Surgery Lecture 3 Surgical Instruments

Front 1

How can you extend the life of your instruments, especially scissors?

Back 1

Tungsten Carbide inserts
-Replaceable

Front 2

What are needle holders used for? What are 2 types?

Back 2

ONLY for suturing
-Not wire twisting etc
-Carbide inserts
2 types: Mayo-Hegar, Olsen-Hegar

Front 3

What are the 2 types of scissors? What are the intended functions for each?

Back 3

Metzenbaums=fine tissue
Mayo= fascia

Front 4

How can you identify kelly hemostatic forceps?

Back 4

Transverse grooves distal half of tips

Front 5

What are the uses of Kelly hemostatic forceps?

Back 5

Grasping bleeding vessels and stumps

Front 6

How can you identify Crile hemostatic forceps?

Back 6

Transverse grooves whole length of tips

Front 7

What are Crile hemostatic forceps used for?

Back 7

Grasping bleeding vessels and stumps

Front 8

How can you identify carmalt hemostatic forceps?

Back 8

Longitudinal grooves whole length of tips, transverse grooves at end of tips (for grasping vessels)

Front 9

What are Carmalt hemostatic forceps used for?

Back 9

Ligation of stumps and pedicles
-spays

Front 10

What are Adson thumb forceps used for?

Back 10

Used for suturing skin and facial planes
-Secure yet delicate grip

Front 11

How can you identify Brown- adson thumb forceps?

Back 11

Intermeshing fine teeth
-Wide tip allows more grasp
-Broad yet delicate tissue grip

Front 12

What thumb forceps are the most traumatic?

Back 12

Brown-adson
-Increased trauma compared to adson or DeBakey

Front 13

What are DeBakey thumb forceps used for?

Back 13

Very delicate tissue handling
-Initially developed for minimizing endothelial damage

Front 14

DeBakey thumb forceps are excellent for ____ and _____ surgery

Back 14

Abdominal & thoracic

Front 15

How do you identify DeBakey thumb forceps?

Back 15

One set of grooves or barbs down the forcep (compared to adson is one set of barbs on tip)

Front 16

What are the 2 general types of retractors?

Back 16

1) Senn
-Hand held
-Muscle/fascia
2) Self-retaining
-muscle/ fascia

Front 17

What is a Balfour retractor?

Back 17

Self-retaining abdominal retractor
-Indispensable for abdominal surgery

Front 18

What are 2 types of self-retaining retractors?

Back 18

Weitlaner (3 prongs)
Gelpi (Single pointy prong)

Front 19

What are Finochietto retractors?

Back 19

Self retaining thoracic retractor
-Indispensable for intercostal approach and midline sternotomy

Front 20

What are the 3 general types of surgical packs?

Back 20

1) Minor instrument pack
2) Major instrument ack
3) Specific use packs
-Spay pack
-Laceration pack
-TPLO pack
-Orthopedic pack
-Laparoscopy pack
-Arthroscopy pack

Front 21

What is the definition of aseptic technique?

Back 21

Methods and practices that prevent cross contamination in surgery

Front 22

What are the 4 components of aseptic technique?

Back 22

1) Facilities and environment
2) Surgical site
3) Surgical team
4) Surgical equipment/ instruments

Front 23

What is the definition of sterilization?

Back 23

Total elimination of microorganisms
-Sterilize any object that contacts inner tissues

Front 24

What are the 3 methods of sterilization?

Back 24

1) Steam
2) Chemical
-Ethylene oxide
-Cold chemical (glutaraldehyde)
3) Plasma gas

Front 25

What are 2 types of chemical sterilization?

Back 25

Ethylene oxide
cold chemical (glutaraldehyde)

Front 26

What is the principle of sterilization using an autoclave (steam)?

Back 26

Causes coagulation and protein denaturization

Front 27

**What is the temperature and time needed for steam sterilization?

Back 27

15- 20 minutes at 250-254 F

Front 28

How does ethylene oxide cause sterilization?

Back 28

Causes alkylation (destruction of proteins)

Front 29

What are 5 warnings of ethylene oxide?

Back 29

1) Flammable
2) Explosive
3) Byproduct (ethylene glycol)
4) Carcinogen
5) Teratogenic

Front 30

How long does sterilization using ethylene oxide take?

Back 30

17 h cycle

Front 31

When is plasma gas the preferred method of sterilization?

Back 31

Metallic and rubberized materials
Porous materials
-Because low temperature

Front 32

How long does plasma gas sterilization take?

Back 32

75 m cycle
-No aeration required
-Low toxicity

Front 33

How does plasma gas work?

Back 33

H2O2 excited by electric charge creates free radicals that are cytotoxic to bacteria

Front 34

What is plasma gas?

Back 34

A cloud of free radicals

Front 35

What are 4 types of drape materials?

Back 35

1) Cotton muslin
140-270 thread count
2) Non-woven (paper or polypropylene) barrier material
3) Paper/plastic pouches (heat sealed)
4) Clear plastic dust covers

Front 36

What is the advantage of using non-woven barrier material for a drape? Disadvantage?

Back 36

Advantage: relatively inexpensive, water resistant barrier/ no strike through
Disadvantage: less durable

Front 37

What method results in the longest sterile shelf life?

Back 37

Double wrapping
Heat sealed
Plastic cover

Front 38

What are the 2 types of sterilization indicators?

Back 38

Chemical
-Most common
Biological
-Spores, sterilization then cultured, if growth then failure of sterilization

Front 39

Label the parts of the instrument

Back 39

Front 40

What are the 2 types of surgical instrument cleaning used before autoclaving?

Back 40

1) Manual
2) Ultrasonic

Front 41

What are the 2 things to be careful about when using paper/ plastic pouches that are heat sealed?

Back 41

Not durable when single wrapped
Fragile when moist (turn upside down to dry)

Front 42

Why is it so important to cool items being removed form the autoclave individually to dry on racks?

Back 42

Otherwise condensation leads to strike through

Front 43

How can you maximum the shelf life via autoclave storage conditions?

Back 43

Store in waterproof dust covers in closed cabinets