Classification and Use of Instrumental
The instruments are designed to provide the surgeon the tools that let you perform specific maneuvers in each intervention. There are basic moves common to the different surgical interventions. The tools by function can be small or large, short or long, straight or curved, sharp or blunt.
Court and dissection:
The cutting tool has sharp edges, is used to: cut, separate, or remove tissue. Among the precautions to be considered sharp edges which are protected during cleaning, sterilization and storage, keeping them separate from others and with careful management, handling.
Scalpels: The most common type of scalpel has a reusable handle with a disposable blade. Almost all the handles are copper and coal and steel sheets.
Considerations in use:
The blade is fixed to the handle by sliding the slit in the notches on the handle
When fixing or removing the blade from the handle never use your fingers, all by forceps
The leaves differ in size and shape
The leaves No. 20, 21, 23 have the same shape and different sizes are used to handle No. 4 and 3.
Mangoes vary in length and width
Scissors: The scissors blades vary according to their purpose, straight, angled or curved with blunt or pointed. Handles can be short or long.
Dissecting Scissors: The type and location of tissue to be cut using scissors determines, can be great for hard tissue, with an angle to achieve structures with long handles for deep body cavities with sharp blades.
Scissors thread: are blunt to avoid cutting the structures near the suture and also serve to prepare the suture material by the arsenalera.
Dressing scissors: used to cutting drains and dressings and open items such as plastic packages.
Tweezers.
Parts of a clip, jaw, lock box, mango, zippers and rings.
The jaws of the instrument securing the tissue pressure and should be closely approximate closing usually are staunch, in the case of needle holder keeps the suture needle sets.
Zippers keep the instrument locked when closed, they should snap it gently.
Clips and decision support: The surgeon should have adequate visibility of the field to grasp and hold tissue in such a way as not to damage nearby structures. Country or Backause clip
Tissue Forceps: Used often in pairs, collect or maintain soft tissue and vessels, there is a wide variety of these instruments, the configuration of each is designed to prevent tissue damage.
Smooth pliers: pliers are also called dull, are staggered and grooves (notches) at the tip resemble pliers. Can be straight or bayonet (angle) short or long, small or large anatomical forceps, tweezers Bossem
Alligator clips, instead of having stretch marks, have a single tooth on one side that fits into the teeth of the opposite side or a line of many teeth at the tip. These clips provide firm support in the hard tissues and skin: Surgical forceps. (Photo 6).
Allis forceps, has slightly curved branches with a line of teeth at the end that allows soft tissue support but surely.
Babcock Forceps: Its action is similar to that of Allis, the end of each branch is round to fit around the structure or to grasp without damaging tissue. This section is rounded fenestrated.
Clamping and occlusion:
Instruments and occlude clamped used to apply pressure.
Hemostats: have 2 parties in grasping the branches with opposite grooves, which are stabilized by a gear hidden and controlled by the rings, the handles are held closed on locking teeth. Used to occlude blood vessels.
There are many variations of hemostats. The branches may be straight, curved or angled, the grooves may be horizontal, diagonal or longitudinal and tips can be pointed, rounded or have a tooth. The length of the branches and the handles can vary.
Determine the instrument’s use, the fine points are used for small vessels and structures. The longer and stronger branches in large vessels, dense and thick tissue structures, the long handles allow you to reach deep structures in body cavities. The best known are: Kelly, Kocher, Faure, Foerster.
Exposure and retraction.
The exposure and retraction instruments are used to retract soft tissue, muscles and other structures for exposure of the surgical site.
Retractor manual: They have a leaf on the handle varies in length and width to match the size and depth of the incision. The curved or angled blade can be solid or serrated as rake. Some retractors have leaves instead of mango. Often their use is in pairs and supports 1 st and 2 nd assistant. The flag used in obstetrics are Farabeuf separator (Photo 11), Valva of Doyen (Photo 12).
Suture.
Needle Holder: Used to take and hold surgical needles curves are very similar to the clamps
hemostatic, the basic difference is the short and strong branches to grab a needle without damaging the suture.
The size of the needle holder must be in accordance with the size of the needle. Generally, the branches are straight, but may be curved or angled and can be long handles for easy insertion of the needle in surgery of pelvis or chest.
Needles. Surgical needles may be curved, straight, disposable or reusable.
Cesarean section curved needle is used that takes you below the surface of the tissue and remove as you see your point. The needles have different curvature and tip and are designated by numbers as P3, P4, P5, P7, P9.
Another type of atraumatic needle is used to suture tissues and friable.
Suture material. There are many types of suture. The choice of material to use in a tissue is based on: individual characteristics of the material, location, type of suture, age, state of the patient, surgeon experience and preference.
The arsenalera is responsible for properly preparing the suture material until the surgeon’s request and pass the time. It should be noted that the suture material such as catgut, flax and yarn, are expensive and delicate.
All these materials must meet certain parameters such as size, tensile strength, sterility, packaging, paints and joint integrity needle and suture material.
Suture material size: The larger the diameter of the strand of suture, the greater the numbers assigned. It begins with 4 or 5, which is the thicker suture material available, decreasing to reach 0. As we continue to show multiples of 0 size, suture material begins to be smaller in diameter. The smallest available is 11 / 0 which is so fine that floats in the air. The fine sutures are used in microsurgery and the heaviest to approximate bone tissue. In obstetrics the numbering system generally used is No. 2-1-0-2/00.
The suture material may occur in the body insert the needle, a level that would be the eye of the traditional needle and is known as catgut with needle attached.
Suture packages: All sutures are involved in 2 separate envelopes. The inner envelope is sterile both inside and out. One side of the outer envelope is transparent allows easy inspection of the data printed on the inner envelope. These include the type, size and length of catgut, needle type and size, manufacturing date and expiration date.
Individual containers come in packs of 12 or 36 envelopes per box.
Suction Aspiration.
Blood, body fluids or tissue and irrigation volumes can be aspirated by suction and manual extraction center.
Suction is applying pressure to remove fluid or blood. Is used to keep the operation site visible.
Aspiration: blood, body fluids or tissue may be manually aspirated samples for laboratory tests. Is drawn with a syringe and needle.
The aspiration of blood, amniotic fluid and secretions is carried out through a network of central aspiration extended to the surgical wards.
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