Instruments, Sutures, And Needles Flashcards
Name the parts for instrument anatomy
Tips Jaws Box lock Box lock pin Shanks Ratchet Ring handles
How are instruments selected for surgery?
Pt physical condition
Surgeons preference
Anatomical structure
What are the basic categories for instruments?
Cutting
Retracting
Clamping
Grasping
Blades are ___________ and handles are ____________.
Disposable, reusable
Blades that start with 1 fit handle _________ and those that start with 2 fit on ________
3 and 7
4
Type of scalpel handles?
3 3long 4 7 Beaver
Instruments used to cut through bone and cartilage?
Chisels Rongeurs Osteotomes Gouges Files/rasps Powered instruments
What instruments are typically used for blunt dissection
Scalpel handle
Blunt sides of scissor blades
Sponge on sponge stick
Allis is typically used for what?
Grabbing skin edges, has teeth
What is the Babcock?
A grasping instrument used for the bowels
What instrument family is the kosher a part of?
Grasping
Tissue forceps may also be known as__________.
Thumbs or pickups
What does a Tuttle forcep look like and what is it typically used for?
Long with round ends without centre.
Has a pin in centre of forcep handle that travels through a small hole across from it to keep alignment
Used for bowels
What are debakeys?
Forceps
Can be long or regular
Has tooth on top and bottom
Either 1:2, 2:3, 3:4
Why are some stone forceps curved?
So you can reach in duct
What family does the tenaculum belong to? What are they for?
Grasping
Have single or multiple teeth
Penetrate tissue to grasp firmly
Used in uterus, etc
What are the most commonly used instruments?
Hemostats
What are haemostats used for?
To clamp blood vessels
What should you never do withs hemostat?
Use it to attach items to drapes because they are pointier and sharp and could poke through sterile sheet.
The rib spreader is an example of what?
A self retaining retractor
When would a terminal end stapler be used?
Closing end of hollow organ
When would an internal anastomosis stapler be used?
To connect hollow organ segments
Makes larger pouch or reservoir
What if the doctor asks you for for multiples of the same instruments in rapid succession?
May be picked up in multiples but must be handed individually
How do you pass an instrument to a surgeon on the opposite side of the table?
Pass across right hand to right hand or left hand to left handed surgeon.
How do you pass to a surgeon or assistant who is on the same side of the table as you?
If on right side pass with left hand
If on left side pass with right hand
What are some physical suture characteristics?
Physical configuration (single or multifilament)
Capillarity (ability to transmit fluid)
Fluid absorption ability
Diameter (sizes)
Tensile strength (breaking load)
Knot strength (force needed to made a knot slip)
Elasticity (ability to regain original for and length after stretch)
Plasticity (
Memory (retain former shape after removed. The higher the les knot security)
Explain the handling characteristics of sutures
Pliability (how easily material bends)
Coefficient of friction (how easily the suture slips through tissue and can be tied) - too high can drag through tissue and cannot tie knots. Too low and knots may come loose
What are some tissue reaction characteristics of sutures?
May have inflammatory response
Allergic reaction
Absorption
Potentiation for infection
Explain absorbable sutures
They are flexible
Prepared from collagen of healthy animal or synthetic fibre
Absorbable in living mammal tissue
By enzymatic activity or hydrolyzed (water in tissue)
Treated with chromium salt which delays absorption
What are the types of absorbable sutures, how long do they last, and where are they typically used?
Plain and chromic gut - 21 days - skin, intestines, stomach
Vicryl - 70 days - skin, fascia, muscle, bowel
Monocryl - 119 days - skin
PDS - 180 days - peritoneum, lung
What are some non absorbable sutures and where may they be used?
Silk - skin, drains, tie off vessels
Nylon (Ethlon & Nurolon) - skin and drains
Polyester (Mersilene & Ethibond) - tendons
Polypropylene (Prolene) - vascular grafts, skin, hernia repairs, muscle
Stainless steel - tension band wiring in fractures
Parts of a needle?
Point, body/shaft, eye or swaged end
Types of needles?
Conventional cutting Reverse cutting Taper Tapercut Blunt
What type of needle has cutting edges on outer curvature?
Reverse cutting
What needle has a rounded tip and why is this?
Blunt, less apt to puncture vessels within organs. Usually used in liver. Or cervix
Which needles are triangular shaped?
Conventional cutting and reverse cutting
Which needles are used for skin closure?
Conventional and reverse cutting
Which needle is smooth and has no cutting edge? Where is it used?
Taper needle
Used to push aside tissue, used on delicate tissue.
What makes the taper cut different from the other cutting needles?
Cutting edge is only at point.
Which needle is used for touch tissue without tearing it?
Taper. Eg fascia
What three areas of the set up do you keep your needles?
In the package
On a driver
Or in needle book/ sharps
Why shouldn’t you run your fingers along suture to remove knots?
Causes fraying
What should u watch for when passing needle to surgeon?
Not to get picked
Avoid contamination by helping suture string over sterile field
What should you do with the suture packages once opened?
Keep on set up
What type of suturing methods are there?
Retention/ stay suture Interrupted Continuous Continuous locking Horizontal/vertical mattress stitch Subticular Purse string Ties
Why must surgical gut and collagen sutures be used immediately after removal from package?
Wet packaged in alcohol solution to provide max pliability. Once removed the alcohol evaporates and strand will lose its pliability.
Can restore by submersing into sterile water or snow at body temp for a few sec. Increased moisture decreases tensile strength
