The difference between an acceptable and an excellent .surgical outcome often rests on how the surgeon handles the tissues. The use of proper ‘incision and flap design techniques plays a role; ‘however, tissue also must be handled
carefully, Excessive pulling or crushing, extremes of temperature, desiccation, or the use of unphysiologic chemicals easily damage tissue. Therefore the surgeon should use care whenever touching tissue. When tissue forceps are used, they should not be pinched together too tightly; rather, the}’ should be used to delicately hold the tissue. When possible, toothed forceps or tissue hooks should be used to hold tissue (Fig. 3-4). In addition, tissue should not be overaggressively retracted to gain greater surgical access, This
includes’ not pulling excessivelyon the cheeks or tongue during surgery.When bone is cut, copious amounts of irrigation should be used to decreasethe amount of bone damage from heat.’ Soft tissues should also be protected from . frictional heat or, direct trauma from drilling equipment.Tissues should not be allowed to desiccate; open wounds should be frequently moistened or covered with a damp sponge. Finally, only physiologic substances should come in contact with. living .tissue. For example, tissue forceps used to place a specimen into formalin during a biopsy procedure should not be returned to the wound until any contaminating formalin is thoroughly removed. The surgeon who handles tissue gently is rewarded with grateful patients whose wounds heal with fewer complications.