In surgeries, how do they control the blood coming out when they cut the skin?
What do you see (cross wise) when you look into the skin that you have cut? Do you see tiny dots where the cappilaries were? How about larger dots for arterioles and ventrioles? Or is it just a big mess of blood?
What happens if you cut a vein/artery by accident?
And how difficult is it to cut the skin? As in similar to what, cutting the edge of an orange?
(Student willing to go for medicine ;p)
Answer:
small bleeders can be "burned" with an electrocautery device called a "bovie"
larger blood vessels need to be tied off with sutures.
don't they now use a scalpel that burns the skins so that you dont bleed as much
I'm not entirely sure on your first question. For starters, doctors are careful and don't cut into major arteries and veins. Also, they'll give you anesthetics to slow your heart rate, so the blood won't burst out like a volcano, third, they probably use special drugs to stop the bleeding.
1) VERY small, so small red blood cells go through them single filed, so no, you can't see them.
2) The cross section of most skin is so thin you can't see anything. Here's a picture of how it looks zoomed up:
http://upload.wikimedia.org/wikipedia/co...
3) Depends how big. Normally, you just bleed. However, if you cut your aorta or jugular (the biggest arteries in your body) you could die.
4) You've never cut yourself by accident? It's not hard at all. Skin is moist and leathery because of the presence of special proteins and oils. I'd say it's something like latex, but doesn't stretch as much. Of course, in some areas it's thicker, especially the bottom of the feet.
When they cut the skin (with a scalpel - they don't use cautery for skin incision), it oozes a little blood, and they seal the bleeding with electrocautery - aka "bovie"- (because "charcoal doesn't bleed") Capillaries are too small to see, but you can see blood welling up.
Surgeons usually avoid most large vessels (they know a lot about anatomy), but if they cut through a medium size one, they grab it with a clamp and either bovie the bejesus out it or tie it off with a suture. There is also a really cool device called an argon beam coagulator that uses argon gas and electricity to burn bleeding things.
For the scalp, they use Rainey clips (I may have spelled that wrong) to pinch off the skin edges:
http://www.medscape.com/content/2004/00/...
The blue clips, in the picture above.
When they cut something by accident, you hear a lot of suctioning, frequently accompanied by a lot of swearing. Then they have to tie it off or repair it.
The skin is tougher than you might think. I don't do surgery, but orange peel might be close. Maybe a surgeon can help us out on that one.
I've had 36 surgeries in my lifetime----due to several spinal deformities and organ deformities. some while I was awake and some while I was asleep. they cut with a scalpel and use what they call SUCTION... if you've ever seen a tip of a waterpick it's looks similar to that---or at the dentist--he uses a suction hose-type hooked device to suction out your mouth---same principle for the blood... the blood is suctioned away from the surgical area so that the surgeon can see what he is OPERATING on... be it a heart, lung, appendix, Uterus, whatever.. surprisingly, when one makes very deep cuts, they have VERY LITTLE BLOOD. my son severely and deeply cut his right arm several years ago and there was only a few spots of blood on his shirt but the cut was TO THE BONE.when the scalpel makes it's first incision, there IS a small amount of blood that oozes out ... Every so often a surgeon WILL nick an artery or major vein by ACCIDENT.. or nick a major organ... which will cause internal bleeding...those nicks are sewn up as soon as they are found because a patient COULD bleed to death if they were not. what you see after you make the first deep incision depends on where that incision IS... on an arm or leg, you are liable to see bone, muscle, ligaments, tendons, veins... a stomach incision might get you a view of the inner organs (stomach, lungs, pancreas, liver, intestines.) and a chest incision will give you a view of the heart and lungs and esophagus.. Your first encounter with all of this MIGHT just be with a CADAVER DONOR... (a person who dies and has left his body to science)...the bodies are usually taken to mortuary schools first where mortuary students practice the art of embalming (for non-jewish people) and preparing the body... then the teaching hospitals accept the body and medical students come into the labs and disect the bodies and examine them --this is how they learn how to perform surgeries as well AT FIRST...they are taught the proper way to cut into a body, where the organs of the body are and what they look like and if there are any abnormalities in the cadaver body (as MY body has)---those bodies are usually used for the specialities (Orthopedics, Neuro, etc)...soo, as an early med student you might not get experience with BLOOD, but you WILL get experience cutting open a person and seeing what it inside.by the way, I AM a cadaver donor and have carried my card for 30 YEARS...Organ donation and cadaver donation is SO much better then just tossing your body into the ground---someone could live with a part of YOU that stays alive inside of THEM ---or someone's life might be SAVED because of something someone found inside YOUR body that helped cure someone else...it's WELL WORTH CONSIDERING.
The skin doesn't bleed much because they use a sharp knife. That sounds coy, but an incision with clean edges is usually almost bloodless, whereas a laceration with torn, ragged edges (even if the raggedness is microscopically small) bleeds more.
Small veins are hard to see (especially the older I get). You can forget seeing venules, much less capillaries, without a microscope.
If you make a small "oops," the first thing is to learn not to say "oops." It tends to be unsettling for the patient if he's awake. Little bleeders usually do fine with a little direct pressure, and most in small cuts need only the pressure of the closure of the skin that you were going to do anyway. Clots form pretty fast. For more vigorous bleeders, you may have to tie them off. Internally, surgeons use a Bovie to cauterize a lot of them.
Your orange analogy isn't too bad. First-time students, though, tend to wimp and barely scratch the surface the first time. This is a timeless chuckle to their instructors. Thanks for the thought. I grew up a farm boy and hunter, and never really thought, even after teaching medical students, that this isn't common knowledge, and I've been in the business I think since before you were born.
ive seen one surgery where they used the electrocautery to cut the skin so it automatically stops bleeding. they use clamps or sutures
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