Surgical Instrumentation Module 6 PDF

Module 6 SURGICAL INSTRUMENTATION The five major surgical instrument lines OR Grade Mid-Grade Physician’s Grade Sterile Disposable Floor Grade Floor Grade The hi...

Module 6 SURGICAL INSTRUMENTATION The five major surgical instrument lines OR Grade Mid-Grade Physician’s Grade Sterile Disposable Floor Grade Floor Grade The highest quality High quality, Mid- Forged from surgical made of Pakistani Made of Pakistani surgical instruments Grade OR grade Pakistani steel, combine low steel and combining made from U.S and instruments made of stainless steel cost with reliable convenience with German grade Pakistani stainless performance reliable function at stainless steel steel an affordable cost designed to meet deliver significant designed for routine Ready to use, and these disposable the exacting value and surgical or suitable in a number instruments are standards required performance in the diagnostic use in the of surgical settings, ideal for non-critical in a surgical setting. clinics, physician’s office setting sterile disposables applications offices, and other surgical settings  Reusable vs. Disposable Instruments Single-use instruments Provide a solution to reprocessing instruments day to day. Reduce cross contamination. Eliminate the need for comprehensive reprocessing instructions and follow-through. Reduce human error in cleaning and sterilizing. Improve patient safety. Reduce tangible and intangible instrument reprocessing costs. Improving Manufacturing and Metallurgy Stainless steel is not actually “stainless” or fully stain-proof. It is stain resistant and does not easily spot, corrode or rust with water the way ordinary, carbon steel does. Stainless steel is ideally suited for the surgical suite, because itis rust resistant, it can be honed to an extremely sharp edge or fine point, and it can be hardened to maintain the delicate, yet precise requirements of the surgeon. Proper care and handling will ensure that instruments made of stainless steel will last from two to five years, or longer, depending on the grade of the steel and bonding used. There are over 150 grades of stainless steel, and several grades of stainless steel are used to produce surgical instruments with special requirements for hardness, sharpness or malleability. The primary grades used in the manufacture of instruments are Austenitic and Martensitic steels.  Stainless steel Austenitic Martensitic steels steels 300 series 400 series  Austenitic stainless steel is the softer, more malleable type within the 300 Series; The 300 Series is used for probes, dilators, retractors and basins. It has the following characteristics: Extreme corrosion resistance. Non-magnetic. Contains high chromium content and nickel. Workable and malleable. Cannot be heat treated to differing degrees of hardness  Basin Probs 300 Retractors series Dilators  Martensitic is the hardened steel within the 400 Series. The 400 Series is used for hemostats, needle holders, scissors, clamps, forceps, etc. It has the following characteristics: Good corrosion resistance Heat treated to varying degrees of hardness and sharpness. High carbon content Strong but more brittle Resistant to breakage, used for precise cutting edges. Magnetic. The highest quality, 410 grade stainlesses used for gripping instruments like forceps, tweezers, retractors, dressing forceps, etc. The highest quality, 420 grades stainless is used for cutting instruments such as bone rongeurs, chisels, gouges, and scissors. Gold plating on an instrument means that tungsten carbide has been introduced – tungsten carbide is an extremely hard metal that is used to laminate high grade stainless steel to increase and maintain sharpness, strength and gripping capability and shelf life Parts of the Instrument Surgical instruments are specially designed tools or devices that perform a variety of procedures or operations. The overall design of an instrument is based on the function it will ultimately perform. All instruments have a basic design and are augmented and enhanced (length and curvature of blades, teeth, serrations, etc.) to provide additional functionality or to accommodate physician requirements and preference. The size, length and width of a surgical instrument usually determines the type of surgery intended  For example, - 12” scissors and forceps are used for cardio, thoracic and gynecology. - 4” delicate scissors and forceps are used for pediatric, ophthalmic and plastic surgeries. - Scissors are used to cut tissue or other materials; - Forceps have interlocking teeth or serrated jaws used to grasp tissue. - Sponge and towel clamps hold gauze or wall-off surgical areas. - Needle holders drive suture needles through tissue. - Retractors access and expose wounds. - Hooks grasp bone, tissue, and suture strands during procedures. - Curettes cut or scrape bones or sockets. - Bone files and rasps smooth bone and cartilage. - Bone chisels and osteotomies cut or mark a bone. Instrument designs include: tips; jaws or blades; spring joints; screw joints or box locks; ratchets; shanks; and finger rings. BOX LOCK INSTRUMENTS :HEMOSTATS, CLAMPS,NEEDLE SCREW LOCK INSTRUMENTS: SCISSORS HOLDERS Instrument Categorization All instruments are categorized by function. The nine categories are: Accessory : An accessory is any instrument that does not fit into a category, but is an important part of the surgical procedure and has a specific function. Examples of accessories are: mallets, harmonic scalpels and guide pins. Clamping and Occluding: Used to compress or close blood vessels or hollow organs, for hemostasis or occlusion. Examples are Crile hemostatic forceps and tube occluding clamps Cutting and Dissecting: Used to separate or incise, dissect or excise soft or compact tissue with a variety of cutting edges and designs. Examples are scalpels, Iris scissors and curettes. Grasping and Holding: Grasping and holding instruments are designed to grip, manipulate, and stabilize body tissues. They may also be used to extract foreign bodies. Examples are Allis tissue forceps, and Backhaus towel clamps. Dilating and Probing: These instruments are used to probe, expand, examine or create an anatomic passage; to enlarge or open a stricture or introduce another instrument. Examples are uterine dilator, mini- dilators/OS finders and probes with eyes.  Exposing and Retracting: Designed to pull aside or hold back wound edges and other tissues to gain access to the surgery or operation site. These instruments are usually called “retractors,” with blunt “blades” that may be curved or angled, or with sharp or dull prongs. Blades vary in size, and some retractors are double ended or come in a variety of shapes, lengths and widths depending on functional needs. Examples are: bone hooks, Volkman retractors and Zalkind retractors. Aspirating and Suctioning: Aspirating and suctioning instruments are used to remove blood and other fluids and debris from the operating site. These instruments are hollow tipped and come in a variety ofsizes and shapesfor ease of access. Examples are: cannulas, aspiration suction tubes. Stapling and Suturing: Used to align, secure and approximate the edges ofsoft or compact tissue for healing; they may employ implants like sutures, staples, clips wires or screws. Examples are: needle holders, suture needles and terminal end staplers. Viewing: Viewing instruments allow the practitioner to illuminate a cavity or structure such as a nasal cavity. Examples include endoscopes, nasal specula, and lighted vaginal specula. The Top 35 In-Demand Instruments 1. Lister Bandage Scissors 2. Operating Scissors – Straight. 3. Operating Scissors – Curved. 4. Mayo Scissors – Straight. 5. Mayo Scissors – Curved. 6. Tungsten Carbide - Operating Scissors – Straight. 7. Tungsten Carbide - Operating Scissors – Curved. 8. Tungsten Carbide - Iris Scissors. 9. Hartmann Mosquito Forceps – Straight. 10. Hartmann Mosquito Forceps – Curved. 11. Halsted Mosquito Forceps – Straight. 12. Halsted Mosquito Forceps – Curved. 13. Kelly Hemostatic Forceps – Straight. 14. Kelly Hemostatic Forceps – Curved. 15. Rochester Pean Forceps – Curved. 16. Rochester Pean Forceps – Straight. 17. Crile Hemostatic Forceps. 18. Dressing Forceps. 19. Tissue Forceps. 20. Mayo-Hegar Needle Holder. 21. Spencer (Littauer) Stitch Scissors. 22. Extra Delicate (XD) Metzenbaum-Lahey Dissecting Scissors. 23. Disposable Operating Scissors. 24. Allis Tissue Forceps. 25. Iris Scissors – Straight. 26. Iris Scissors – Curved. 27. Backhaus Towel Clamp. 28. Adson Tissue Forceps. 29. Adson Dressing Forceps. 30. Debakey Atraumatic Tissue Forceps. 31. Metzenbaum Dissecting Scissors. 32. Foerster Sponge Forceps. 33. Vaginal Speculum. 34. Disposable Vaginal Speculum. 35. Disposable Iris Forceps Instrument Sets Instrument sets, surgery trays and brush sets are assembled for convenience, according to practice specialty, procedure to be performed and the need for economy of time and cost. Instrument sets are often stored for later use and organized according to procedure, major or minor designation and/or specialty area. Examples of Basic Surgery Sets are: Minor Surgery Tray. Minor Basic Surgery Set. Uses: Ready to use surgery trays contain the most common instruments and supplies needed for particular functions, procedures or operations. Description: Includes: Scalpel #15”; Mosquito Hemostats, straight and curved; Mosquito Hemostats, straight and curved; Webster Needle Holder; Iris Scissors, curved; Kelly Forceps, straight; OR Scissors, Adson Tissue Forceps; Dressing Forceps; Gauze Sponges; Blue Linen OR Towels; Clear Utility Drape; Instrument Trays. Notes: Cases of 10, disposable, individual sterile packages. Shown: Sterile Grade.  Uses: Specialized surgical packs contain the most common instruments needed for a particular function, procedure or operation. Description: Scalpel Handles #3 and #4; Yankauer Suction Tube; Mayo Dissecting Scissors, curved 5 ½”, 6 ¾”; Halsted Mosquito Forceps, straight 5”; Halsted Mosquito Forceps; Crile Forceps, straight; Crile Forceps, curved; Dressing Forceps; Tissue Forceps 1x2 teeth; TC Mayo- Hegar NH, serrated; Operating Scissors S/S, straight”; Mayo Scissors, curved; Probe Double End 6”; Allis Tissue Forceps 4x5 teeth; Adson Brown Tissue Forceps; Backhaus Towel Clamps; Frazier Suction Tube 8 French; Goelet Retractor Double End; US Army Retractors; Zalkind Ribbon Retractors; Senn Retractors, sharp and blunt; Metzenbaum Scissors curved; Foerster Sponge Forceps straight and curved. Shown: OR Grade - Minor Basic Surgery Set.