general surgical equipment.pptx

derma

1. General Surgical instruments Preparation of surgical instrument 4/24/2019 1

2. Surgical instruments Surgical instruments & tools are specially designed tools / devices used by the experts in the medical fraternity for performing specific actions during surgeries or operations . The performance of the OR team is enhanced when team members know each instrument by name , how each item is safely handled , and how each is used . 4/24/2019 2

3. Surgical instruments cont … Basic laparatomy instruments are essential to accomplish most types of general surgery.  Each instrument can be placed into one of the four following basic categories Cutting and dissecting Clumping and occluding Grasping and holding Retracting and exposing 4/24/2019 3

4. Surgical instruments cont … Cutting and dissecting Cutting and dissecting instruments are sharp and are used to cut body tissue or surgical supplies . They are used to dissect, incise, separate, penetrate, or excise tissue. This group includes: scissors, knives, biopsy punches, scalpels (blades), saws , osteotomes , drills and curettes, needles, chisels, etc. 4/24/2019 4

5. Different sizes of surgical blade(scalpels) 4/24/2019 5

6. Knife handles # 7, #3, #4 (left to right) 7 handle with 15 blade (deep knife) - Used to cut deep, delicate tissue.  3 handle with 10 blade (inside knife) - Used to cut superficial tissue.  4 handle with 20 blade (skin knife) - Used to cut skin. 4/24/2019 6

7. tissue Scissors straight Mayo , curved Mayo , Metzenbaum (left to right) 4/24/2019 7

8. Suture scissors Straight Mayo scissors - Used to cut suture and supplies.  Also known as: Suture scissors. 4/24/2019 8

9. Surgical instruments cont … Curved Mayo scissors - Used to cut heavy tissue (fascia, muscle, uterus, breast).  Available in regular and long sizes. 4/24/2019 9

10. Metzenbaum scissors used to cut delicate tissue.  Available in regular and long sizes. 4/24/2019 10

11. A B C A. Suture scissors, B. wire cutters and scissors, C. dressing/bandage scissors 4/24/2019 11

12. A, Osteotomes . B, Rasps. C, 1-6 Tissue curates. D, Blunt dissectors, 4/24/2019 12

13. Clamping and occluding instruments are used to compress blood vessels or hollow organs for haemostasis or to prevent spillage of contents. 4/24/2019 13

14. haemostat is used to clamp blood vessels or tag sutures.  Its jaws may be straight or curved.  Other names: crile , snap or stat. Strait arteries 4/24/2019 14

15. A mosquito   is used to clamp small blood vessels.  Its jaws may be straight or curved. hemostat, mosquito (left to right) 4/24/2019 15

16. Kelly is used to clamp larger vessels and tissue.   Available in short and long sizes.  Other names: Rochester Pean . Kelly, hemostat , mosquito (left to right) 4/24/2019 16

17. Grasping and holding instruments Grasping and holding instruments are used to hold tissue, drapes or sponges and manipulate structures. Needle holder, thumb forceps, tissue forceps, Alli’s forceps, bone holders, tenaculi ( tenaculm , singular) etc. are included in this category. 4/24/2019 17

18. Allis is used to grasp tissue.  Available in short and long sizes.  A "Judd-Allis" holds intestinal tissue; a "heavy allis " holds breast tissue. 4/24/2019 18

19. Babcock is used to grasp delicate tissue (intestine, fallopian tube, ovary).  Available in short and long sizes. 4/24/2019 19

20. A Kocher is used to grasp heavy tissue.   May also be used as a clamp.  The jaws may be straight or curved.  Other names: Ochsner . 4/24/2019 20

21. sponge stick is used to grasp sponges and used to a traumatically hold viscera (bowel and bladder). 4/24/2019 21

22. A dissector is used to hold a peanut. 4/24/2019 22

23. A Backhaus towel clip is used to hold towels and drapes in place.  Other name: towel clip. 4/24/2019 23

24. large & small towel clips 4/24/2019 24

25. Pick ups, thumb forceps and tissue forceps are available in various lengths, with or without teeth, and smooth or serrated jaws. 4/24/2019 25

26. Mayo- Hegar needle holders are used to hold needles when suturing.  short, medium & long (top to bottom) 4/24/2019 26

27. EX: Needle holder with suture. 4/24/2019 27

28. Different types of blade holders (scalpel handles). 4/24/2019 28

29. Retracting and exposing instruments are used to hold back or retract organs or tissue to gain exposure to the operative site.   They are either "self-retaining" (stay open on their own) or "manual" (held by hand).  4/24/2019 29

30. A Deaver retractor (manual) is used to retract deep abdominal or chest incisions.  Available in various widths. 4/24/2019 30

31. A Richardson retractor (manual) is used to retract deep abdominal or chest incisions. 4/24/2019 31

32. An Army-Navy retractor (manual) is used to retract shallow or superficial incisions.  Other names: USA, US Army. 4/24/2019 32

33. A goulet (manual) is used to retract shallow or superficial incisions. 4/24/2019 33

34. A malleable or ribbon retractor (manual) is used to retract deep wounds.  May be bent to various shapes.   4/24/2019 34

35. A Weitlaner retractor (self-retaining) is used to retract shallow incisions. Ends can be blunt or sharp. Has rake tips. Ratchet to hold tissue apart. 4/24/2019 35

36. A Gelpi retractor (self-retaining) is used to retract shallow incisions. Has single point tips and ratchet to hold tissue apart 4/24/2019 36

37. Recommendations for Inclusion in Local Policy The three main areas for consideration are: • Care of instruments • General safeguards • Storage of instruments 4/24/2019 37

38. A. Care of Instruments Instruments must only be used for the purpose for which they are designed. Proper selection requires a general understanding of surgical procedures and a knowledge of anatomy. Instruments must not be immersed in saline, hypochlorite, and chemical disinfectants. Delicate instruments should be handled with care and separated from other instruments. Specialized instruments should be regularly checked by an appropriately trained person. 4/24/2019 38

39. B. General Safeguards Regular inspection of all instruments should be made by an appropriately qualified person. instruments found to be contaminated with dried blood or body tissue prior to surgery must be discarded. Each tray of instruments should contain an instrument checklist, which incorporates the information necessary for a recorded program of use. The scrub person should ensure that instruments are handled in such a manner as to avoid personal injury. 4/24/2019 39

40. Cont… Special care should be taken with sharp instruments(e.g., scalpels and loaded needle holders). It is strongly recommended that all sharp instruments are transferred between staff in a receiver. Instruments must not be allowed to rest directly on the Patient. Instruments which have been taken directly from an autoclave into the operating room must be allowed to cool naturally before use. 4/24/2019 40

41. C. Storage of Instruments The storage area should be clean, dry and free of dust. All storage surfaces should be smooth, nonporous and be easily cleanable. Sterile items should be protected from direct sunlight. The temperature of the storage areas should range between 22 C and 24 C with a relative humidity. Sterile items should be transferred to and from storage areas on clean, specifically designated trolleys . 4/24/2019 41

42. Thanks 4/24/2019 42