Post Operative Care of Surgical Instrument Sets

Manual washing prior to mechanical washing should be kept to a minium. The most important factor is soap selection, which should be of neutral PH. Never use a soap that is not exclusively designed to be used on surgical instruments. The manual washing step is where brushing occurs to clean box locks, serrations and lumens.

Don’t Use These Soaps on your Surgical Instruments:

-          Housekeeping soaps

-          Laundry soaps

-          Surgeon’s hand scrub

-          Iodine based soaps

Ultrasonic Surgical Instrument Cleaning:

The cleaning of surgical instrument sets with ultrasonic energy is the single best practice you can do. This technology removes bioburden very efficiently and is very safe for instruments. The longer the instruments are in the ultrasonic cleaner, the cleaner the instruments will be. Only use a neutral PH ultrasonic solution and never put manual instrument soap in the ultrasonic cleaner.

Rinsing of Surgical Instruments:

After manual washing or ultrasonic cleaning, rinse the surgical instruments with water, preferably with distilled water. Remove residue left on from detergents, both from ultrasonic and machine washing.

Drying of Surgical Instruments:

Never allow water to dry onto surgical instruments as this will result in water spots, which will turn into stains.

Lubrication of Surgical Instruments:

All hinged surgical instruments need lubrication after each use. A spray-on lubricant or machine applied lubrication works best. Neutral PH lubricants are recommended. Mineral based lubricants should never be used as steam cannot penetrate mineral oils and instruments will not achieve sterility.

Other Facts:

-          Temperature of tank solution can improve performance with heated solution.

-          Change solution daily or when bioburden is noticed in tank.

-          The longer the surgical equipment are left in… the better.

-          Do not overload ultrasonic cleaner as this reduces its cleaning efficiency.

-          Surgical instruments always be in the open position when placed in the ultrasonic cleaner.

New Surgical Instruments

Most professionals will recognize that the new surgical instruments feel different. New instruments, especially scissors, feel flawless and ratcheted surgical instruments can feel stiff. These surgical instruments can feel harder and stiffer because as instruments age, they soften with use and processing. With proper care and use, these devices can last a lifetime. It’s important to realize, however that even the highest-grade surgical instruments will initially feel harder and will stain. New instruments tend to be more magnetic in the box locks, serrations and ratchets due to the manufacturing process transferring the magnetism. This magnetism gradually wears off and this is one of the reasons newer surgical instruments tend to stain more rapidly.

Enemies of Surgical Instruments:

-          Allowing blood to dry onto the instruments

-          Soaking instruments in water

-          Soaking instruments in saline

-          Any and all long-term soaking will damage surgical instruments

-          Sterilizing surgical instruments with ratchets closed

-          Improper use of the instrument

-          Rough handling/dumping of instruments

-          The use of improper cleaning solutions and lubricants

-          Allowing water to dry onto instruments

Post Operative Care of Surgical Instrument Sets

Never allow blood to dry onto surgical instruments. Immediately (within 10-20 minutes) after the case, separate the rings of the instruments and begin the decontamination process. To prevent blood from drying onto the surgical equipment, simply saturate a towel with tap water and lay over the bloody, contaminated instruments. The use of spray-on moisturizers is also a very effective way to prevent the blood from drying, along with the use of enzymatic solutions. 

Metals and Terminology used in Manufacturing of Surgical Instruments

AISI: American iron and steel institute has identified various stainless steel formulas and classified them.
ASTM: American Society of Testing and Materials sets the standard for metal material.
Austenitic: A stainless steel that cannot be heat-hardened. Stainless steel that falls into this category is 300 series stainless steel, which is highly corrosion resistant.
Martensitic: A stainless steel that can be heat hardened. Stainless steel that falls into this category is 400 series, which is subject to corrosion due to lack of nickel.
Rockwell Scale: A method and scale used to measure the hardness of metals.
Stainless Steel: The most popularly used in metal in the manufacturing of surgical instruments Stainless steel stains and stainless steel rusts.

304 Stainless: Used to make bowls and basins.
316 LVM Stainless: Used to make implantable devices such as pins, plates and screws.
420 Stainless: Pakistan-made and disposable quality instruments are made of this type of stainless steel.
Sterling Silver: Used to make probes and tracheotomy tubes.
Titanium: Very strong and non-magnetic, lightweight metal used for microsurgical instruments. This metal is identified by its blue color and is stronger and lighter than stainless steel.
Tungsten Carbide: An extremely hard metal used in jaws of needle holders and blades of surgical scissors. When tungsten carbide is used, the handle of the instrument will be gold in color.
Pakistani-Made Surgical Instruments: Most surgical instruments are made in Pakistan. In fact 75% of all surgical instruments are made in Pakistan. The vast majority of them are made in Karachi, Islamabad and Lahore. Most suppliers will look to Pakistan to make descent quality low priced surgical instruments.
German-Made Surgical Instruments: Besides Pakistan, Germany makes the 2nd most surgical instruments the world. These are typically more expensive but higher grade quality. Most suppliers will buy from Germany if there looking for a better grade surgical instrument.

Medical Malpractice Explained

Medical malpractice is something that is more frequent then what many people think. It’s often affecting hundreds of thousands of people in America in a year. Some studies show that at least 98,000 people have been affecting by the doctor or his/her medical instruments each year. Medical malpractice is a situation where a doctor in the medical field has made some sort of an error in the medical field using their instruments for surgery or just a bad prediction that shouldn’t have been made. This can be misdiagnoses in cancer, a prescription error, and failure to find a particular illness or disease that should have been found. Often it’s just failing to find infections.

Medical compensation is a part of medical malpractice. Generally that compensation covers the cost of medical treatment into the future, lost wages into the future or any expenses you’ve occurred up until now. Sometimes it varies from state to state but certain disability amounts can by compensated by the state. (I.e. emotional or physical damage, pain or suffering, etc.) Also it is possible for your spouse to have a claim.

Deadlines apply to these kinds of cases. There often called statute of limitations. These time frames vary from state to state. It is very important to know what those time restrictions are. If you miss them then you can be barred from filing a lawsuit. The times frames range from one year to five years. Some cases go has high as six. If you’re dealing with children sometimes there claim doesn’t start running until they turn into an adult. The point here is you need to be aware of what the time frame is for you. Not just in general because it’s so different and it varies. This is why it’s important to speak to a lawyer if you feel you have been mistreated by a doctor or the doctor’s surgical equipment.

How to Perform Laser Eye Surgery

Short and long sightedness and stigmatism are all due to light not focusing precisely on the retina. Surgeons and there surgical instruments can fix this by using a laser to reshape the curvature of the front surface of the eye. The doctor will not use retractors for surgery in this case.

The surgeon operates on the eye one at a time. He cleans the eye, the lid and the lashes with antiseptic and administers antiseptic drops to freeze the eye and lid. He opens the lid wide with a speculum. The surgeon rinses the eye with a saline solution from his surgical instrument set. Everything is frozen so the patient doesn’t feel a thing.

Next are anti-biotitic drops which prevent infection. Before every operation the surgeon tests the equipment. He fires the laser on a metal plate to test its energy level. The surgeon administers a few more antiseptic drops then inspects the micro-carotene. The device used to lift a very thin layer from the outer surface of the eye. The patient’s cornea is measured using an ultra sonic surgical equipment.The surgeon uses the speculum again to prop the lid open then begins the operation. The eye is marked with a sterile ink. It’s a reference to mark to be used later.

Next a metal ring is position around the cornea. The ring is attached to a suction pump so it clings to the eye. Like holding a tomato steady when you slice it. It holds the eye steady while the surgeon cuts the tissue. The surgeon lubricates the eye with sterile water then mops up the water with a small absorbent sponge. Then the micro-carotene is slipped into the grooves in the metal suction ring. Within a matter of seconds the device moves across the eye cutting open a thin piece of tissue. The same way a carpenter’s blade shaves a layer of wood.

The Surgeon uses a sterile sponge to keep tears from contaminating the cornea. He folds back a piece of tissue exposing the cornea. Then mops up the excess liquid, and finally starts up the laser. Meanwhile the tiny sponge keeps the piece of thin tissue moist. The laser is an invisible beam of light fires in 50 pulses a second. Each pulse vaporizes a one-quarter microbe of corneal tissue. The laser is controlled by a computer program so it knows exactly how to reshape the cornea to give most patients 20/20 vision.

In less than a minute the laser has done its job. The surgeon removes the sponge and then using the ink marks he used earlier as a reference folds the flap of tissue back to its original position. If the flap doesn’t go back exactly where it was before then the patient will have distorted vision. Using a syringe that flushes the area with sterile water the surgeon carefully smoothes the flap. Within 45 seconds the negative pressure inside the cornea sucks the flap back on. The flap literally seals itself. Anti-biotitic drops are applies as a preemptive measure and the micro-carotene is applied once again to verify once everything is OK before moving on to the other eye.

When that’s done the surgeon uses a high power microscope to make sure the thin tissue is wrinkle free. Finally the patient wears protective shields overnight for just a week.

… And that’s how you do laser eye surgery

The Basics of Surgical Instruments

If you’re a medical student or a doctor then you need to know how to use basic surgical instruments because it’s not only surgeons that need to know instruments for surgery. Sometimes in a clinic you may be faced with a case where you need surgical instruments. Therefore knowledge about basic surgical instruments will keep you one step ahead.

Let’s first start with the most common instrument we use in a general surgical practice and that is dissecting forceps. This particular forceps is also called the Mitchell’s forceps. It’s a non-dissecting forceps and usually used to hold things like blood vessels. You may ask yourself how to hold dissecting forceps? You would hold it like a pen between your thumb and your index finger.

Let us move on to a different category of surgical instruments which is scissors. A scissor is usually used to cut structure. Basically you have two different types of scissors curved scissor and straight scissor. The most common is called the metzenbaum curved scissor. The metzenbaum scissor is used to cut finer tissue such as a bladder or muscle tissue. 

The best method to hold straight scissors is to put your finger on the joint of the scissors. This makes sure the scissors is more firmly held and keeps a more controlled movement. Never be out of control or never lose control of your instruments because sometimes you can cut more of what you intend to cut. So always support the scissors with your finger from the opposite hand. Another method is you can use is by placing your opposite finger at a distance which will help you regulate how much tissue you want to have cut. 

The more you learn about medical equipment in a broad sense. The more you’ll be able to make out-of-field predications and diagnosis for your patients.