History
What is a surgical instrument?
-A specially designed device or apparatus used to carry out a specified task during a surgical procedure.
-Surgical instruments date back to prehistoric times when early ancestors used sharpened stones and animal teeth.
History
List the materials historically used to create surgical instruments.
- Ivory
- Wood
- Bronze
- Iron
- Silver
-These materials reflect the evolution of surgical instruments throughout history.
History
What significant discoveries in the nineteenth century influenced surgical instrumentation?
- Anesthesia
- Asepsis
-These discoveries were pivotal in the evolution of surgical practices.
History
What development in the twentieth century changed surgical instrumentation?
- Stainless steel
-The development of stainless steel marked a significant advancement in the durability and functionality of surgical instruments.
History
Name three modern advancements in surgical instrumentation from the twentieth century.
- Electrocutery
- Ultrasonic devices
- Endoscopic devices
-These advancements have transformed surgical techniques and instrument design.
History
What new materials are currently being used in the manufacturing of surgical instruments?
- Titatnium
- Vitallium
- Vanadium
- Carbides
- Polymers
-These materials contribute to the innovation in surgical instrument design.
History
What are the three types of finishes used on stainless steel instruments?
- Mirror-is highly polished and reflects light. Causes a glare, but the instrument is highly resistant to corrosion.
- Satin or Matte- a dull finish that reduces glare and is the preferred finish.
- Ebony- a black chromium finish that completely eliminates reflection and glare; instruemnts with this finish are used during laser procedures to prevent light beam deflection.
History
What does gold plating on an instrument signify?
- That tungsten carbide was incorporated into the manufacturing process.
History
What is tungsten carbide and what is it used for?
- extremely hard metal
- used to laminate scissor blades
- increase and maintain sharpness
- inserted into the jaws of needle holders to increase strength and gripping abilities
Care and Handling of Instruments
Why is it important to properly prepare, use and process surgical instruments?
- large financial expense for medical facilities
- promotes patient safety
- prolongs the life of the instrument
- decreases repair and replacement costs
Care and Handling of Instruments
Why is it important to not misuse an instrument?
- designed for specific use
- using them for other purposes will damage or dull the instrument (e.g., using tissue scissors to cute drapes or dressings or using a hemostat to open a medication vial)
- can endanger patients
Care and Handling of Instruments
What steps keep instruments in proper working order during surgery?
- handled individually or in small groups to prevent damage that might occur if they become entangled or are piled on top of one another
- not be jostled around in the tray when setting up or looking for a certain item
- before, during, and after surgery, instruments should be placed onto the designated area
- not be tossed or dropped
- heavy items and instruments should never be on top of another instrument; these mishandlings can cause misalignment and dull blades and can damage instrument tips
Care and Handling of Instruments
What should be done to ensure patient safety?
Instruments should be-
* inspected and tested before each surgical procedure
* clean and free of debris
* properly aligned
* damage free
* in good working order
Care and Handling of Instruments
Why and how should instruments be maintained during surgery?
- instruments should be wiped or rinsed with sterile water as they become soiled with blood and tissue
- ensures removal from the box lock, serrations, jaws, and any crevice
- blood and tissue that is allowed to dry and harden can cause an instrument to become stiff and not work properly
- can make the cleaning process difficult and interfere with sterilization process
- nondisposable suction tips should be periodically irrigated with a syringe and sterile water to remove trapped blood and debris
- saline should not be used to wipe, rinse, or soak instruments; exposure to saline will cause corrosion and pitting
Care and Handling of Instruments
How should all disposable sharps and blades be handled after the surgical procedure?
All disposable sharps and blades should be removed and discarded in a sharps container.
Care and Handling of Instruments
How should instruments be cleaned after the surgical procedure and why?
- Instruments hould be opened, disassembled, and submerged in water or enzymatic solution.
- Instruments should be placed in the solution so that they do not become entangled or damaged.
Care and Handling of Instruments
How should heavy and lighter instruments be handled after surgery?
- Heavy instruments should be placed first, and lighter, more delicate ones should be placed on top.
Care and Handling of Instruments
How should sharp edges or tips be handled after surgery?
- Sharp edges or tips should be placed so that they do not endanger the personnel who will be cleaning them.
Care and Handling of Instruments
How should delicate instruments be handled after surgery?
- Delicate instruments, rigid endoscopes, cameras, and fiberoptic light cords should be seperated to prevent damage.
- All cords should be loosely coiled
- Power saws and drills should never be immersed in solutions
Care and Handling of Instruments: Microsurgical Instruments
How should microsurgical instruments be cared for or handled?
- special containers are used to protect the instruments
- these racks keep the instrumentss separate and help in identification by providing a place to label them
Care and Handling of Instruments: Microsurgical Instruments
How should microsurgical instruments NOT be handled?
- not drop these instruments
- not allow them to become entangled with each other
- not place heavy items on top of them
Care and Handling of Instruments: Microsurgical Instruments
Why can using care prevent injuries when handling microsurgical instruments?
- All microsurgical instruments should be inspected for damge before use
- Many have sharp tips that can that can easily compromise the integrity of gloves and/or skin.
Care and Handling of Instruments: Microsurgical Instruments
How should instruments be passed to the surgeon?
- When passing instruments, a surgeon should be able to remain focused and not have to move away from the microscope.
Care and Handling of Instruments: MIcrosurgical Instruments
How should ringed forceps be passed?
