Ron Barbosa MD FACS
Nonuniversity level 1 trauma/critical care/general surgeon. ECMO service. PGY-26. Father of 4. Surgical instrument threads. History enthusiast. Opinions own.
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🧵regarding several ways in which you can inadvertently damage the tissues when approximating them with sutures. These are particularly important to recognize when the tissue is th...
🧵regarding 'the crimp' and other technical pointers having to do with securing surgical drains with suture. We'll go over my preferred method, other methods like the Roman sandal,...
Short 🧵regarding the use of 'slip' knots to keep the tissues approximated when they are under tension, so that they stay in the right position when throwing the rest of your knots....
🧵regarding some technical points about passing drains or chest tubes through the body wall. Aside from the normal techniques, we will show what to do with the less common 'troca...
🧵regarding some of the instruments used for debridement of the soft tissues. For those familiar with my threads, we will also introduce 2 new instruments: the curette and the rong...
🧵of 🧵: we've already covered most commonly used sutures. Today, we cover barbed sutures. The use of barbs wasn't even invented by humans - they are present in many plant and an...
🧵regarding the Combat Application Tourniquet: its parts, how it's applied, some history of tourniquets; and an experiment to see if my mother (75 years old) is strong enough to t...
🧵regarding the 'suture ligature' or 'stick tie', or whatever you call it in your part of the world. Here, I'll use my long-suffering chickens to show 3 different methods for doing...
🧵regarding the CUT and COAG modes of the device commonly referred to as a 'Bovie' or 'diathermy'. Both of these are misnomers, but you know what I mean. We will go over what CUT an...
Before we get to that: It's customary to hit the button just *before* the Bovie tip hits the tissue (L picture). We usually *don't* put the Bovie tip on the tissue and then hit th...
🧵 demonstrating a few basic errors that can be made when working with a Bovie. Note: I won't try to cover all of the science of surgical energy devices, as Twitter threads do have...
Short 🧵(for people going into critical care) regarding when a tracheostomy tube is the same 'size' as its endotracheal tube counterpart, and when it is not. Warning: minutiae fol...