3-35. ASSISTING DURING SURGERY
a. Operative Techniques. One of the most helpful procedures performed by the
dental specialist in oral surgery is the manipulation of the suction apparatus or the use of
gauze sponges in such a way as to keep the surgical field free of blood, saliva, and tissue
while interfering as little as possible with the view of the dental officer. To perform oral
surgery properly, the surgeon must be able to see the tissue he is manipulating. Other
ways in which the oral surgery assistant helps to afford good vision of the operative site is
by keeping the operating lamp adjusted for maximum illumination, by wiping blood and
other material from the mouth mirror as it accumulates, and by careful retraction of
cheeks, lips, and other tissues. Efficiency of the operation is further enhanced by keeping
the instrument tray in order, removing instruments and materials no longer needed,
preparing other instruments and materials for use before needed, and being ready to take
each instrument as the dentist finishes using it and to replace it with the one he will need
next. The assistant must also learn how to use the surgical mallet. Proper malleting
technique requires working with the dentist in a coordinated rhythmic pattern and knowing
how much force to apply, at what angle the mallet must strike the chisel, and when to
begin and when to discontinue malleting. During the placement of sutures, the assistant
will be expected to help by cutting the suture material after each knot is tied.
b. Caring for the Patient. The oral surgery assistant should be ever mindful of
the patient, seeing to his comfort and preventing accidental soiling of his clothes. During
surgical procedures, the assistant should carefully observe the patient for signs of
syncope (clammy or pale skin and lips) or apprehension and notify the dental officer of
the change. When surgical procedures are prolonged, he can often lessen the patient's
discomfort by supporting his head and mandible. When the operation is completed, the
oral surgery assistant should remove blood and other traces of the operation from the
patient's face and lips. Before the patient is dismissed, the assistant should be alert to
remind the dental officer of needed postoperative instructions or medications and to
reemphasize the dental officer's instructions to the patient.
3-36. POSTOPERATIVE CARE OF THE PATIENT
a. Dismissing the Patient. The patient should not be dismissed until blood or
any other evidence of the operation has been removed from his face or lips. He should
receive the necessary postoperative instructions and medications and future
appointments, if needed. If he has been given medication that leaves him with
incomplete control of his faculties, someone should escort him to his quarters. This
should be arranged beforehand. The dental officer may want to detain the patient in the
clinic for observation or recovery.
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