Surgical Instruments

#11 blade used for

deep tendons, around a mass, tight area (specialty, not commonly used)

Self-retaining Retractors

ratchets mechanism, holds in place once they are positioned

Most common types of scalpels

reusable handles with detachable single use blades

Tripod grip

use thumb and ring finger to hold (most common)

Hartman's Straight (Mosquito) Forceps

used as both a hemostat and for fine tissue dissection in shallow wounds and procedures, clamping instrument to halt blood flow so that cauterization or ligation can be performed.

Kelly curved forceps

used for clamping large blood vessels or manipulating heavy tissue. They may also be used for soft tissue dissection. Teeth-halfway down

Curved 1x2 iris thumb tissue forceps

used for grasping and handling tissue in ophthalmic procedures

Mayo-Hegar Needle Holder

used for holding heavy needles when suturing; stuttering and stapling

#15 blade used for

used for smaller or more precise incising (dewclaws)

Jones towel clamp

used to attach and secure drape material, used for delicate surgeries like ophthalmic procedures

Halstead Curved (Mosquito) Forceps

used to clamp smaller blood vessels or to grasp finer delicate materials and tissues.

Olsen-Hegar Needle Holder

used to drive suture needles through tissue that requires suturing and to assist in tying sutures. can cut the suture as well

Adson-Hudson Tissue Forceps ( aka Rat Tooth Forceps)

used to stabilize and grasp soft tissues during surgeries, · Fine, rat tooth tips · Gentle grasp of tissues · Sx to manipulate delicate tissues o Fascia and skin during suturing · Linear row of serrations · Multiple teeth, provide secure grasp of tissues and suture needles

Hobby saw

-Purchased at hardware stores -Uses: Precise cartilage and sub-chondral bone cuts in ortho sx

Spratt Bone Curette

-Round oval cup on edge of strong steel shaft -Collect bone grafts and debride soft or bony tissues -Used to "scoop out" bone tissue

Gigli wire

-Used to cut through bone -Uses: goat horns, hind leg amputations -Heat is produced by the friction

Another name for #11 blade

Beaver blade

Roschoir Retractor

Bites off little pieces of bone

___ is NOT a good sterilization, but can be used as a disinfectant, chlorine can pit and damage the instruments

Chlorhexidine

SHORT OK sterilization indicator

Indicate whether the conditions during a steam autoclave cycle were adequate to achieve a defined level of microbial inactivation.

Snook Spay Hook

Instrument used to retrieve the uterine horn from the body

Mayo Scissors

Used to perform blunt dissection and to cut through bulky connective tissues. Tough fibrous tissues, Lines alba.

Brown-Adson Tissue Forceps

Used to pick up, hold, and maneuver delicate tissues

Barraquer wire lid speculum

Used to retract eyelids away from surgical site for intraocular procedures

Gold handles are made of

Tungsten Carbine

Stevens Tenotomy Scissors

Used for delicate dissection and cutting Uses: ophthalmic procedures

Straight Iris Scissors

Used for dissecting/cutting fine tissue

Chalazion Lid Speculum

Used for eyelid tumor removal

Curved Baby Metzenbaum Scissors

Used in delicate surgery requiring small instruments.

Backhaus Towel Clamps

Used to attach towels and drapes to the patient

Metzenbaum Scissors

Used to blunt-dissect or cut delicate tissues, causes less damage to tissue

Rochester Carmalt Forceps

Used to clamp tissue bundles that contain blood vessels, Clamping uterine stump, vascular pedicles (ovarian) · Longitudinal serrations

Sharp-Blunt Operating Scissors

Used to cut inanimate objects (sutures, paper, etc.). NEVER use on live tissues

Castroveijo locking needle holder

Used to grasp and guide the needle when suturing

Scalpel/blade holder

Used to hold scalpel blade

Allis Tissue Forceps

Used to hold tissues and can be used as a retractor. Use caution as it can cause tissue damage. Only apply to fascial planes or connective tissue, NEVER apply to skin or organs that are made to remain functional

Crile Forceps

Used to occlude vessels More teeth (go all the way down) -Large

#10 blade used for

general surgeries

Types of Retractors

handheld/self-retaining

Handheld Retractors

have to hold on to retractor the whole time

Comply Stericage (Integrator)

integrator will show that both time and temperature were reached

#4 scalpel handle is used for

larger animals

Bone Cutting Forceps

paired chisel like tips, used for cutting bone

Pencil grip

sm needles, for fine motor control

#3 scalpel handle is used for

small animals

Standard vs. Flash sterilization

· All instruments must be thoroughly cleaned of any organic debris before autoclaving · Instruments must be dried, box locks opened, all surfaces exposed for proper sterilization · In autoclave, containers are placed right ride up · Instrument packs are loaded vertically and longitudinally with space between the to allow steam to travel all around · Temp: 121 degrees C (250 degrees F) inside center of pack · Sterilization time of 12-15min (15 psi): standard min. exposure time w/ additional 2-5 min is often added for safety

Sterilization indicators

· Chemical indicators · Steam indicator strip · Steam tape · Plasma indicators

Doyen Tissue Forceps

· Gastric and intestinal sx (prevents contents from leaking out) · Gentle, atraumatic grip due to the tips of jaws meet when first teeth of ratchet are engaged · Bowed shape

Army Navy Retractor

· Handheld · Longer, 90-degree blade at each end · Retracting deeper layers of tissues

Mathew-Senn Retractor

· Handheld · Retract skin and superficial muscles · 3 prongs, right angle blade at all other end

Plasma sterilization

· Hydrogen peroxide gas used to produce free radicals which kills microorganisms in a closed chamber. · Radio frequency is turned on to activate process and then turned off to revert chemicals to unharmfal oxygen, water, other byproducts · Rapidly replacing ethylene oxide sterilization in some countries · Ability to kill a broad spectrum of microorganisms · Linens, gauze sponges

Steam tape

· Indicates sterilization has occurred · Can be used to seal packs and has labels to mark initials and time of sterilization · Turns black when it reaches certain temp, indicating appropriate temp was achieved at one point during sterilization · DOES NOT indicate duration and temp, DOES NOT confirm sterility of pack

Chemical indicators

· Indicates sterilization has occurred · Often in tape form or paper strips that are included in or on pack during sterilization · Chemicals in indicator change color when they reach certain temp (only that appropriate temp was achieved at one point during sterilization · DOES NOT indicate duration of exposure to correct temp and pressure, and DOES NOT confirm sterility of pack

Steam indicator strip

· Indicates sterilization has occurred · Steam turns strips black · Can be placed within packs to ensure appropriate temp has been reached at center of pack · They DO NOT indicate the duration of exposure to correct temp and pressure, they do NOT confirm sterility of pack

Biological indicators

· Most accurate method · Highly resistant bacterial spores are stored in container that is sterilized with the instruments then cultured to determine bacterial growth is present

Gravity displacement sterilizer (autoclave)

· Most common · Operate by entering steam into top of autoclave chamber and displacing air towards the bottom for eventual removal · When air is replaced by steam, specific temp is reached in chamber which is maintained for a period of time to kill microorganisms · 121 degrees C for 30min

Steam Sterilization (autoclave)

· Most common method · Kills microorganisms by using moisture and extreme heat to cause coagulation of cellular proteins required for survival. · Pressure is used to increase the temp of the steam and allows more efficient sterilization · Oils and grease: can NOT be sterilized with steam · Gravity displacement · Prevacuum · Steam Pulsing autoclaves

Cold Sterilization

· Often used for material and instruments that cannot be sterilized with steam · "cheaper" instruments · Glutaraldehyde: non-corrosive cold sterilant that utilizes alkylation to kill bacteria, viruses, spores · Glutaraldehyde and other aldehydes (formalin) can be irritating to skin and mucous membranes, can cause hypersensitivity and reactions. · Instruments soaked in an aldehyde cold sterilant should be rinsed thoroughly with a sterile saline prior to use · Chlorhexidine is NOT a good sterilization, can be used for disinfectant, chlorine can pit and damage the instruments

Steam-pulsing autoclave

· Operate by pulsing steam into chamber to set pressure and removing air. · Cheap, but not as fast as prevacuum autoclaves · Faster than gravity displacement autoclaves

Prevacuum autoclave

· Operate by removing all air from chamber using a vacuum pump and then pumping in steam o Allows for a more rapid sterilization process and allows for steam to penetrate instrument packs faster · Flash sterilization can be done to instruments when needed quickly: this cycle is done on a non-wrapped instrument and using a fenestrated tray · Flash sterilization of single instruments can be done at 270 degrees F for 3-4 min at 30psi in a fenestrated metal tray

Radiation sterilization

· Prepackaged material for sterile vet us often use ionizing radiation · Expensive method of sterilization, lg hospital use · Bulk products, (Syringes, catheters, suture material)

Gelpi Retractor

· Self-retaining · Good for leverage on tissues being ratcheted · Deep muscle retraction during neuro or ortho sx

Weitlaner Retractor

· Self-retaining · Sharp or blunt prongs on either end · Soft tissue, ortho, neuro sx

Gas sterilization

· Used for things that cannot withstand harsh environment of an autoclave · Ehtylne oxide is a gas when at temp above 10.9 degrees C. · Can kill microorganisms such as bacteria, spores, fungi, mainly large virus particles · Killing occurs by alkylation, impairing metabloc functions of all organisms · Effectiveness of sterilization using this compound varies with the gas concentration, temp, exposure time, and humidty of the environment used. · Exposure time can vary from 48 min to several hours · Gas diffuses through instrument packs and packages killing organisms it contacts · Before the sterilization is complete, an aeration period must occur to allow the ethylene oxide to diffuse out of packs · Certain objects, plastics and rubbers, require 168 hours or more before handling and use. Stainless steel stools require little time to aerate · Sx implants can require 14 days aeration before handling and implantation is safe · Contact with ethylene oxide impregnated objects may cause sever burns to patients and handlers · Ethylene oxide is flammable and explosive in air mixtures and very irritating when inhaled