, Adson c/d -
Disecció
s/d, Martin, Rusa.
Pinzas de prehensión contínua
prehensió contí
Pinza de Gregoire
Pinza de Allis
Pinza de Foerster
Pinza de Babcock
Pinza de Duval
Pinza de aro
PINZAS Descripción
Descripció
PARTES DE UNA PINZA: mandíbula,
mandí OJOS O ANILLOS
caja de traba, mango, cremalleras y Elemento que sirve para sujetar la pinza, de tal
anillos. manera que permita al cirujano realizar una
serie de maniobras quirúrgicas.
quirú
CREMALLERAS
Mantiene el instrumento trabado cuando está
está
cerrado. Ellas deben engranarse suavemente.
Deben lubricarse
Descripción
Descripció
MANGO MANDÍBULAS
MANDÍ
Asegura la prensión del tejido. La mayoría son
prensió mayorí
Área de un instrumento quirúrgico entre la
quirú aserradas, algunas tienen una lámina
lá
caja de traba y las anillas. recambiable de carbono. Ejemplo: Porta agujas.
CAJA DE TRABA PUNTAS
Unidad de articulación del instrumental que
articulació Constituyen sus extremos. Cuando el instrumento
se encuentra cerrado, ellas deben quedar
permite dar movilidad de apertura y cierre estrechamente aproximadas. Su ausencia
durante la manipulación
manipulació implica cambio del instrumental.
6
7. Pinzas de Allis
Foerster
posee ramas ligeramente curvas, con una
línea de dientes al final que permite
sostener el tejido suave pero seguro
Duval Babcock
Allis
Pinzas de Babcock Pinzas de tejido
: su acción es similar a la de Allis, el final
acció Usadas a menudo en pares, recogen o
de cada rama es redonda para encajar sostienen tejidos suaves y vasos,
alrededor de la estructura o para asir el existiendo una gran variedad de estos
tejido sin dañar. Esta sección redondeada
dañ secció instrumentos, la configuración de cada
configuració
es fenestrada una se diseña para prevenir daños a los
diseñ dañ
tejidos.
Pinzas lisas Instrumental de Hemostasia
son llamadas también pinzas torpes, son
tambié Sirve para cohibir la hemorragia a través de la
travé
escalonadas y con estrías (muescas) en la
estrí prensión a los vasos, ocluyen temporalmente
prensió
punta asemejan a las tenazas. Pueden ser hasta ligar o anudar inmediatamente por debajo
del extremo de la pinza.
rectas o en bayoneta (en ángulo) cortas o
Tienen 2 partes prensiles en las ramas con
largas, pequeñas o grandes:
pequeñ
estrías opuestas, que se estabilizan por un
estrí
engranaje oculto y se controlan por los anillos;
al cerrarse los mangos se mantienen sobre
dientes de cierre
7
8. Existen muchas variaciones de pinzas Las características del instrumento
caracterí
hemostáticas.
hemostá determinan su uso; las puntas finas se
Las ramas pueden ser rectas, curvas o en utilizan para vasos y estructuras
ángulo; las estrías pueden ser horizontales,
estrí pequeñas. Las ramas más largas y fuertes
pequeñ má
diagonales o longitudinales y las puntas pueden
en vasos grandes, estructuras densas y
ser puntiaguda, redondeada o tener un diente.
tejido grueso; los mangos largos permiten
La longitud de las ramas y de los mangos
puede variar.
alcanzar estructuras profundas en
cavidades corporales
Instrumental de Hemostasia
Halsted
Pinza de Kocher
Pinza de Oschner
Pinza de Pean
Pinza de Halsted Crile
Pinza de Crile
Pinza de Bertola
Kocher
Instrumental de separación
separació
Maniobra destinada a desplazar estructuras
en un sentido tal que se puedan exponer
Clamps vasculares
planos profundos.
Esta maniobra es responsable de dar
claridad, calidad, simplicidad y seguridad a
todas las demás maniobras realizadas por
demá
el cirujano.
Satinsky
8
9. Instrumental de separación
separació
Por su característica pueden ser:
caracterí Separadores dinámicos, aquellos que
diná
necesitan de una mano que traccione
Superficiales: piel, tejido celular
Superficiales: de ellos.
subcutáneo, muscular.
subcutá
Profundas: para separar el contenido
abdominal separadores estáticos o autoestáticos,
está autoestá
que se mantienen solos entre los
bordes de la herida.
Separadores dinámicos
diná
Farabeuf Maleable Doyen Harrington
Parker
Finochietto
Valva de Doyen Langenbeck
Suprapúbicas
Valva de Finochietto
Valvas maleables de Caeiro Senn-Miller
Valva flexible de Deaver
Farabeuf Roux de nervios
Separadores estáticos
está
Adson Adson articulado
Gosset
Balfour
Gelpi
Gelpi modificado
Separador costal de Finochietto
Finochietto
9
10. Instrumental de síntesis
sí Porta agujas
Síntesis, es el tiempo de la intervención
intervenció Se usa para tomar y sostener agujas
destinado a la unión de los tejidos que
unió quirúrgicas curvas, son muy parecidos a
quirú
fueron escindidos en la diéresis.
dié las pinzas
El instrumental que se emplea incluye los
materiales de sutura, agujas y porta
agujas.
Porta agujas
Porta agujas Hemostáticas
Hemostá
la diferencia básica son las ramas cortas y firmes
bá
para asir una aguja, sin dañar el material de
dañ Anastomótico De pared
sutura.
El tamaño del porta agujas debe ir de acuerdo
tamañ
con el tamaño de la aguja. Generalmente, las
tamañ
ramas son rectas, pero pueden ser curvas o en
Codman
ángulo y los mangos pueden ser largos para
facilitar la inserción de la aguja en cirugía de
inserció cirugí
pelvis o de tórax.
tó
Clasificación de suturas
Clasificació Clasificación de suturas
Clasificació
Según su absorción:
Segú absorció
Absorbible Según su origen
Segú
No absorbible Natural
Sintético
Sinté
Según la cantidad de hebras
Segú
Monofilamento Según su efecto en los tejidos
Segú
Multifilamento Atraumático
Atraumá
Traumático
Traumá
10
11. Suturas Catgut simple
Absorbibles: Se absorbe rápidamente
rá
Requiere el mínimo de apoyo durante el
mí
• Naturales: proceso de cicatrización
cicatrizació
- catgut simple Se usa para ligar vasos sanguíneos
sanguí
- catgut crómico
superficiales y suturas TCS
cró
• Sintéticos.
Sinté
- Vicryl recubierto
- Dexon
Catgut crómico
cró
Se utiliza para lo tejidos de cicatrización
cicatrizació - Vicryl ( Poliglatina 910)
910)
más lenta, ej. Peritoneo,uretra,vejiga - Dexon (Acido Poliglicolico)
Poliglicolico)
Evitar pasar los dedos enguantados hacia
abajo de la hebra perjudica la resistencia La absorción mn.15 dias mx. 30 dias
- absorció mn.15 mx.
tensil
- Total reabsorción a los 60 a 90 días
reabsorció dí
postoperatorio
Suturas Equivalencias
No absorbibles:
Naturales Lino Algodón
Algodó
- Seda
- Lino
- Algodón
Algodó
100 4-0
- Acero inoxidable 70 3-0
• Sintéticos
Sinté 40 2-0
- Prolene 30 1
- Ethilon
- Poliéster
Polié
11
12. Lino: se utiliza en cirugía gastrointestinal
cirugí - Materia muy resistente y de muy poca
Seda : Se sutura cerebro, ojos, nervios, reacción tisular
reacció
gastrointestinal - Prolene:
Prolene:
Algodón: Se usa en aponeurosis y ligadura
Algodó - Ethilon
de vasos - Poliéster
Polié
Acero inoxidable: Se usa en neurocirugia,
neurocirugia,
tendones, ortopedia , cardiovascular
Materiales optativos para Agujas
cierres cutáneos
cutá
Las agujas quirúrgicas pueden ser curvas
quirú
y rectas, desechables o reutilizables.
Engrapadora cutánea descartable
cutá En cesárea se utiliza la aguja curva que
cesá
Cintas para el cierre de piel permite pasar por debajo de la superficie
del tejido y retirar a medida que aparece
Adhesivo tópico para piel
tó
su punta.
Las agujas tienen distinta curvatura y
punta y se designan por números como:
nú
P3, P4, P5, P7, P9.
Otro tipo de aguja es la a traumática que
traumá
se utiliza para sutura de tejidos finos y
friables.
12
13. Agujas con ojos Agujas con ojos
Punta redonda o cónica:
có Punta roma:
Menos traumática, poca penetración
traumá penetració Sin punta, con el extremo delgado. Se usa
(gastrointestinales, cuerpo muscular , tej.
tej. para tej. Friables( bazo, higado)
tej. higado)
delicados y celular)
Punta triangular o lanceolada: Aponeurosis y
tej. Fuertes como la piel
tej.
CUIDADOS DEL
Agujas atraumáticas
atraumá INSTRUMENTAL
Reduce el trauma y descartables La habilidad de cirujano se ve obstaculizada si se
le obliga a trabajar con equipo de inferior
Pueden estar cargadas con seda, ácido calidad como:
poliglicólico
poliglicó Tijeras desafiladas
Pinzas que luego de tomar un vaso sanguíneo
sanguí
no permanecen cerradas
Porta agujas que se abren espontáneamente
espontá
Pinzas cuyos dientes no engranan como es
debido
Verifique que le funcionamiento adecuado
del instrumental frecuentemente de las
siguientes maneras
La enfermera tiene la responsabilidad de dar
manteamiento a los instrumentos ayudándose de la sig.
ayudá sig. a) examine primero el instrumental
Normas: b) los mangos de las pinzas hemostáticas, porta agujas y
hemostá
1.- manéjese los instrumentos con suavidad
1.- mané tijeras deben estar derechos
2.- no los tire dentro de las palanganas que contengan
2.- c) el instrumental debe abrirse y cerrarse varias veces
corrosivos para verificar:
3.- No mantengan los instrumentos o superficies
3.- Si engrana adecuadamente las cremalleras
cortantes dentro de una superficie metálica que pueda
metá Una vez que ha cerrado el instrumento verifique que se
amellarlo mantenga en su posición, tomándolo de una punta y
posició tomá
4.- emplee para cada trabajo el material correcto
4.- golpeándolo suavemente los ojos y anillos, un
golpeá
instrumento forzado se abre con este ligero golpe.
13
14. INSTRUMENTOS CORTANTES CUIDADO DEL INSTRUMENTAL
DURANTE LA OPERACIÓN
OPERACIÓ
Como tijeras y osteótomos deben ser
osteó
Manipular el instrumental con suavidad
periódicamente examinados en busca de astillas
perió No los tire dentro de las vasijas
y melladuras a lo largo del borde cortante. Mantener las superficies cortantes de los instrumentos
Cualquiera de los instrumentos defectuosos que lejos de otras superficies metálicas que pueden
metá
deteriorar
se haya encontrado debe ser enviado No moje o enjuague los instrumentos con ClNa 9%
conservación para su reparación o en su
conservació reparació porque produce corrosión. Sólo utilice agua destilada
corrosió Só
defecto a la jefatura para el cambio de un nuevo Limpie la sangre y tejidos en todo momento. Evite la
disecación.
disecació
Emplee para cada trabajo el instrumento correcto.
DESPUÉS DE LA OPERACIÓN
DESPUÉ OPERACIÓ
Remojar con un detergente enzimático
enzimá
Realizar el lavado de instrumental observando las normas de
Bioseguridad
Secado de instrumental
Preparar el instrumental, observando separar instrumentos pesados
pesados
de los delicados
Procesar todo el instrumental utilizado para su respectiva
esterilización compatible
esterilizació
Almacenamiento de instrumento
Mientras los instrumentos reciban un adecuado manejo y
mantenimiento podrán durar mucho tiempo porque implica un costo
podrá
social muy alto.
14