Saturday, February 22, 2014

Surgical Instruments Sharp 1




 General Surgical Instruments
introduction
The choice of incision is based on easy access to the diseased organ and the positioning of the patient also provides a similar advantage. Thus the operation list sent by the surgical team is the source of information on all the basic issues and identifies for the OT staff its work for the following day. The procedure to be preformed identifies the instrument requirements including those for anesthesia.
GENERAL SURGical INSTRUMENTS
In this chapter some selected instruments are presented as sets. They are put together for specific operations, putting together of these sets insures:
•       That instruments required will be available during the opera­tion.
•       That sets for all the operations can be prepared and autoclaved for a given list on a given day.
•       Hospital administrators can assess how many operations can be undertaken without recycling instruments.
•       Hospital administrators can foresee the need for procurement when new procedures are added to the existing list at a hospital.
•       OT staff in charge of different theaters should be able to identify and put together the required sets on receiving the lists for work for each day and send them for autoclaving.
         It will be our objective in this chapter to provide an overall plan of classification of instruments and line drawings to aid easy recall and identification of these instruments.
         Broadly speaking surgical instruments are used for:
•       Surgical procedures (operations).
•       Investigations and diagnosis.
Classification
The surgical instruments used for operation are broadly classified as:
•       Sharp cutting instruments.
•       Dissecting forceps.
•       Hemostats (artery forceps).
•       Tissue forceps.
•       Gastric + intestinal clamps.
•       Needle holders.
•       Suture materials.
•       Tubes, catheters and drains.
•       Retractors.
•       Dilators.
•       Special instruments.
•       Diagnostic instruments.
         The other instruments that are in use for surgical patients but have not been included here are:
•       Monitoring equipments Monitors for BP Cardioscopes.
•       Life support equipment.
•       Diathermy (Discussed in Chapter 2).
•       Cryosurgery (Discussed in Chapter 2).
•       Autoclaves (Discussed in Chapter 1).
•       Ultrasound.
•       CT scanners, etc.
         These instruments not discussed are of great importance in surgical practice but have not been included because of shortage of space. They are also in the charge of departments that provide support to the surgical services, i.e. Intensive Care Units and imaging departments. A special effort should be made to acquire a working knowledge of these equipments.
Sharp Instruments
Scalpel
A scalpel is a small knife used in surgical operations. In surgical practice the term knife refers to a cutting tool other than a scalpel and is usually reserved for amputation knives and skins grafting knives which are substantially larger than scalpels. The scalpels in use are:
•       Scalpel (Fig. 8.1)
•       Scalpel handle (Fig. 8.2A and B)
•       Scalpel blades (Fig. 8.3)
         Scalpels are used for incising skin and deeper structures to obtain access. They are very sharp and thus cause minimum injury to incised tissue. Disposable separate blades are sterile when packed and thus require no autoclaving thus there is no loss of sharpness.

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