1. dia

1. dia

BASIC SURGICAL TOOLS and SURGICAL MATERIALS Andrea Ferencz Semmelweis University, Faculty of Medicine Department of Surgical Research and Techniques www.semmelweis.hu/mutettan BASIC SURGICAL TOOLS

BASIC SURGICAL TOOLS Surgical instruments are - precisely designed and manufactured tools. - for single (disposable) or multiple use (non-disposable), - must be resisted physical and chemical effects, body fluids, secretions, cleaning agents and sterilization For this reason, most of them are made of high-quality stainless

steel; chromium and vanadium alloys ensure the durability of edges, springiness and resistance to corrosion. BASIC SURGICAL TOOLS Classification: 1. 2. 3. 4.

5. 6. Cutting and dissecting instruments Grasping, clamping, occluding instruments Hemostatic instruments Retracting and exposing instruments Wound-closing instruments and materials Special instruments

BASIC SURGICAL TOOLS 1. Cutting and dissecting instruments The function of these instruments is to divide tissues, sutures, bandages, etc. BASIC SURGICAL TOOLS 1.1. Scalpels

Handle and detachable blade Conventional scalpel Use of scalpels Fiddle-bow-holding Pencil-holding

BASIC SURGICAL TOOLS 1.2. Scissors BASIC SURGICAL TOOLS Use of ring-ended instruments with right and left hands 1-4 instrument-holding

BASIC SURGICAL TOOLS 1.3. Dissecting hemostatic forceps Pean Mosquito abdominal Pean

Three mail functions: - dissecting tool, - grasping tool, - hemostatic tool. BASIC SURGICAL TOOLS 1.4. Electrocoagulating system Monopolar Bipolar

BASIC SURGICAL TOOLS 1.5. Ultrasonic 1.6. CUSA cutting system (Cavitron Ultrasonic Surgical Aspirator) 1.7. CO2-LASER, neodymium-YAG-LASER

BASIC SURGICAL TOOLS 1.8. Dissector 1.9. Amputating knives 1.10. Saws 1.11. Raspatories BASIC SURGICAL TOOLS

2. Grasping, clamping and occluding instruments These istruments are used to grasp, pick up, hold and manipulate tissues, tools and materials. BASIC SURGICAL TOOLS 2.1. Forceps

Anatomical forceps Surgical forceps Ophtalmological Ring tip forceps forceps Dental

forceps BASIC SURGICAL TOOLS Use of forceps Forceps should be held like a pencil! Forceps must never be held in the palm!!!!!!

BASIC SURGICAL TOOLS 2.2. Towel-holding clamps Bachaus towel clamp Schaedel towel clips BASIC SURGICAL TOOLS

2.3. Hemostatic forceps Traumatic Kocher Lumnitzer

Atraumatic hemostatic forceps Bulldog Blalock Satinsky BASIC SURGICAL TOOLS

2.4. Needle holders Mathieu needle holder Hegar needle holder BASIC SURGICAL TOOLS 2.5. Organ clamps Allis

(lungs) Ringed gallblader clamp Babcock (gallblader) Klammer (intestinal clamp) BASIC SURGICAL TOOLS

2.6. Sponge-holding clamp Sponge-holding clamp Handled sponge BASIC SURGICAL TOOLS

3. Hemostatic instruments These instruments are establishing hemostasis during the operation. BASIC SURGICAL TOOLS Important member of this group are the hemostatic claps (Pean, mosquito, abdominal Pean, Kocher, Lumnitzer, Satinsky, bulldog) and electocoagulatins system. 3.1. Deschamp needle and Payr probe

BASIC SURGICAL TOOLS 3.2. Argon beam coagulator (ABC) BASIC SURGICAL TOOLS 4. Retracting and exposing instruments These instruments are used to hold tissues and organs in order

to improve the exposure and hence the visibility and accessibility of the surgical field. BASIC SURGICAL TOOLS 4.1. Hook 4.2. Rake retractor 4.3. Roux-retractor

BASIC SURGICAL TOOLS 4.4. French retractor 4.5. Visceral retractor 4.6. Abdominal wall retractor BASIC SURGICAL TOOLS 4.7. Weilander self-retractor

4.8. Gosset self-retractor BASIC SURGICAL TOOLS 5. Wound-closing instruments and materials These instrument and surgical materials are used during tissue closure procedures. BASIC SURGICAL TOOLS

5.1. Staplers Circular Stapler Linear Stapler BASIC SURGICAL TOOLS 5.2. Clips 5.3. Self-adhesive strips

Michel-clips 5.4. Surgical adhesives BASIC SURGICAL TOOLS 5.5. Surgical materials BASIC SURGICAL TOOLS 6. Special instruments

These instruments are not used routinely during all surgical interventions. BASIC SURGICAL TOOLS 6.1. Volkmanns curette 6.3. Probe

6.2. Instruments of bone surgery 6.4. Sucker system SURGICAL MATERIALS SURGICAL MATERIALS Surgical needles Medicina is used numerous materials (bone, fishbone, thorn)

as surgical needles, and metal needles are widespread from the XIX. Century. SURGICAL MATERIALS The criteria of the ideal surgical needles - Made in best quality and minimal tissue reaction causing stainless steel - Slim and narrow, but strong - Stabil fixation and control in the needle holder

- Lead the thread by safely and minimal traumatisation - Sharp to get through the tissues - Rigid, but flexible - Easy sterilisation SURGICAL MATERIALS Conventional needles Closed eyed - Double thread (traumatisation)

- Lace time - Re-sterilisation - Care of needle-tip - Corrosion French-eyed SURGICAL MATERIALS Atraumatic needles

- Simple thread (atraumatic) - Manufactured connection of needle and threads - No Lace time - No re-sterilisation - No Care of needle-tip - No Corrosion SURGICAL MATERIALS

Shape of needle Circle 3/8 Circle Circle 5/8 Circle Progressive curved

Multiple curved Straight J-shaped SURGICAL MATERIALS Shape of its body Round needle

Triangular (Cutting) needle SURGICAL MATERIALS Round needle Taperpoint Tapercutting

Blunt taper SURGICAL MATERIALS Cutting needle Conventional Reverz cutting Spatula

SURGICAL MATERIALS Criteria of ideal surgical materials Moynihan, 1912: Nonelectrolytic, noncapillary, nonallergenic, noncarcinogenic. Nonferromagnetic, as is the case with stainless steel sutures. Easy to handle. Minimally reactive in tissue and not predisposed to bacterial growth.

Capable of holding tissue layers throughout the wound healing Resistant to shrinking in tissues. Absorbed completely with minimal tissue reaction after serving its purpose. Sterile. SURGICAL MATERIALS Classification of surgical materials Raw material

Natural Synthetic Structure Monofil Multifil Absorbability Absorbable Non-absorbable

SURGICAL MATERIALS Raw material: Natural Advantage: Present in the nature - cheap?? Good handling Knotting properties, knot security Disadvantage:

Strong tissue reaction by animal and vegetable tissues Enzimatic absorbtion tissue reactions Uncalculable absorbtion Procurement, screening, monitoring (economies ?) SURGICAL MATERIALS Raw material: Synthetic Advantage: Minimal tissue reaction

Absorbtion by hydrolysis calculable Strong Disadvantage: Bad handling of Monofil threads SURGICAL MATERIALS Structure: Monofil Advantage:

Smooth surface Smaller tissue trauma No bakterial culture No capillarity No tumor cell invasion Disadvantage: Bad handling and knotting Thread memory

SURGICAL MATERIALS Structure: Multifil Advantage: Strong Soft and flexible Good handling Good knotting Disadvantage:

Bacterial and tumor cell invasion Capillarity Elongation Rough surface tissue trauma (sawing and cutting) SURGICAL MATERIALS Absorbability: Absorbable Advantage:

The human body break down them Not remain foreign materials (granuloma) Disadvantage: Time of tissue cohesion (important the choose) SURGICAL MATERIALS Absorbable

1.Polyglycolic acid (Safil, Safil Quick, Dexon) 2. Polyglactin (Vicril, Vicryl Rapide) 3. Glycomer (Biosyn) 4. Polyglytone (Caprosyn) 5. Glyconate (Monosyn) 6. Polyglyconate (Maxon) 7. Polydioxanone (PDS II, MonoPlus) 8. Lactomer (Polysorb) 9. Gut (Cromic Gut, Plain Gut)

SURGICAL MATERIALS Absorbability: Non-absorbable Advantage: Permanent tissue cohesion Disadvantage: Resist foreign materials in the tissues (foreign-body reactions, granuloma, microabscess, fibrosis)

Suture rejection SURGICAL MATERIALS Non-absorbable . Polyamide (Dafilon , Ethilon, Supramid, Nurolon, Surgilon) . Polyester (Ethibond, Ti-Cron, Synthofil, Dagrofil, Mersilene) . Polybutester (Novafil, Vascufil) . Polypropylene (Premilene, Prolene, Surgipro)

. Silk (Silkam, Virgin silk, Mersilk, Softsilk) . Steel (Steelex, Steel wire, Steel) SURGICAL MATERIALS No ideal surgical materials! Choice: - Synthetic - Absorbable

- Coated multifil or flexible monofil SURGICAL MATERIALS The size-systems of threads Metric units / European Pharmacopeia/ from 0,1 metric (0,010-0,019 mm) to 10 metric(1,00-1,09 mm) USP /United States Pharmacopeia/

from 11/0 (0,010-0,019 mm) to 7 (1,00-1,09 mm) 11/0, 10/0, 9/0, 8/0, 7/0, 6/0, 5/0, 4/0, 3/0, 2/0, 0, 1, 2, 3, 4, 5, 6, 7

Recently Viewed Presentations

  • Catholiccatechist.org

    Catholiccatechist.org

    CATHOLICCATECHIST.COM #1 SOURCE FOR ONLINE CATHOLIC CURRICULUM SUPPLEMENTS READY WHEN YOU ARE THOUSANDS OF FILES READY TO DOWNLOAD INSTANTLY NEW FILES ADDED MONTHLY EASY TO EDIT HELPFUL LINKS The Ten Commandments Confession/Reconciliation Mary Advent and Christmas Creation Miscellaneous Angels Curriculum...
  • Calorimetry - teachnlearnchem.com

    Calorimetry - teachnlearnchem.com

    Burning of a Match. Zumdahl, Zumdahl, DeCoste, World of Chemistry2002, page 293. Energy released to the surrounding as heat. Surroundings. System (Reactants)
  • Physics 1425: General Physics I - University of Virginia

    Physics 1425: General Physics I - University of Virginia

    The (Fixed) End of the StringWhat happens when a pulse reaches the end of the string, and the end is fixed? It will decay. It will bounce back, looking much the same. It will bounce back, but an up pulse...
  • Welcome to our school! Our school is in

    Welcome to our school! Our school is in

    When people enter our school they look at the displays on our wall to see the wonderful work we do. Ce sontnos panneaux d'affichageFrançais. Nous apprenons: la nourriture, les vĂȘtements, les numeros et la famille. ... This is our playground...
  • $100 Dollar Laptop One Laptop Per Child Project

    $100 Dollar Laptop One Laptop Per Child Project

    BIRTH OF $100 Dollar Laptop. First Introduced at the World Summit for Information Society by Kofi Annan and Nicholas Negroponte. Provide hand-crank powered laptops to children in developing countries
  • Study Skills Vocabulary

    Study Skills Vocabulary

    A life of poverty is filled with much strife. Appease. Ah-peez. Verb. Definition: to soothe or relieve by giving into. ... Adjective. Definition: bold and shameless. The thieves were brazen enough to leave a mocking note for the investigators. Conundrum....
  • U.s. Antarctic Research Program Aeronomy, Space and ...

    U.s. Antarctic Research Program Aeronomy, Space and ...

    Aeronomy and Astrophysics Program Aeronomy, Space Physics, and Astrophysics Program Vladimir Papitashvili Antarctic Sciences Section NSF/Office of Polar Programs
  • Lecture 11 CS 2013 Liang, Introduction to Java

    Lecture 11 CS 2013 Liang, Introduction to Java

    Regex: [tT]\w* // words that begin with T or t. Results: I found the text "The"starting at index 0 and ending at index 3. I found the text "thrill"starting at index 4 and ending at index 10. I found the...