This document discusses the manufacturing, inspection, identification, and care of surgical instruments. It begins by outlining the objectives of reviewing instrument manufacturing processes and categories. It then describes the manufacturing steps including forging, grinding, heat treating, and passivation. It emphasizes the importance of Central Service Technicians and outlines proper procedures for instrument inspection, identification, lubrication, and tray assembly to maximize instrument lifespan.
2. Objectives:
As a result of successfully completing this chapter, students
will be able to:
Review the process by which surgical instruments are manufactured
Define basic categories of surgical instruments based upon their
functions, and identify the points of inspection, anatomy (features) of,
and procedures to measure the following types of instruments:
Hemostatic Forceps
Needleholders
Tissue Forceps
Dressing Forceps
Retractors
Scissors
Suction Devices
Single and Double Action Rongeurs
Kerrison/Laminectomy Rongeurs
Nail Nippers
Graves and Pederson Vaginal Speculums
3. Objectives:
Identify solutions that can damage stainless steel instruments
Explain procedures to test instruments for sharpness, and to
identify (mark) them
Emphasize the importance of instrument lubrication, and
review tray assembly safeguards
5. Martensitic (400 Series)
Stainless Steel
Hard, used when sharp cutting
edges are needed
Often used for scissors,
osteotomes, chisels, hemostatic
forceps, and needleholders
6. Austenitic (300 Series)
Stainless Steel
Highly Corrosion Resistant
Not as hard as 400 Series
Used for retractors, cannulas, rib
spreaders, suction devices
7. Instrument Manufacturing
Forging
Grinding and Milling
Assembly
Heat Tempering
Polishing
Passivation
Final Inspection
Etching
Note:
Instruments are
inspected
throughout their
manufacturing
process
8. Passivation
A chemical process applied during
instrument manufacture that provides
a corrosion-resistant finish by forming
a thin transparent oxide film
9. Instrument Finishes
The instrument on the
left has a matte, or
satin-finish
The instrument on the
right has a shiny, or
mirror finish
10. Overview of
Surgical Instruments
Pages 178 – 187
provide an overview
of basic surgical
instruments along
with tips and
techniques for
proper inspection
11.
12.
13.
14.
15. Post-Ooperative Care of
Surgical Instruments
Keep instruments moist
Transport to Central Service for
cleaning as soon as possible
16. Solutions that Damage Surgical
Instruments
Saline
Betadine
Peroxide
Dish Soaps
Soaking in Water
Soaking in Saline
Bleach
Iodine
Hand Soaps
Laundry Detergents
Long-term Soaking in
Rust Remover
Long-term Soaking in
Stain Remover
Surgeon’s Hand Scrubs
Household Lubricants
Household Powder
Cleaners
19. Scissors Testing Material
Use RED Test Material
for Scissors greater
than 4.5”
Use Yellow Test for
Scissors smaller than
4”
Use Single-Ply Facial
Tissue for
Laparoscopic Scissors
24. Tape
Clean hands thoroughly with alcohol to remove oils
and grease
Wipe the part of the instrument where the tape will
be placed with alcohol
Cut the tape at an angle
Wrap the tape 1 to 1.5 times around the device
Autoclave the instrument to allow the heat to help
bond the tape to the instrument
28. Instrument Lubrication
The use of a neutral pH lubricant extends the
life of instruments
Use lubricants in according with instrument
manufacturers’ and the lubricant
manufacturer’s recommendations
ALL Lubricants must be approved for use as
a surgical instrument lubricant
29. Tray Assembly Tips
Place heavy instruments on the bottom or side of the tray
Select an instrument tray that allows adequate space for weight
distribution
Place all curved instruments in the same direction
Nest Tissue and Dressing Forceps
Protect Delicate Instruments
Use Instrument Stringers (holders) to keep instruments open
and in place
Avoid metal to metal contact between laser finish instruments