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PT/SK/2003/4
DEFINITION
Surgery : Chirourgia (Greek),
consisting two words, cheir (hand)
and ergon (to work).
Chirurgia (Latin), is defined as the
treatment of disease, injury, or
deformity by manual or instrumental
operations, as the removal of
diseased parts of tissue by cutting.
Chirurgeon or Surgeon, known
since the 1300s (Rutkow IM, 1993)
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Surgery Teamwork
Multidiscipline
Professional
Knowledge
Skill
Art
Ethic
Human
3. JAPAN
During the Muromachi period (AD 1334-
1568) the so called Kinso-I, or wound
surgeon, came into social prominence
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F. The Middle Ages (500 1500)
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G. The Renaissance
William Harvey
(1578) : Cains College
Cambridge
Discovery of the
lesson of the blood
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I. The Eighteenth Century
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J. The Nineteenth Century
Cellular
Pathology
Experiment
al
Physiology
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Anesthesia
Crawford W. Long
:
ETHER 1842 PT/SK/2
Ferdinand
Sauerbruch (1875
1951)
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Bacteriology and Surgical Antisepsis
and Asepsis
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X Rays
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K. The Twentieth Century
General Surgery
Colorectal Surgery
Gynecological Surgery
Neurological Surgery
Ophthalmological Surgery
Orthopedic Surgery
Otorhinolaryngological Surgery
Plastic Surgery
Thoracic Surgery, Cardiac & Vascular
Surgery
Urological Surgery
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THE HISTORY OF SURGERY
IN INDONESIA
1. The first period : The period from
the end of the 1st World war till the
capitulation oh the Dutch.
2. The second period : The period of
the Japanese Occupation time and
the initial stage of the revolution of
the Republic of Indonesia.
3. The third period : The period of
Complete independence of the
Republic of Indonesia.
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1. The First
Period
In 1920 to the new Central
Hospital, the present, Cipto
Mangunkusumo Hospital. The 1st
head of the Department was
Prof. Lesk a native of Austria
and the first resident was the late
Professor Margono Soekarjo,
honorary member of this
association.
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The successor of Prof. Lesk
was Dr. Wieberdink and later
on Prof. Reddinguis about
1930 and Prof Oetama was
his last resident.
In this period there are only
about 10 Indonesia doctors
trained in Jakarta as well as in
Surabaya.
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2. The Second Period
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CLINICAL EXAMINATION
a
There are two aspects of the
examination :
1. That concentrating on the
specific complaint, the
lump or the pain.
b
2. That reviewing the whole
patient (holistic).
Examination of the whole
patient particularly before a.Hodentorsion
an operation b.Phimose
performed in a routine
medical examination. In
examining a specific
surgical feature, it is
important to follow an
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accurate clinical
a
b
c d
Important
specific signs
: Thrill, Sign of
compression,
Sign of
indentation,
Signofan
aneurysm
An ulcer is a loss of
epithelial lining; when
examining an ulcer,
attention should be
paid to the following
points:
Shape, Edge, Floor,
Base, Surrounding
tissues
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Ulcers are of five main
varieties :
The septic ulcer with
sloping varieties
The tuberculous ulcer
with undermined edges
The carcinomatous
ulcer * with averted
hard edges
The rodent ulcer with
barely visible pearly
edges
The syphilitic
punctuated
Fig. ulcer
Squamous carcinoma on the nose
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Terminolog
y
In describing an
examination, terms
should be used
specifically and
correctly.
A fistula, A sinus,
Lyphangitis,
Phlebitis, Cellulites,
Inflammation,
Crepitus,
Translucency,
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HEAT REDNESS SWELLING PAIN LOSS OF
FUNCTION
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IMAGING
Most physical signs can be confirmed
by ultrasonography, plain
radiography, computed tomography
or magnetic resonance imaging,
doppler imaging (aneurysm).
Magnetic resonance imaging will
define abnormalities in joints and within
the skull, whereas computed
tomography, particularly with contrast
enhancement, will outline solid
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AORTIC ANEURYSM
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a b
c
a. Hand-held Doppler Ultrasound
b. Doppler Scanner
c. Colour Duplex Scanner of
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COLLES FRACTURE
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DIAGNOSTIC PROCESS
The initial surgical process is complete
when a diagnosis has been obtained by
(1) history, (2) examination and (3)
imaging, supported by (4) pathology.
Experience enables correct weighting to
be placed on each aspect of this process
to define the correct treatment.
Surgical conditions trend to follow a
logic based on anatomy, physiology and
pathology; if that logic is transgressed,
mistakes are made, and the patientPT/SK/2
may
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