Prepared By:

Prepared by: Alcantara, MaryJoy C. Almuete, Rommelyn Mhae C. Buenaventura, Ma. Concepcion D. Carlos, Criselle S. Delen, Rene Rose P. Lopez, Rosario Bernadeth D.

Submitted to: Mrs.Perlita Espinosa, RN,

Brief History of Surgical Instruments The history of surgical instruments has an important place within the history of medicine, as well as in the history of technology. Archaeologists have discovered primitive knives from as early as 10000B.C. and there is evidence of attempts to suture from as far back as 2500 B.C. It was in Ancient Greece, however, that the precursor to modern instrumentation was born.

BSN 4A-2 ‘10

Brief History of Surgical Instruments The father of modern medicine, Hippocrates (460-ca. 377 B.C.), founded classical surgery. It is from Hippocrates that we have reports of instruments formed of hardened iron. In addition to iron and copper, bronze and brass were used to make instruments, which were cast, forged or cold-worked. Some reports indicate the existence of as many as 200 instrument types.

BSN 4A-2 ‘10

Brief History of Surgical Instruments After the decline of the Greek civilization, this development continued in the Roman Empire. Roman generals followed the motto “For the best legions, the best surgeons,” and at those surgeons’ disposal was a multitude of instruments including knives, saws, catheters, needles, forceps and specula. The Romans also knew how to make steel instruments.

BSN 4A-2 ‘10

Brief History Instruments When the ancient city of ofSurgical Pompeii was discovered, archaeologists uncovered a large package of surgical instruments in a building which may have housed a very early surgical instrument business. Large leaps in technology continued in the centuries to follow. Surgery came into its own as a discipline in the 1700’s, and in the 1800’s Paris became its center. To judge from archaeological finds, Germany by that time was also a center for instrument craftsmen.

BSN 4A-2 ‘10

Brief History of Surgical Instruments The invention of stainless steel in the twentieth century brought perhaps the greatest change to the manufacturing process, until the most recent event of minimally invasive instrumentation. As surgery has developed, the trade of the instrument makers has developed alongside it. There is evidence that in ancient times there were metal craftsmen who specialized in the manufacture of medical instruments

BSN 4A-2 ‘10

Brief History of Surgical Instruments

Two of the very striking features of the ancient instruments were their good quality and their elaborate ornamentation. The purpose of the decorations was partly functional they provided a more secure grip for the surgeon. In later periods, instruments were crafted by blacksmiths, cutlers and armourers.

BSN 4A-2 ‘10

Brief History of Surgical Instruments

With the onset of the Industrial Revolution, and the general increase in the rationalization of production methods, instrument making advanced another step. It has continued to develop, to reach the high level of precision crafting we know today

BSN 4A-2 ‘10

BSN 4A-2 ‘10

DIAGNOSTIC INSTRUMENT

Berliner •Uses-

Dejerine •uses

Moeltgen •uses

BSN 4A-2 ‘10

DIAGNOSTIC INSTRUMENT

Pinard •uses

Wartenberg •uses

Taylor •uses

BSN 4A-2 ‘10

grasp and handle dressing and other material

BSN 4A-2 ‘10

Dressing forceps

bryant forceps bozemann dressing forceps bozemann douglas forcep BSN 4A-2 ‘10

Dressing forceps

Cheron dressing forceps

Foester sponge holding forceps

Collin forceps

BSN 4A-2 ‘10

Dressing forceps

Foerster sponge holding forceps

Gross maier forceps BSN 4A-2 ‘10

Dressing forceps

Lister dressing forceps

Pelkmann forceps BSN 4A-2 ‘10

Dressing forceps

Cheron dressing forceps

Foester sponge holding forceps BSN 4A-2 ‘10

To clamp and restrict arteries or tissue, to control the flow of blood

BSN 4A-2 ‘10

haemostatic forceps

Bangolea forceps

Adson baby forceps

Adson forceps

BSN 4A-2 ‘10

haemostatic forceps

Collin forceps Chaput forceps Carfoord forceps BSN 4A-2 ‘10

haemostatic forceps

Crile kocher forceps Crile forceps Collin forceps BSN 4A-2 ‘10

haemostatic forceps

Crile Rankin forceps Dandy forceps Crile Rankin Kocher forceps BSN 4A-2 ‘10

haemostatic forceps

Gemini forceps Fergusson forceps

BSN 4A-2 ‘10

haemostatic forceps

Halsted mosquito forceps

Hartmann forceps

Halsted mosquito micro forceps BSN 4A-2 ‘10

haemostatic forceps

Heiss forceps

Herrick forceps

Kelly forceps

BSN 4A-2 ‘10

haemostatic forceps

Kocher forceps

Lahey forceps

Lawrence forceps BSN 4A-2 ‘10

haemostatic forceps

leriche-forceps

lovelace-forceps

lovelace-forceps BSN 4A-2 ‘10

haemostatic forceps

mayo-guyon-forceps

meeker-forceps

mixture-baby-forceps BSN 4A-2 ‘10

haemostatic forceps

mixture-forceps

pean-forceps

pennington-forceps BSN 4A-2 ‘10

haemostatic forceps

Overholt geissenolderfer forceps

Pratt forceps BSN 4A-2 ‘10

haemostatic forceps

providence-hospital-forceps

Roberts forceps

Rochester pean forceps BSN 4A-2 ‘10

haemostatic forceps

Rochester ochsner forceps Rochester pean forceps BSN 4A-2 ‘10

haemostatic forceps

Rumel forceps

Spencer wells forceps BSN 4A-2 ‘10

haemostatic forceps

Sarot forceps Toennis forceps

Tuffier forceps BSN 4A-2 ‘10

haemostatic forceps

Willet martel forceps

Zenker forceps BSN 4A-2 ‘10

To suture or ligate: Suture or ligation is used to close or rejoin a wound or an area of operation, e.g., a vessel, a nerve or tissue. There are a variety of sutures and clips, as well as suture needles and ligating instruments. BSN 4A-2 ‘10

Surgical clips

Collin

Michel

Childe clip

BSN 4A-2 ‘10

Surgical clips

• uses

michel3 michel2

michel1 BSN 4A-2 ‘10

Surgical clips

wachenfeldt_clip Richter heart BSN 4A-2 ‘10

d for the diagnosis or any surgical procedure of the bladder.

BSN 4A-2 ‘10

Gall bladder instrument

Blanks 109 Blake 102

Desjardin BSN 4A-2 ‘10

Gall bladder instrument

Desjardins113 fergusson110 Mayo blake103 BSN 4A-2 ‘10

Gall bladder instrument

Mayo blake104 Mixter 105

Moynihan 108 BSN 4A-2 ‘10

ed for the diagnosis or any surgical procedure of the larynx.

BSN 4A-2 ‘10

Larynx instrument

Jackson

Reichert

Chevailer Jackson

Fraenkel BSN 4A-2 ‘10

Larynx instrument

Chevailer Jackson Jurasz

BSN 4A-2 ‘10

To hold and guide suture needles securely for suturing

BSN 4A-2 ‘10

Suture needle holders

Derf Needle Holder

Collier Needle Holder

Halsey Needle Holder BSN 4A-2 ‘10

Suture needle holders

Crile Murray Needle Holder

Baumgartner Needle Holder Neivert Needle Holder BSN 4A-2 ‘10

Suture needle holders

Boynton Needle Holder Mayo Hager Needle Holder Jamison Needle Holder BSN 4A-2 ‘10

Suture needle holders

Arruga Needle Holder

Heaney Needle Holder

Masson Needle Holder BSN 4A-2 ‘10

Suture needle holders

Johnson Needle Holder Metzenbaum Needle Holder Adson Needle Holder BSN 4A-2 ‘10

Suture needle holders

Stevens Needle Holder Sarot Needle Holder Crile Needle Holder BSN 4A-2 ‘10

Suture needle holders

Stevens Needle Holder

Olesn Hegar Needle Holder Mathieu Needle Holder BSN 4A-2 ‘10

Suture needle holders

Gillies Needle Holder Kalt Arruga Needle Holder Kalt Needle Holder BSN 4A-2 ‘10

Suture needle holders

Castroviejo Needle Holder Metzenbaum Needle Holder BSN 4A-2 ‘10

Used for the diagnosis or any surgical procedure of the female reproductive organ or Delivery

BSN 4A-2 ‘10

obstetric INSTRUMENT

Green-Armtage Forceps Martin Pelvimeters

Simposon Obstetrical Forceps BSN 4A-2 ‘10

obstetric INSTRUMENT

Simpson Braun Naegele Obstetrical Forceps Kielland Obstetrical Forceps BSN 4A-2 ‘10

obstetric INSTRUMENT

Pestalozza Curette Winter Forceps BSN 4A-2 ‘10

BSN 4A-2 ‘10

oral INSTRUMENT

Heister Roser Koenig

Doyen Jansen BSN 4A-2 ‘10

oral INSTRUMENT

Collin

Young BSN 4A-2 ‘10

to cut or incise: Instruments used for this purpose are frequently referred to as “sharps”. They include scissors, knives, scalpels, chisels and osteotomes, among others. BSN 4A-2 ‘10

Scalpel knives

No. 8

No. 7 No. 3 Graduated

BSN 4A-2 ‘10

Scalpel knives

No. 4

No. 4 BSN 4A-2 ‘10

To cut suture, gauze and other materials

BSN 4A-2 ‘10

Operating scissors

Blunt / Blunt

Sharp / Blunt

Sharp / Sharp BSN 4A-2 ‘10

Operating scissors

Deaver

Mayo

Metzenbaum BSN 4A-2 ‘10

Operating scissors

Sanvenero

Jeseph

Reynolds BSN 4A-2 ‘10

Operating scissors

Kilner Sharp

Kilner Blunt

U.S. Pattern BSN 4A-2 ‘10

Operating scissors

Busch

Schumacher

Braun Stadler BSN 4A-2 ‘10

Operating scissors

Strully

Toennis - Adson

McIndoe

BSN 4A-2 ‘10

Operating scissors

Dandy

Schmieden Taylor

Thorex BSN 4A-2 ‘10

Operating scissors

Satinsky Crafoord

Klinkenbergh-Loth

BSN 4A-2 ‘10

BSN 4A-2 ‘10

Stitch scissors

Spencer

Northbent BSN 4A-2 ‘10

Stitch scissors

Littauer

Heath BSN 4A-2 ‘10

BSN 4A-2 ‘10

Gum Scissors - Wire & Plates Shears

Universal Wire Shear

Smith US Army Beebee Wire Shear BSN 4A-2 ‘10

Gum Scissors - Wire & Plates Shears

Wagner

Quinby

BSN 4A-2 ‘10

BSN 4A-2 ‘10

Bandage scissors

Bergmann Lister

Esmarch BSN 4A-2 ‘10

Bandage scissors

Dimeda Excenter

Lornez Knowles BSN 4A-2 ‘10

Bandage scissors

Braun Wire and Clothing

Universal BSN 4A-2 ‘10

to cut or incise: Instruments used for this purpose are frequently referred to as “sharps”. They include scissors, knives, scalpels, chisels and osteotomes, among others.

BSN 4A-2 ‘10

Dissecting scissors

Lexer Straight

Lexer Curved

Lexer Baby BSN 4A-2 ‘10

Dissecting scissors

Metzenbaum Straight

Metzenbaum Curved

Metzenbaum Fino BSN 4A-2 ‘10

BSN 4A-2 ‘10

Ophthal Nasal Scissors

      

Stevens

Abeli BSN 4A-2 ‘10

Ophthal Nasal Scissors

Heymann Foman Curved

BSN 4A-2 ‘10

BSN 4A-2 ‘10

Tonsil Vascular Scissors

Cottle Beuse Dean

BSN 4A-2 ‘10

Tonsil Vascular Scissors

Boettcher

Good

Prince BSN 4A-2 ‘10

Tonsil Vascular Scissors

Potts De Martel

Potts Smith BSN 4A-2 ‘10

Tonsil Vascular Scissors

Debakey Debakey Blunt Debakey Sharp BSN 4A-2 ‘10

BSN 4A-2 ‘10

Gynecological Scissors

Wertheim Sims Siebold BSN 4A-2 ‘10

Gynecological Scissors

Doyen

Dubois

Kelly BSN 4A-2 ‘10

BSN 4A-2 ‘10

Ophthalmic Scissors

Wecker

Noyes Barraquer BSN 4A-2 ‘10

Ophthalmic Scissors

McGuire Westcott Sharp

Westcott Blunt BSN 4A-2 ‘10

Ophthalmic Scissors

Vannas

Castroviejo Blunt Castroviejo Sharp BSN 4A-2 ‘10

BSN 4A-2 ‘10

Trocars Needles

Ochsner Fleurant

Nelson

BSN 4A-2 ‘10

Trocars Needles

Abdominal

Lichtwitz Universal

BSN 4A-2 ‘10

Trocars Needles

Douglas

Coakley BSN 4A-2 ‘10

o attach towels, to handle sponges and other material

BSN 4A-2 ‘10

Towel Forceps

Roeder

Lane

Schaedel BSN 4A-2 ‘10

Towel Forceps

Backhaus

Lorna

Jones BSN 4A-2 ‘10

Towel Forceps

Moynihan

Ball and Socket Bernhard BSN 4A-2 ‘10

Towel Forceps

Doyen

BSN 4A-2 ‘10

To grasp and handle soft tissue

BSN 4A-2 ‘10

Thumb Tissue Forceps

Adson Brown Cushing

Potts-Smith BSN 4A-2 ‘10

Thumb Tissue Forceps

Lerche

Thumb

Stille BSN 4A-2 ‘10

Thumb Tissue Forceps

Graefe

Adson Micro

BSN 4A-2 ‘10

d for the diagnosis or any surgical procedure of the genito- urina

BSN 4A-2 ‘10

Urology Instruments

Blake Gall Stone Forceps Mayo-Blake Gall Stone Forceps Randall Kidney Stone Forceps BSN 4A-2 ‘10

Urology Instruments Elsasser Kidney Seizing Forceps

Mixter Gall Stone Forceps

Mayo-Blake Gall Stone Forceps BSN 4A-2 ‘10

BSN 4A-2 ‘10

Bone Rongeurs

Friedman Mini Bone Rongeurs Friedman Bone Rongeurs

Cleveland Bone Rongeurs BSN 4A-2 ‘10

Bone Rongeurs

Blumenthal Bone Rongeurs Mead Bone Rongeurs

Luer Bone Rongeurs BSN 4A-2 ‘10

Bone Rongeurs

Luer Bone Rongeurs

Lempert Bone Rongeurs Adson Bone Rongeurs BSN 4A-2 ‘10

Bone Rongeurs

Stiller Luer Bone Rongeurs Zaufal Jansen Bone Rongeurs

Stiller Luer Bone Rongeurs BSN 4A-2 ‘10

To excise, trim and sculpt soft (cancellous) or hard (cortical) bone. Bone Cutters: To cut bone or to remove bone splinters.

BSN 4A-2 ‘10

Bone Cutting Forceps

Liston

Semb Cottle Kazanjain BSN 4A-2 ‘10

Bone Cutting Forceps

Stille Liston

Langenbeck Verbrugge Self Centering Forceps BSN 4A-2 ‘10

To hold, stabilize, rotate, reduce and compress bone To position bone screws and plates and insert K-Wire

BSN 4A-2 ‘10

Bone Holding Forceps

Farabeuf Lambotte

Lambotte

Kern BSN 4A-2 ‘10

Bone Holding Forceps

Lane Bone Holding

Bircher Genske Sequester

Bone Forceps BSN 4A-2 ‘10

Bone Holding Forceps

Martin Bone Sequester Forceps

BSN 4A-2 ‘10

To scrape, shape and clean bone

BSN 4A-2 ‘10

Bone Curettes

Volkmann Bone Curettes

Burns Bone Curettes

Spratt Bone Curettes BSN 4A-2 ‘10

Bone Curettes

Simon Bone Curettes Halle Bone Curettes

Volkmann Bone Curettes BSN 4A-2 ‘10

To score, cut, scrape, clean and sculpt bone Osteotomes: To shape and sculpt bone, particularly cancellous Chisels: To cut a window in the bone cortex to allow harvesting of pure soft bone Gouges: To scoop away strips of soft bone, especially in bone grafting BSN 4A-2 ‘10

Bone Chisels & Gouges

Alexander Chisels & Gouges Osteotomes Chisels & Gouges

Partsch Chisels & Gouges BSN 4A-2 ‘10

Bone Chisels & Gouges

Smith Peterson Chisels & Gouges Stille Chisels & Gouges

Lambotte Chisels & Gouges BSN 4A-2 ‘10

Bone Chisels & Gouges

Hibbs Chisels

Lebsche Bone Chisels Brunetti Bone Chisels BSN 4A-2 ‘10

To exert force on osteotomes, chisels, gouges, etc. To drive the instruments for inserting nails into the medullary canal

BSN 4A-2 ‘10

Bone Hammers

Gerzog Bone Hammers

Bone Hammers Kirk Bone Hammers BSN 4A-2 ‘10

Bone Hammers

Williger Bone Hammers Collin Bone Hammers

Lucae Bone Hammers BSN 4A-2 ‘10

To elevate and dissect bone, tissue, nerves. To clean and scrape bone. To expose fracture sites or bone in other procedures. Periosteal elevators are used to strip portions of the membrane (periosteum) covering the exterior surface of a bone. BSN 4A-2 ‘10

Bone Periosteal Elevators

Lambotte Periosteal Elevators Farabeuf Periosteal Elevators

Sedillot Periosteal Elevators BSN 4A-2 ‘10

Bone Periosteal Elevators

Williger Periosteal Elevators Alexander Periosteal Elevators

Doyen Periosteal Elevators BSN 4A-2 ‘10

Bone Periosteal Elevators

Adson Periosteal Elevators Semb Periosteal Elevators

Adson Periosteal Elevators BSN 4A-2 ‘10

BSN 4A-2 ‘10

E.N.T. Instruments

Yankauer

Troeltsch

Lubet Barbon BSN 4A-2 ‘10

E.N.T. Instruments

Knight

Noyes Bruenings BSN 4A-2 ‘10

E.N.T. Instruments

Cottle

Joseph

Freer BSN 4A-2 ‘10

E.N.T. Instruments

Bruenings

McKenty Converse BSN 4A-2 ‘10

E.N.T. Instruments

Roger

Fomon

Maltz-Cottle BSN 4A-2 ‘10

E.N.T. Instruments

Silver Killian Claus

Hajek BSN 4A-2 ‘10

E.N.T. Instruments

Lewis West Aufricht

BSN 4A-2 ‘10

E.N.T. Instruments

Gallaher

Fomon BSN 4A-2 ‘10

E.N.T. Instruments

Voltolini

Mod Wien

Thudichum BSN 4A-2 ‘10

E.N.T. Instruments

Tieck Halle

Hartmann Halle

Mod Wien BSN 4A-2 ‘10

E.N.T. Instruments

Struycken

Hajek Kofler BSN 4A-2 ‘10

E.N.T. Instruments

Rubin

Citelli BSN 4A-2 ‘10

E.N.T. Instruments

Beyer

Middleton Jansen BSN 4A-2 ‘10

E.N.T. Instruments

Krause Killian

Lichtwitz BSN 4A-2 ‘10

E.N.T. Instruments

St. Clair Thomson

Walsham

Faulkner BSN 4A-2 ‘10

E.N.T. Instruments

Beckmann

Asch

Coakley

BSN 4A-2 ‘10

E.N.T. Instruments

Jatho BSN 4A-2 ‘10

BSN 4A-2 ‘10

Instrument Care Instructions

•New Instruments Newly purchased instruments must be cleaned, lubricated and autoclaved immediately before use.

•Correct Use

Obvious as it sounds, it bears repeating: instruments are designed for a particular purpose and should be used only for that purpose. Even the strongest instrument can be damaged when used inappropriately, i.e., when a nail splitter is used to cut wire.

BSN 4A-2 ‘10

Instrument Care Instructions

•Water and Stainless Steel Ordinary tap water contains minerals that can cause discoloration and staining. Therefore, we recommend the use of distilled water for cleaning, disinfecting, sterilizing and rinsing instruments. To avoid staining, use a cleaning solution with a pH near neutral (7). Instruments should be placed in distilled water immediately after use. They should never be placed in saline solution, as it may cause corrosion and eventually irreversible pitting.

BSN 4A-2 ‘10

Instrument Care Instructions

•Manual Cleaning and Soaking When handling instruments, be very careful not to damage their fine tips and mechanisms. If instruments have been exposed to blood, tissue, saline or other foreign matter, they must be rinsed in warm (not hot) water before these substances are allowed to dry. Failure to do so may result in rust. After rinsing, immerse them in a cleaning and disinfecting solution. Because many compounds, including certain chemicals, are highly corrosive to stainless steel, rinse and dry instruments immediately, in case they have come in contact with any potentially harmful substances BSN 4A-2 ‘10

Instrument Checkup The best time to review the condition of instruments is after they have been cleaned and lubricated and have cooled off. Consider the following:

•Function: “Sharps” must cut cleanly (resharpen if needed) and close properly. Check for burrs along the cutting edges. Needle holders and clamps must engage properly and meet correctly at the tips.

BSN 4A-2 ‘10

Instrument Checkup

Surface: Carefully inspect surfaces for any sign of staining, cracking or other irregularities. Common sources of staining are: · Inadequate cleaning · Mixing dissimilar metals · Impurities in the water · Unsuitable or improper preparation and usage of cleaning and disinfecting or maintenance agents · Non-compliance with operating procedures of cleaning and sterilizing equipment.

BSN 4A-2 ‘10

Instrument Checkup

•Lubrication and Autoclaving All instruments must be properly cleaned before autoclaving. Then their moving parts, such as box locks and hinges, should be well lubricated. Be careful to use surgical lubricants and not industrial oils. Always sterilize instruments in the open, unlocked position. We recommend that instruments be wrapped in cloth and then placed in the container, or that a cloth be put on the bottom of the pan to absorb moisture. The cloth should be pH (7) neutral and have no residue of detergents. Finally, avoid sudden cooling. Instruments should be allowed to air dry, not rinsed or dried off. BSN 4A-2 ‘10

Instrument Checkup •Cold Sterilizing or Disinfecting Prolonged immersion in disinfecting or sterilizing solution can damage surgical instruments. Do not soak instruments for longer than 20 minutes. To render the instruments sterile and ready for use, use an autoclave cycle. •Caution: Instruments with tungsten carbide inserts, such as wire cutters, needle holders and TC scissors, should never be immersed in sterilizing solutions containing benzyl ammonium chloride (BAC). BAC will soften and dissolve the tungsten carbide. Never use bleach as it will cause severe pitting. BSN 4A-2 ‘10

Storage

•Once instruments are thoroughly dry, store them in a clean, dry environment. Never put them in areas where chemicals may emit corrosive vapors or where temperature and moisture variations could cause condensation on the instruments.

BSN 4A-2 ‘10