Chapter 28 Surgical Instruments and Aseptic Technique

2 Learning Objectives Name and describe the commonly used surgical instruments State advantages of surgical stapling and list common surgical stapling devices List commonly used instruments and equipment for ophthalmic, orthopedic, and arthroscopic procedures

3 Learning Objectives List surgical instruments and supplies routinely included in general and emergency surgical packs for small and large animals Describe procedures for cleaning, packing, and sterilizing instruments Differentiate between sterilization and disinfection

4 Learning Objectives List and describe physical and chemical methods of sterilization and methods of quality control of sterilization methods State safe storage times for sterile packs List and describe common antiseptic and disinfectant agents

5 Learning Objectives Describe preparation requirements for patients, including skin preparation, patient positioning, and draping Describe preparation requirements for the surgical team and explain the procedures that may be used for hand scrubbing before surgery Describe the procedure for donning surgical attire Describe procedures for opening sterile items

6 Technician’s Role During Surgery Maintain aseptic technique Assist in surgery – Immobilization of body part – Tissue retraction – Hemostasis control Anticipate instruments needed

7 General Surgery Instruments Thousands of different instruments – Increase efficiency – Ease performance Specific purpose for each instrument

The most commonly used material is stainless steel, which is an alloy of iron, chromium, silicon, manganese, nickel, molybdenum, sulfur, phosphorus, and titanium. There are 2 basic compound types: Martensitic- high carbon and low chromium content, rendering it very strong, highly magnetic, and susceptible to corrosion. i.e. thumb forceps, hemostats, retractors, etc. Austenitic- stainless steel is compounded mainly of chromium and nickel. Superior in that is has high tensile strength and is very resistant to corrosion i.e. implants, pans, bowls, handles, and trays

9 Scalpels Blades are task-specific

10 Biomedical Lasers Most common types – Carbon dioxide (free beam; noncontact) – Neodymium:yttrium-aluminum-garnet (contact) Measured in joules, effect depends on the wavelength Advantages Disadvantages

11 Electrosurgery Electric current passes through tissue – Cut tissue – Coagulate tissue Monopolar electrosurgery Bipolar electrosurgery Parts – Electrosurgical unit – Foot switch – Monopolar handpiece – Ground plate – Bipolar handpiece

12 Monopolar Electrosurgery

13 Bipolar Electrosurgery

15 Scissors

20 Needle Holders “needle drivers”

21 Basic Components of a Needle Holder

25 Thumb Forceps

26 Close-up of Tips of Thumb Forceps

27 Close-up of Tips of Thumb Forceps

33 Tissue Forceps

34 Close-up of Tips of Tissue Forceps

43 Hemostatic Forceps

44 Close-up of Jaws of Hemostatic Forceps

45 More Hemostatic Forceps

46 Close-up of Jaws of Hemostatic Forceps