Introduction to Operative Skills

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Introduction to Operative Skills

• POD12PCS Podiatric Clinical Skills
• Matthew Oates Felicity Prentice

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Lecture Outline

• Preparing the treatment environment
• Preparing the patient
• Nail care
• Indications
• Equipment
• Nail clippers, Blacks file Rasp
• Nail drill
• Indications
• Equipment
• Burr technique

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Preparing to treat your patient

• Preparing your treatment environment
• Podiatrist Patient positioning
• Pre-operative skin disinfection

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Preparing your treatment environment

• Disinfect treatment surfaces

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Podiatrist Patient Positioning

• Prioritise your ergonomic well being.
• Make use of the fact that your patient chair
  moves in all directions.

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Preoperative skin disinfection

• Purpose
• Technique

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Nail Care

• Indications
• Vision impairment, eg. Glaucoma, Macular
  degeneration
• Inability to reach feet, eg. Osteoarthritis
• Inability to use instruments
• Nail deformity which makes nail reduction
  difficult
• Important to assess ability to self-care and
  level of risk

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Equipment Nail Clippers

• Anatomy
• Use
• Safety considerations

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Nail clippers

• Anatomy
• Double action
• Serrated edge

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Nail Clippers

• Use
• Hand positioning
• Operative hand
• Non-operative hand
• Think about your posture relative to the
  patients feet!!
• Nail cutting technique

• Nail cutting technique
• Nails should be smooth
• Dont cut below the free edge
• Dont cut in one piece, cut in sections
• Nails should be cut straight across the top the
  two corners filed smooth

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Nail Clippers

• Safety considerations

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Equipment Blacks file

• Anatomy
• Use
• Safety Considerations

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Equipment Blacks file

• Anatomy

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Equipment Blacks file

• Use
• Remove onychophosis
• File the free edge of the nail

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Equipment - Rasp

• Anatomy
• Use
• Safety considerations

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Equipment - Rasp

• Anatomy

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Equipment - Rasp

• Use

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Special Considerations

• Onychauxic nails
• Onychomycosis
• Onychogryphosis
• Involuted nails
• Angiokeratoma
• Ingrown toenails
• Onychocryptosis

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Nail drill

• Anatomy
• Use
• Safety considerations

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Nail Drill - Anatomy
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Nail Drill - Use

• PPE
• Eyewear
• Mask
• Instructions to patient
• Action

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