Introduction to Basic Surgical Skills
Designed as a quick‑reference guide for students, trainees, and anyone beginning a career in the operating room.
1. Core Principles of Surgery
| Principle |
What it Means |
Practical Implications |
| Asepsis & Antisepsis |
Prevent contamination of the surgical field. |
Hand‑scrubbing, sterile gloves, gowns, drapes, and proper skin prep. |
| Hemostasis |
Control bleeding to maintain a clear view and reduce blood loss. |
Use of clamps, electrocautery, topical agents, and proper vessel ligation. |
| Tissue Handling |
Preserve tissue viability and promote healing. |
Gentle traction, minimal crush, use of appropriate instruments. |
| Anatomical Knowledge |
Precise identification of structures. |
Pre‑operative imaging review, intra‑operative landmarks, and “time‑out” verification. |
| Safety Checks |
Reduce preventable errors. |
WHO Surgical Safety Checklist, instrument counts, and intra‑operative monitoring. |
2. Essential Instrumentation
| Instrument |
Primary Use |
Key Handling Tips |
| Scalpel (No. 10, 11, 15) |
Incision of skin & soft tissue. |
Hold like a pencil; keep blade angled 30–45° to skin. |
| Metzenbaum Scissors |
Fine cutting of delicate tissue. |
Open blades fully before cutting; avoid crushing. |
| Mayo Scissors |
Cutting dense tissue (muscle, fascia). |
Use with a firm grip; close blades slowly. |
| Tissue Forceps (Adson, Gerald) |
Grasping tissue without trauma. |
Tip‑to‑tip contact; avoid excessive force. |
| Hemostats (Kelly, Crile) |
Clamping vessels, temporary occlusion. |
Lock firmly; release after 15 min to prevent necrosis. |
| Needle Holders (Mayo, Crile) |
Suturing. |
Pinch needle 2–3 mm from tip; maintain a 30° angle. |
| Retractors (Balfour, Richardson) |
Exposure of deep fields. |
Apply steady, even pressure; avoid slippage. |
| Electrosurgical Unit (ESU) |
Cutting/coagulation. |
Use lowest effective power; verify grounding pad. |
3. Basic Surgical Techniques
3.1. Incision & Exposure
- Mark the incision – use a sterile skin marker; confirm laterality.
- Skin incision – scalpel with controlled depth; follow natural skin tension lines (Langer’s lines) when possible.
- Layered dissection – separate subcutaneous tissue, fascia, and muscle with appropriate instruments (scissors, electrocautery).
- Use retractors – maintain a clear view; adjust tension to avoid tissue ischemia.
3.2. Hemostasis
- Mechanical: clamps, ligatures, ties.
- Thermal: monopolar/bipolar cautery; keep tip in motion to avoid charring.
- Topical agents: oxidized cellulose, gelatin sponge, fibrin sealant.
3.3. Suturing Basics
| Suture Type |
Indication |
Needle & Thread |
| Simple interrupted |
General closure, skin, fascia |
3/8‑circular needle, absorbable or non‑absorbable thread |
| Running (continuous) |
Long, straight wounds |
Straight needle, monofilament |
| **Matt |
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