- Use for visceral puncture - Difficult to control depth

- Large animal surgery only - Deep incision

Instrumentation Flashcards by Janina Wait

What are #10 scalpel blades used for?

Small animal general purpose

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What are #15 scalpel blades used for?

Cat, general purpose

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What are #20 scalpel blades used for?

Large animal, general purpose

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What are #12 scalpel blades used for?

Suture removal

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What scalpel blades do size 3 scalpel handles take?

10, 11, 12, 15

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What scalpel blades do size 4 scalpel handles take?

20, 21, 22, 23

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What are size 4 scalpel handles usually used for?

Large animal surgery

- Accept larger blades

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What are the advantages and disadvantages of the penholder scalpel grip?

Advantages: very stable, good contact angle
Disadvantages: allows only short slide cuts

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What are the advantages and disadvantages of the fingertip scalpel grip?

Advantages: allows long slide cuts
Disadvantages: less stable, flatter contact angle

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Outline slide cutting

Use curved part of blade to incise the skin

- Assisting hand tenses tissue and reduces downward force

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Outline stab cutting

Use for visceral puncture

- Difficult to control depth

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Outline the push cut

Large animal surgery only

- Deep incision

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What are the 3 types of scissors?

Suture
Bandage
Tissue

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Outline suture scissors

Do not use tissue scissor for cutting suture material

- Carless and Littauer

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What are Carless scissors used for?

Heavy duty suture scissors

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What are Littauer scissors used for?

Removal of tight/small or awkward sutures

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Name the 2 types of tissue scissors

Mayo and Metzenbaums

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Describe Mayo scissors

Wider, robust blades

- Deals with tough tissue

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Describe Metzenbaum scissors

Fine blades

- Used for delicate dissection

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What are the cutting forces exerted by scissors?

Closing
Shearing
Torque (twisting)

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Describe dressing scissors

Used to cut dressing material and general work

- Also used for cutting suture material during surgery

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What instruments can be used for haemostasis in surgery?

Artery forceps
Swabs
Suction
Electrical

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Name the 4 most common artery forceps

Mosquito
Spencer-Wells
Rochester-Pean
Cholescystectomy or Roberts

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Compare the serration on artery forceps and bowel clamps

Serrated edge runs transverse on artery forceps

- Runs lengthways on bowel clamps

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What are Bowel clamps used for?

- Striations are less traumatic | - Though tot be more secure in sealing the bowel during surgery

What are curved forceps used for?

Pick up small bleeders and for grasping tissue bunches

How are artery forceps held?

Standard tripod grip

Describe surgical swabs

- Cotton strand/fibre - More cotton = more effective - Raytex markers important for cavity surgery as are radiopaque so can be found if left in - Laparotomy sponges are very large - Dental rolls and Q tips can also be used

Describe suction for haemostasis

- Can be attached to a wall mounted system or mobile generator - 4 main types: Yankauer, Frasier, Poole, Adson

What is Yankauer suction used for?

- General purpose - Suction of large volumes of fluid - Used during dental scaling to remove excess fluid

What is Frasier suction used for?

Finer control suction, similar appearance to Yankauer

What is Poole suction used for?

- Cavity suction - Good for large volumes e.g. abdominal lavage - Guard reduces risk of viscera and omentum blocking tip

What is Adson suction used for?

- Spinal surgery | - Greater control of suction close to delicate structures by releasing finger from over the hole

What instruments are used for tissue manipulation?

- Thumb forceps - Tissue forceps - Retractors - Block ended serrated dressing forceps

Name the different types of thumb forceps

- Adson/Adson-Brown - Gillies - Lanes, Treves - DeBakey

What are Adson/Adson-Brown forceps used for?

- Fine tissue control - GOod for skin - Can have rat toothed or serrated ends

What are Gillies forceps used for?

Fine tissues, general purpose

What are Lanes and Treves forceps used for?

- Heavier duty - General purpose - Can be rat toothed

What are DeBakey forceps used for?

- Very atraumatic | - Suitable for chest, GI, liver etc

Name the different types of tissue forceps

- Allis - Babcock - Spay

Describe the purpose Allis forceps

- Robust - Traumatic - Only used on connective tissue or fascial planes - Never for skin or a hollow viscus

Describe the purpose of Babcock forceps

- Fine | - Used on bladder, liver and lung

Describe the purpose of spay forceps

- Used to elevate uterine horn in cat spay - Have a DeBakey grip (secure) but less traumatic - Good for surgery of ear, bowel or urogenital tract as have very thin working end

Name the different types of retractors

- Gelpi - Weitlaner, Wests - Abdominal (Balfour, Gosset) - Hohman - Senn - Handheld

What are Gelpi retractors used for?

- Excellent general purpose - Sharp tips - Especially good for joint surgery and spinal surgery

What are Weitlaner and West retractors used for?

- Excellent general purpose - Sharp tips - Retraction of skin and superficial soft tissue

Describe Gosset retractors

- Used in abdominal surgery - Light, do not get in the way - Rib retractor/laparotomy retractor

What are Hohman retractors used for?

- Retraction of bones/bone fragments during fracture repair | - Are handheld

What are Senn retractors used for?

Fat pad retraction in medial meniscus repair (handheld)

What are Balfour retractors used for?

Retraction of body wall during exploratory laparotomy

What are the pros and cons of handheld retractors?

- Pros: light, cheap | - Cons: need to be handheld

Name the handheld retractors

- Hohman | - Senn

Outline the use of block ended serrated dressing forceps for tissue manipulation

- Are cheap dressing forceps | - Minimal use during surgery

What type of instruments are needed in tissue reconstruction?

Needle holders

Name the different types of needle holders

- Mayo - Olsen-Hegar - McPhail - Gillies

Which needle holders have a locking catch?

- All but Gillies | - I.e. Mayo, Olsen Hegar, McPhails

Which needle holders have scissors?

Olsen-Hegar and Gillies

Describe the Backhaus Towel clamp

- Used to secure drapes to the patient - Very traumatic - Pierce drape material - Very secure

Describe the spay hook

Used to atraumatically lift the uterine horns within the abdomen

What instruments are commonly used in ophthalmic surgery?

- Castroviejo needle holders | - Castroviejo corneal scissors

What are Rongeurs used for?

- Orthopaedic surgery | - "nibbling" through edges of bone

What are periostal elevators used for?

- Orthopaedic surgery | - Used to remove periosteum from bone

What are burdizzos used for?

Bloodless castration of large animals

What are emasculators used for?

Open castration of large animals