With a knife , but what knife? The absolute best choice is a knife made for this purpose,
a scalpel,
1. Stretch the skin, make a swift cut, if you hesitate or the skin is loose, you get a
jagged wound, which will not heal so good and leave a bigger scar.
2. Wounds heal better if they are across muscle pull and in line with the skins
wrinkles.
3. Scissors crush skin while cutting, do not use them for skin, only for deeper tissues.
Never use dull scissors or knives, as they will traumatize the tissue.
4. You can hold skalpell like an ink pen at a 90-degree angle to the skin, or like a
knife for eating, with a skalpell always ! cut only in one direction.
5. Make yourself familiar with the different blades available.
6. Read good books, such as R. M. Kirks Surgical Technigues.
7. Never use your medical tools for anything else.
8. Do not try to sterilize single-use blades, they will corode, if you want to use them for other purposes, you can clean them, dry them imediatly and keep in a dry place.
Whenever you cut tissue of a living body, it will bleed, so this causes some problems
as the blood obstructs your viev of the wound and loosing to much blood will kill the owner of the bleeding wound. But there are ways to deal with the bleeder:
1.Clamps look a litle like scissors, hold them with your thumb and ringfinger pushed halfway into the rings, support with your index finger.
2.Get hold of the bleeding vessel only, clamping can kill tissue and thus interfere with healing.
3. Use the clamp with its concave side towards the tissue for the above reason.
Another important way of dealing with bleeding is LIGATURE
1. The bleeding vessel is is first clamped.
2. Lift it carefully.
3. Tie an absorbable suture below the clamp.
4. Add another knot.
5. Remove the clamp, check carefully for leakage.
6. Do not tie too tight or else you cut the vessel.
7. If you are working in an area, where there are one or more larger blood vessels,
you should ligature them before cutting, cut vessels can retract, pull themselves back into deeper tissue layers, than it can be hard to find them and the bleeding takes all your view (and blood).
Regardless how good you are at any technigue, you must understand function and form of the involved material, in this case living tissue. Without that understanding you will not get far. There is nothing that can prepare you to deal whith living matter, anatomy books show the average body and you should study them intense, but they can never prepare you entirely for the real thing. Even those anatomy atlas made from actual pics of preserved corpses show only a dead, preserved body, its not breathing or bleeding. Also the coulors are not at all real. No, ther are no blue veins. Your body comes in shades of red. At least on the inside. To get some sense you could look at pics taken at operations, such as wolfe medical atlas series, or The sacred heart by Max Aguilera-Hellweg, its an atlas of the body seen trough invasive surgery. To learn more on wounds and their care, check books on General Surgery. You should learn to detect infections as early as possible and you should understand the healing process.
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