Chapter 28

Surgical Instrumentsand Aseptic Technique

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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

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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

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Technician’s Role During Surgery

• Maintain aseptic technique• Assist in surgery– Immobilization of body part– Tissue retraction– Hemostasis control

• Anticipate instruments needed

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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

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ScalpelsBlades are task-specific

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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

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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

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Monopolar Electrosurgery

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Bipolar Electrosurgery

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Scissors

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Needle Holders“needle drivers”

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Basic Components of aNeedle Holder

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Thumb Forceps

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Close-up of Tips of Thumb Forceps

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Close-up of Tips of Thumb Forceps

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Tissue Forceps

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Close-up of Tips of Tissue Forceps

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Hemostatic Forceps

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Close-up of Jaws of Hemostatic Forceps

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More Hemostatic Forceps

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Close-up of Jawsof Hemostatic Forceps