Types of surgical instruments used in the operating room
Surgical instruments are critical components for facilitating different medical and surgical operations. They come with various shapes, sizes, and functionality. The following is a rundown of the main types of surgical instruments in the operating room:
Scissors
These instruments cut through body tissues or materials. There are many modes of tissue scissors, including the following:
- Metzenbaum scissors: They cut delicate tissues and are ideal for dissecting muscles or other delicate tissues.
- Bozeman's: These scissors with clamps and angled tips help suture ligatures on tissue bleeders during surgery.
- Irwin Nail Scissors: These small scissors have cutting blades and a notch for thick nails and are often used in pedicure and wound care.
- Needle Holder Scissors: Incorporate features to grasp and insert curved needles into tissues and sutures seamlessly.
- Metzenbaum Scissors: Used for cutting delicate tissues and suture ties. They come with slender, tapered blades suited for precise cutting in small incisions.
Tweezers
Surgical tweezers are used to hold objects firmly. They include:
- Thumb Forceps: Used for grasping tissues, sutures, or other small objects. They come with smooth or serrated tips and work without locking mechanisms.
- Splinter Tweezers: Have a pointed, slim tip designed for extracting splinters, foreign particles from wounds, or other small objects in wound care.
- Adson Forceps: Their tips comprise serrated ridges and smooth surfaces, allowing the precise grasping of tissue during surgical procedures.
- Tissue Forceps: Used to hold tissues in the operation. They come with teeth to provide a firm yet gentle grip on tissues without causing much damage.
Scalpels
These are surgical knives used for making incisions in the skin. The commonly used ones include:
- Disposable scalpels: Come with detachable, reusable blades that can be replaced without buying a new scalpel. It's an economical choice for minor surgeries and wound dressings.
- Chemical-resistant Scalpel: This is chemically reinforced to cut through tough skin, cartilage, or other dense tissues while resisting wear from chemicals.
- Scissors Are: With curved blades and rounded tips, these scissors enable surgeons to make precise incisions on delicate areas like the cornea during eye surgery.
Hemostats
They are also called hemostatic forceps. They help to stop bleeding by grasping blood vessels tightly. Most of them feature:
- Locking Mechanism: Holds the clamps in place, preventing blood from flowing and reducing the need for constant hand pressure.
- Jaws with Serrations: Their serrated jaws ensure a secure grasp on tissues or blood vessels. Their vertical grooves give a strong grip without slipping.
- Curved Thanks Hemostats: They have an upward curve that allows the surgeon to reach deeper areas of the body and make incisions on blood vessels or tissue.
- Straight Towne's Hemostats: These are the classic linear design that helps control bleeding during surgery on surface areas. Its direct form provides a clear view of the target.
- Additional Adson Forceps: Angled tips combine tissue grasping with bleeding control. They are ideal for holding sutures while sealing vessels during repairs.
Industrial applications of instruments in the operating room
These instruments play an integral role in surgical procedures, with their importance extending to various industries. Some of these industries include:
Health care
These instruments are used in hospitals and clinics. They perform surgeries like grafting, organ transplantation, tumor removal, and other complex medical procedures. An accurate incision, smooth suture, or versatile forceps significantly enhances the efficiency and success rate of these critical interventions.
Veterinary medicine
Precision instruments like scalpels and forceps aid in treating animals. They perform surgeries, handle injuries, and conduct health assessments using similar tools like hemostats and tweezers due to their effectiveness in controlling bleeding or grasping tissues in small and large animals.
Rehabilitation services
In rehab centers, instruments like splinter tweezers and wound scissors treat injuries and manage wounds. They help specialists provide better care, promoting faster recovery through efficient tools to handle and dress injuries or assist with medical referrals.
R&D
Smooth scissors, tissue forceps, and Adson's tweezers are often used in medical research. They analyze tissues, test drugs, and develop new surgical techniques. They enable researchers to handle samples with care for accurate results and medical breakthroughs.
Manufacturing and Sterilization of Medical Equipment
The medical-grade instruments used in surgeries are produced and subjected to rigorous sterilization by the producers and suppliers. This guarantees that the tools fulfill quality and hygiene requirements needed for surgery while controlling the uniformity of surgical instruments.
Emergency services
Ambulance personnel utilize them in critical care during transit to the hospital. Forceps, scissors, and scalpels treat open wounds, control bleeding, and stabilize patients. They ensure timely intervention and optimal patient outcomes during transport to a medical facility.
Practices of Plastic Surgery
In addition to the aforementioned, plastic surgery practices extensively employ surgical instruments and supplies to promote aesthetic enhancement, repair injuries, or address congenital deformities.
Military medicine
Similar Adson forceps, Metzenbaum scissors, and hemostatic clamps are used to treat injuries. They keep soldiers alive and treat trauma in locations without enough infrastructure for medical tools.
Product specifications and features of instruments in the operating room
Key ingredients/key features
- Tungsten carbide: Mostly used for tips for enhanced durability and precision cutting.
- Stainless steel: Common in digestive surgery due to its resistance to disinfectant corrosion. Usually, it will be hardened for extra toughness in heavy use.
- Titanium:Often chosen for its lightweight. Also, it is non-magnetic and super strong.
- Plastic: It is gamma-sterilized and often single-use surgical instruments.
How to sterilize
- Steam sterilization: The pack is then placed in an autoclave and exposed to saturated steam at a temperature of 134-137°C for 3-10 minutes. The steam penetrates the load, killing organisms while allowing the pack to remain dry and sterile the following day.
- EtO sterilization: EtO is blended with alcohol, circulated, and allowed to dwell for 2-3 hours. It's ideal for moisture/heat-sensitive items. The load is packed in a way that facilitates penetration. It is typically sterilized in a humid, low-temperature environment that permits gas entry into items.
- Hydrogen peroxide plasma: Items are cleaned, then placed in a chamber with H2O2 to form plasma that permeates the load. Plasma residues are removed by rinsing wit water. The process exposes instruments to a high concentration of hydrogen peroxide, creating plasma that bacteria can't resist.
- Chemical sterilization: Involves soaking instruments in chemical disinfectant solutions. Them, chemical indicators are used to confirm the sterilization has worked.
- Dry heat sterilization: Items are exposed to hot air at 160-170°C for 60-120 minutes or 121°C for 1-2 hours. The long-winded method is less effective than moist heat for microbial spores but sterilizes moisture-sensitive items.
Maintenance
- Regular cleaning: Requires immediate degreasing and a soak in warm soapy water after use, then an abrasive scrub with a brush, cloth, or ultrasonic cleaner for thorough cleaning before sterilization.
- Lubrication: After sterilization, apply a thin antimicrobial oil to hinges/locking mechanisms that may dry, then gently wipe off excess oil without leaving residue on blades/tips.
- Inspection: Regularly might involve checking for visible damage like corrosion or wear, run fingers over the sharpened edge, look for microscopically visible protruding metal filings, and feel for burrs or roughness.
- repairs: Instruments with cracks, significant dents, or bent parts should be returned for repair/salvage or discarded, as small internal damages can worsen during procedures and endanger patients.
- Storage: Instruments are separated using foam holders, specifically placed to minimize contact and damage, and organized in wall cases with secured glass doors for identification and safety.
Quality and safety considerations for instruments in the operating room
Key materials/ingredients
- Corrosion-resistant: It is easy to clean,care and sterilize, such as titanium and surgical steel. For instance, surgical steel is made of chromium, steel, nickel, and molybdenum, with a standard melting point of 1400 °C.
- Semi-malleable: Also, non-magnetic materials, like titanium, are designed for various surgical uses, including tools, implants, and devices, especially for MRI patients.
- Non-toxic:Only radiopaque materials that show up on X-rays should be seen at the surgical site to prevent further procedures. These include tungsten, bismuth, and tantalum.
Key parts of sterilization pouches
- Filtering paper layer:Assists in maintaining sterility by trapping incompatible small particles.
- Spunbound Polypropylene: Durable,synthetic material that tears and punctures easily.
- Steam Sterilization Indicator: Changes color to signal successful steam sterilization. Other methods use different colored indicator strips, such as autoclave.
- Two Sealing Bars: The pouch is sealed by 2 close sealing bars, leaving 3 narrow sealed seams at the pouch's ends.
Quality check
- Instrument Testing:It is tested for functionality. Also, weak parts are exposed by stress-testing tools for wear and tear, usually through a series of operations that see how well they stand up to heavy use. Common operating room instruments include hammers, scalpels, and sutures.
- Sterility Testing: This is done through culture tests that identify microscopic life forms remaining on items after sterilization.
- Load Monitoring:Uses special indicators in instruments bags to show if sterilization occurred, with internal badges placed inside to confirm the process reached the center of each item. Also, Monitoring colors change.
- Technical Specifications:Follow ergonomics, mechanics, and material requirements, with written procedures for assessing effectiveness and safety.
- Repairs: Damaged instruments have detailed written procedures for repair, with clearly stated limits for what can be fixed versus total replacements.
Durable design
- Rounding tips: All kinds of sharp instruments have rounded tips that are important for safety as they do not puncture the tissues unnecessarily.
- Tissue Separation: Special clamps/tissue holders are provided to securely grasp and hold tissues away from the surgical field during surgery.
- Tumor:Exposure and excision of masses or unhealthy tissues using cutting instruments designed for precise incision without excess bleeding.
Frequently Asked Questions (FAQs) about instruments in the operating room
Q1: What are the most common surgical instruments used?
A1: Some are more common than others. They include scalpels, forceps, scissors, and tweezers. Adson's forceps and hemostats, and Metzenbaum scissors are also widely applied in surgeries.
Q2:What are the uses of surgical instruments in various industries?
A2:Often, surgical instruments used by operating room personnel are circulated to various industries like clinics, hospital, veterinarian practices, military medicine, and rehabilitation centers. These instruments treat injuries, manage wounds, and perform surgeries in various settings, ensuring survival and effective treatment.
Q3:What factors are considered when selecting surgical instruments?
A3:Often, the choice is based on the type of surgery and the professional preference of the surgeons. Materials for the instruments include corrosion and heat resistance, and the instruments' strength to endure chemical and mechanical wear are considered.
Q4:How are these instruments maintained.
A4:The instruments are put in various positions to ensure equal pressure is applied. They are then cleaned, usually using an ultrasonic machine, and are thoroughly examined before being sterilized and securely stored in a locked sterilization container or pouch.
Q5:How are surgical instruments kept sterile before an operation?
A5:A sterilizer, often nicknamed an autoclave, is routinely used in operating theaters, hospitals, and clinics to sterilize surgical instruments. The sterilizer uses saturated steam and a long time to destroy germs, ensuring the instruments are safe from germs before surgery.
