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BASIC SURGICAL
INTRUMENTS
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FORCEPS
Also known as non-locking forceps,
grasping forceps, thumb forceps or
pick-ups. They are used for grasping
tissue or objects and can be toothed
(serrated)or non-toothed at the tip
Toothed Non-toothed Hold the forceps like a pencil
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FORCEPS
THUMB TISSUE FORCEPs ADSON TISSUE FORCEP DEBAKEY TISSUE FORCEPS
DeBalry Tssue Forceps (na !
Oedcate tssu)
Adson Tissuo Forcops
Thumb Tissuo Forcops (very delicato tissuo)
fine ips wth broad handles
taperng wdth Irom the handle to the tps for mote secute detcalegrasping with
[Link] se wider than (he Adson tissue forceps minimal crushing nyury. sees of longtudinal & transvets grooves
•
used as an straumatrc manrpulation of
used for better & w:der gtup of tissue, more
vascular & fragde trssues
serure hold wilh less finger pressure
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CLAMPS
Used to compress blood
vessels or hollow organs for
hemostasis or to prevent
spillage of contents. May also
be used for dissecting soft
tissue
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G MOSQUITO
FORCEPS
Straight Cunved Suaight Cunved
Serated 1 x2 Teeth Serrated 1 x2 Teeth
used to clamp small blood yessels & fine
dissection and pinpoint control of small
bleeding vessels
ratcheted, with traversing interdigitating
*
grooves along the entire length of the
jaws
may
bestraight or curved, 3 -5 inches
long
smaller than hemostat forceps.
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*
G HEMOSTAT
FORCEPS
larger, heavier clamps
used to clamp larger blood vessels,
grasp larger tissue, or tag sutures.
ratcheted, with traversing
interdigitating
grooves along the entire length of the
jaws
may be straight or curved
Hemostat Forceps
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-o KELLY FORCEPS
larger, crushing clamps;
available in short and long sizes Crved
ratcheted, with traversing
interdigitating
grooves half of the entire length
of the jaws from the tip
may be straight or curved
used to clamp larger vessels and
tissue.
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HOW TOHOLD
CLAMP
1. Insert the thumb and ring fingers into the
rings of the forceps
2. Place on vessels using the tips of the jaws.
3. Use the ratchet lock to secure the position
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ALLIS FORCEP
traumatic, ratcheted, with
· O
interlocking teeth for
secure & prolonged hold
used to grasp tissue such
as the breast and fascia
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KOCHER OR G
OCHSNER *
CLAMP
heavy, traumatic, ratcheted
instrument,with horizontal
serrations on the entire length
of the jaws, and with teeth
used to grasp/clamp medium
to heavy tissue such as fascia,
muscles
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D
·
BABCOCK
FORCEPS
Ratcheted, with series of
longitudinal grooves along
the tips for atraumatic hold
used to grasp delicate tissue
such as intestines, appendix
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OVUM
FORCEPS
·
O
used to grasp, hold,
manipulate and remove
tissue from inside the
uterus including the ovum
and placenta
May be used to hold other
delicate tissues
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BACKHAUS
TOWEL CLIP C
·
a perforating clamp
used for grasping tissue,
and holding or reducing
smallbone fractures
used to hold towels or
drapes in place
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SCISSORS
tong&dlvidlng tissue and suturast also forsharp sectlon oi
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0 METZENBAUM
finer design with longer
handles
. 0
used for cutting &
dissection of fine tissues,
i.e. subcutaneous & light
fascia
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0 C MAYO SCISSORS
.
sturdier design
used for cutting heavier
tissues, i.e. thick fascia,
lineaalba, and,often,
heavy sutures
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0 0
IRISSCISSORS
.
relatively smaller with short
blades that narrows to a fine &
sharp point.
originally for ophthalmic
surgery (iridectomy)
used for cutting & dissection of
small& fine tissues, i.e.
subcutaneous fascia
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InSer Igers
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into the rings of the scissors so that
just the distal phalanges are within th
rings.
2. Use the index finger to steady the
scissors by placing it over the joint.
3. When cutting tissues or sutures,
especially at depth, it often helps to
steady the scissors over the index
finger of the other hand.
[Link] with the tips of the scissors for
accuracy rather than using the crutch
which will run the risk of damaging
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tissues beyond the item being dividee
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SCALPEL
Scalpels are used for incising the skin and a wide range of blade shapes and types is available
depending on the tissue to be incised.
Consists of a blade and handle
Blade #1O Blade #11 Blade #15
Used for making large skin Used for making precise or Smaller version of #10 blade
incisions, e.g., in laparotomy. sharply angled incisions. used for making finer incisions. 20
0
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BLADE HOLDER .
Used to hold scalpel
blade
Comes indifferent sizes
Size #3: blades 10,11, 15
Size #4: blades 18 and
above
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RETRACTORS
In varying forms,retractors are used
tohold an incision open,hold back
tissues or other objects to maintain
a clear surgical field, or reach other
structures. They can either be hand
held or self-retaining via a
ratcheting mechanism
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·
ARMY NAVY
RETRACTOR
used to retract shallow or
superficial incisions
double ended feature allows
for one side (longer end is the
"navy side") to be inserted
deeper into the wound
has a hollow at the middle of
the handle
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- RICHARDSON
RETRACTOR
handheld, right angled, with broad blades,
ideal for getting into& exposing large
muscles
concave blades are different sizes with
crescent-shaped lips
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⑧
SENN RETRACTOR
handheld, double-ended retractor
used to retract primarily surface
tissue
It is often used in plastic surgery,
small bone and joint procedures, or
thyroidectomy and dissection of
neck tissue.
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DEAVER
RETRACTOR
developed with the intention to keep
the organs inside the abdomen away
from surgical instruments during the
surgical process
blade shaped like letter "C" or a
question mark used to retract deep
abdominal or chest incisions;
available in various widths
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02 SELF-RETAINING
RETRACTOR
lockingmechanisms that keep
the blades apart arnd in place
while spreading the edges of
the incision and holding other
tissue in place
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Yankauer Suction Tip
Poole Suction Tip
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Kldney Basin
Round Basin
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1. Inthe palmar grip, the knife is held in
between the thumb and middle finger. The
end of the handle rests on the surgeon's
palm while the index finger is used to
stabilize the knife.
2. With the pencil grip. Hold the scalpel
Palmar grip gently between index finger and thumb.
3. Incise the skin by holding the scalpel at
an angle of 90° to the skin.
Pencil grip
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NEEDLES AND SUTURES
SUTURES
Available in sizes between #5 and #11-0. Higher numbers indicate larger suture
diameter, and more zeros indicate smaller suture diameter (e.g.,#4-0 is smaller
than #3-0)
2 4
10-0) 4-0) 2-0 1-0
• Suture diameter affects handling properties and tensile strength
Choose the smallest size possible capable to doing the job
Take into account naturaf tissue strength
Tonsllo strongth is a measure of the time it takes
for sutures to lose 70% to 80% of its initiel strength
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②
Suture Types
Absorbable Non-absorbable
Braided Monofilament Braided Monofilament
Vlcryl
PDS Silk Prolene
Skin closure Fascial/ skin Vessel ligation Skin closure
Intestinal closure
anastomosis
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Needles come in many shapes and
NEEDLES AND cutting edges for various applications.
Suture can be absorbable, non
NEEDLEHOLDER absorbable,and are available in different
sizes.
Tip
Swage
Body
D
Needle
-
Needle Holder Parts of a Surgical Needle
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-
round and tapers to asimple point. Most commonly used
in softer tissue such as intestine but may also be used in
I
tougher tissue such as muscle.
A
Round Needle
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triangular with sharp edges, and one edge faces the
inside of the curved needle. Used for tougher tissues such
* as skin.
Cutting Needle
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<br>
Proper knot tying is one of the essentials in the performance of
a
good surgical procedure.
The art and science of surgery requires that knots be tied not
only with dexterity and speed, but they should be placed with
the right amount of tension for proper approximation of tissues
and ligation of blood vessels.
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GENERAL PRINCIPLES
1. When handling sutures, one must take care to avold damage to the suture
material.
2. In tyíng any knot, frlction between strands must be avoided to prevent
weakening of the Integrity of the suture.
3. Sutures should be ted with approprlate tenslon to prevent tissue strangulation
or gaping of edges,
The completed knot must be secure.
8.
5.
For mornofilamentsutures, at least 5 throws are requlred tosecurely hold the
knots in place as less than thls may result in a tendency for the knots to loosen.
Additonal throws do not add to the strength of a propsrly tied knot.
6. For braided sutures, two throws are required to securely hold the knot.
7. Sutures must be cut to their proper length.
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THE SQUARE KNOT
AKA Reef knot
Flat knot is the gold-standard for surgical
practice
Consists of two mirror-imaged throws
Single overhand knot on topof a reversed
overhand knot
THE SURGEONS KNOT
Modification of the Square knot
Adds an extra twist in the first throw
Provides more friction to hold a knot
Used when tension can loosen the tie