Upload
lahcmultimedia
View
1.064
Download
4
Embed Size (px)
Citation preview
Surgical Instrumentation
Chapter 11
Objectives:As a result of successfully completing this chapter, students will be able to:
Review the process by which surgical instruments are manufactured Define basic categories of surgical instruments based upon their functions, and identify the points of inspection, anatomy (features) of, and procedures to measure the following types of instruments:
Hemostatic Forceps Needleholders Tissue Forceps Dressing Forceps Retractors Scissors Suction Devices Single and Double Action Rongeurs Kerrison/Laminectomy Rongeurs Nail Nippers Graves and Pederson Vaginal Speculums
Objectives: Identify solutions that can damage stainless steel instruments
Explain procedures to test instruments for sharpness, and to identify (mark) them
Emphasize the importance of instrument lubrication, and review tray assembly safeguards
Central Service Technicians…
…are responsible for the quality of instrument
Martensitic (400 Series)Stainless Steel
Hard, used when sharp cutting edges are needed
Often used for scissors, osteotomes, chisels, hemostatic forceps, and needleholders
Austenitic (300 Series)Stainless Steel
Highly Corrosion Resistant
Not as hard as 400 Series
Used for retractors, cannulas, rib spreaders, suction devices
Instrument Manufacturing Forging Grinding and Milling Assembly Heat Tempering Polishing Passivation Final Inspection Etching
Note: Instruments are inspected throughout their manufacturing process
Passivation
A chemical process applied during instrument manufacture that provides a corrosion-resistant finish by forming
a thin transparent oxide film
Instrument Finishes The instrument on the
left has a matte, or satin-finish
The instrument on the right has a shiny, or mirror finish
Overview of Surgical Instruments
Pages 178 – 187 provide an overview of basic surgical instruments along with tips and techniques for proper inspection
Post-Ooperative Care of Surgical Instruments
Keep instruments moist
Transport to Central Service for cleaning as soon as possible
Solutions that Damage Surgical Instruments
Saline Betadine Peroxide Dish Soaps Soaking in Water Soaking in Saline Bleach Iodine Hand Soaps
Laundry Detergents Long-term Soaking in
Rust Remover Long-term Soaking in
Stain Remover Surgeon’s Hand Scrubs Household Lubricants Household Powder
Cleaners
Surgical Sharps Testing
Scissors Guidelines NEVER use them
to cut other products
Protect Blades
Test Between Uses
Scissors Testing Material
Use RED Test Material for Scissors greater than 4.5”
Use Yellow Test for Scissors smaller than 4”
Use Single-Ply Facial Tissue for Laparoscopic Scissors
Bone Cutters
Test with an Index Card
Rongeur Testing Kerrison, Laminectomy
and Double Action Rongeurs should be tested using a 3” x 5” index card
Look for clean bites
Curettes, Chisels, and Osteotomes
Test each using a plastic dowel rod
Each should shave off pieces of the rod
Instrument Identification Procedures
Tape Clean hands thoroughly with alcohol to remove oils
and grease
Wipe the part of the instrument where the tape will be placed with alcohol
Cut the tape at an angle
Wrap the tape 1 to 1.5 times around the device
Autoclave the instrument to allow the heat to help bond the tape to the instrument
Acid Etching
Process that uses a stencil, solution and electricity to
mark and instrument
Heat-fused Nylon
A process that leaves a thin color-coded layer on nylon
on an instrument
Laser Etching
Permanent marking method done by instrument
manufacturers and repair vendors
Instrument Lubrication
The use of a neutral pH lubricant extends the life of instruments
Use lubricants in according with instrument manufacturers’ and the lubricant manufacturer’s recommendations
ALL Lubricants must be approved for use as a surgical instrument lubricant
Tray Assembly Tips Place heavy instruments on the bottom or side of the tray
Select an instrument tray that allows adequate space for weight distribution
Place all curved instruments in the same direction
Nest Tissue and Dressing Forceps
Protect Delicate Instruments
Use Instrument Stringers (holders) to keep instruments open and in place
Avoid metal to metal contact between laser finish instruments