Articles by Flaviapatricia Timothy
Selecting Surgical Instruments
At Black & Black Surgical we are committed to helping you select instruments for longevity; instruments that will allow you to operate with ease and also be cost effective.
Our catalog includes photographs showing choices of platform grids for our instruments with recommendations for needle sizes to be used with each needle holder.
Your instruments should be chosen with care. You must consider how you want an instrument to perform in your hands. The care you give instruments will contribute to their longevity. Joint mechanisms should be lubricated and scissors sharpened regularly. You should know how an instrument will feel and work in your hands — it allows you to work more effectively and efficiently.
These small but crucial considerations will help you achieve, with increased frequency, a more predictable, successful outcome.
If an instrument is not purchased by an informed user, the decision is based on catalog information alone. Most of the time, purchasers replace like for like, too rarely matching the instrument to corresponding procedures, or even discussing this with the company’s representative.
Purchasing a needle holder is one of the most important decisions you will make in assembling a surgical tray to fit your needs. Most surgeons seek “feel” — how the instrument’s joint mechanism releases, the length, the tip.
What surgeons rarely or too seldom consider is the “platform” that comes with that standard needle holder. One must consider value — for which procedure do you need this needle holder? How much will you use it? And how long should it last?
Needle holders are designed for use with specific needle sizes. For example, when a needle holder with a 2500 platform grid is used on a P-1 or P-3 needle, its coarseness weakens and ultimately breaks a small needle — especially after multiple grasps and releases. The size grid of the platform contributes to shearing a small suture.
Frequently, the blame goes incorrectly to the suture company’s product. Awareness in addressing these issues reflects in cost savings to monthly/annual budgets.
Forceps fall into the same category as needle holders. One must consider length, thickness, and platform when matching instrument to procedure.
Next, consider your scissors — size, length and shape of tips, blunt, sharp, straight, or curved. “Thickness” of the tips may determine how and where to use a specific scissor. A curved tenotomy may be available in different thicknesses and the thicker tip may be inappropriate for finer work in tighter areas.
Once you are aware of the differences, choose instruments appropriate for the type of work you expect of them. Adhere to a high standard of maintenance for your valued instruments.
Cleaning Your Instruments
See also: Suggestions for Cleaning & Sterilization of Fine Surgical Instrumentation
Review recommendations inserted with instrument orders.
According to AORN, instruments should be kept free of gross soil during surgical procedures. If left to dry, blood and body fluids can cause pitting of instruments and can be difficult to remove. While this can lead to a shorter lifespan of the instrument, it is more important to realize that fluids not removed from the instruments can prevent adequate sterilization which allow a possible avenue for transmission of other infectious materials.
Intra-operative instruments should be wiped with sponges moistened with sterile water. Blood, body fluids and saline are highly corrosive. Rusting and pitting occur when saline, blood and debris are allowed to dry in or on surgical instruments.
Instruments with lumens should be treated in the same fashion by irrigation with sterile water.
Instruments can be soaked in sterile water or an instrument cleaning solution before leaving the operating room. In decontamination, the instruments should be rinsed under cold running water. This rinse will remove gross debris.
Manual cleaning should be accomplished by submerging the instrument in warm water with an appropriate detergent followed by complete submersion of the instrument in rinse solution if an ultra sonic cleaner is not available.
Ultrasonic cleaners should only be used after gross soil has been removed. The automated cleaner, washer, decontaminator/disinfector machine will leave instruments dried and ready to package.
