Surgical-Instruments and their sterility- 2023 - Copy.pptx

Surgical instruments and how to maintain sterility

1. Surgical Instruments

2. Inst r uments Instruments are classified by their function Cutting & Dissecting Grasping & Holding Clamping & Occluding Exposing & Retracting Suturing & Stapling Viewing Suctioning

3. Inst r uments Dilating & Probing Measuring Microinstruments Powered instruments

4. Cutting & Dissecting

5. Cutting & Dissecting Cutting instruments have sharp edges. They are used to dissect, incise, separate, or excise tissue. Most instrument sets will include #3 and #7 knife handles & suture, curved mayo, metz and tenotomy scissors.

6. Knife Handles Come in various widths & lengths Blades are attached by slipping the slit in the blade into the groove on the handle #7 #4 #3

7. Knife Blades Blades with numeric prefix of “1” (e.g., 10, 11, 12, 15) fit #3 or #7 handles Blades with the numeric prefix “2” (e.g., 20, 21, 22, 23, 24) fit #4 handles

8. Knife Blades #10 are used for large skin incisions #15 are used for short shallow incisions #11 are used for initial skin puncture of tiny deep incisions #10 #15 # 1 1

9. Other Knife handles Long handles are used inside deep incisions (e.g., open abdominal cases) Beaver knifes are used for small delicate cases

10. Scissors Blades of scissors may be straight, angled, or curved Tips may be pointed or blunt, handles may be long or short Should be used only for their intended purpose

11. Straight Mayo (Suture) Scissors

12. Bandage/Dressing Scissors Used to remove bandages and dressings Probe tip is blunt; inserted under bandages with relative safety

13. Tissue/Dissecting Scissors

14. Sharp/Sharp Scissors Used to cut and dissect tissue Both blade tips are sharp

15. Sharp/Blunt Scissors Used to cut and dissect fascia and muscle One blunt tip and one sharp tip

16. Curved Blunt/Blunt Scissors Both blade tips are blunt Can be curved or straight

17. Curved Mayo Scissors

18. Metzenbaum Scissors

19. Tenotomy scissors Used in delicate operations

20. Iris Scissors

21. Grasping & Holding

22. Grasping & Holding These instruments are used to grasp tissue and hold it in place without injuring surrounding tissues Forceps can be ringed or the thumbed variety

23. Grasping & Holding Most instrument sets will include kocher, allis, babcock, adson, tissue, debakey forceps, sponge sticks & towel clips.

24. Forceps

25. Kocher Used to grasp heavy tissue or clamp large blood vessels to control bleeding

26. Allis used to hold or grasp heavy tissue

27. Babcock to grasp delicate tissues during surgical procedures

28. Sponge Stick allows sampling without directly handling the sponge

29. Towel Clamp/ clip Adds weight to drapes and towels to ensure they stay in place Allow exposure of the operative site

30. Adsons

31. Tissue

32. Ferris Smith

33. DeBakey

34. Russians

35. Clamping & Occluding

36. Clamping & Occluding These instruments are used to apply pressure Some clamps are designed to crush the structure when applied Others are noncrushing and are used to occlude or secure tissue

37. Clamping & Occluding Most instrument sets will include mosquito, crile, kelly, tonsil, peon, and right angle clamps.

38. Anatomy of a Clamp

39. m osquito c r i l e kelly tons i l peon

40. Exposing and Retracting

41. Exposing and Retracting Used to pull Soft tissue and muscle aside to expose surgical site 2 types: Hand held Self retaining

42. Exposing and Retracting Most instrument sets will include small hand held , army-navy, malleable, weitlaner, and richardson retractors.

43. Hand Held Retractors

44. Skin Hooks

45. Senn

46. Cushing Vein Retractor

47. Volkman

48. Army - Navy

49. Richardson

50. Kelly

51. Harrington

52. Deaver

53. Self Retaini n g Retractors

54. Weitlaner

55. Cerebellar

56. Gelpi

57. Balfour

58. Bookwalter

59. Diathermy An energy device which is commonly used to cut through tissue, but has both cutting and coagulation properties. It works by a high-frequency electrical current which heats the tissue to which it is applied. The options for cutting or coagulation make different sounds when they are being deployed.

60. Suturing and Stapling

61. Suturing and Stapling Needle holder sizes vary according to type of needle used Most instrument sets will have webster, crilewood, and mayo hegar type needle holders.

62. Suturing and Stapling Clip appliers place individual staples, available in reusable and disposable Disposable staplers

63. Needle Holders

64. Webster

65. Crilewood

66. Mayo Hegar

67. Skin Stapler

68. Viewing

69. Viewing Surgeons can examine body cavities, hallow organs, or structures with viewing instruments Procedures may be performed through them

70. Nasal Speculum

71. Vaginal Speculums

72. Rectal Speculums

73. Rigid Endoscope

74. Laparoscopic Trocars

75. Laparoscopic Instruments

76. Thorascopic Trocars

77. Cystoscopy Sheath

78. Suctions

79. Yankauer

80. Frazier

81. Miscellaneous Towel clips (for attaching things onto drapes): akin to small forceps that hold together different sections of the drape. Hammers : of various shapes, most often used in orthopaedics for driving nails into bone, or alongside a chisel in amputations Drills: cordless battery-operated drills are used to drive screws into bone and also create boreholes in the skull during neurosurgery

82. Cont ’ Saws: these come in both battery-operated and manual versions, such as the Gigli saw, commonly used in amputations Dilators: blunt probe-like instruments used for stretching lumens, such as the urethra. Tunnellers : long hollow tube-like instruments that can be pushed under the skin, once in place drains can be placed through them before removal of the tunneller device

83. Minor Set

84. Major Set/Lower Tray

85. Major Set/Upper Tray

86. Major Retractor Set

87. Care & Handling of Instruments

88. Handling instruments Instruments are placed firmly into the surgeon’s palm in such a manner that it is ready of immediate use. Ringed instruments are handed with the box locks closed. Curved instruments are passed with the curve in the direction of intended use.

89. To facilitate suturing the needle is secured about 1/8 inch down from the tip of the needle holder and about a third of the distance from the eye or swaged end

90. Care of Instruments During the procedure, used instruments should wiped with a damp sponge or placed in a basin of sterile distilled water.

91. Care of Instruments Do not use saline on instruments. Do not allow blood to dry on instruments. Saline & blood can damage instrument surfaces causing corrosion and pitting.

92. Care of Instruments Flush suction tips with sterile distilled water periodically to keep lumens patent. Flush all lumened instruments thoroughly at the end of case to prevent blood from drying inside lumens.

93. Care of Instruments Powered hand pieces and batteries should not be immersed in liquid as this could damage internal mechanisms.

94. . Thank you