We start preparation for Surgical Instruments by deciding how much space for tools we need. Is Mayo enough or do I need an extra table. Once I know how to plan the space, I need to prepare it for work, i.e. cover it sterile. Everyone has their own cladding system, it depends not only on individual preferences, but also on the type of surgery and available cladding . In hospitals where there is only one-time cover, complete for covering the operating field, there is usually a table cover. When we have reusable cover, we must complete the table cover ourselves.
It is assumed that both the operational field and the table should be covered with 3 layers.
You have to pay attention to cover the tables thoroughly and that the upper layer covers all the lower ones, i.e. that nothing protrudes from under it. Here some Surgical Instruments Pictures display to create a pocket for tools, e.g. coagulations, electric knives. I never used it mainly because my friends I didn’t learn from, but I know that it is very popular in other places. If we have a disposable covering, it is good to add a layer, because you can pierce a thin covering with a blade or needle and dirty the table and tools unnoticed. When the cladding is ready, we proceed to unfold the tools. Formally, tools can be divided into
- – cutting tissue
- – for holding tissues including clamps
- – for tissue extraction – hooks
- – for tissue suturing
- – for preparation, probing
- -for sharp / blunt tools
More about the tools in the very interesting “instrumentation basics” script available at https://signsymptom.com
On the Mayo table we spread the tools with which we work, while the “spare” ones are convenient to keep on the side table. As a result, they remain sterile, we do not dirty them by looking for something axis. We start arranging the tools from those that will be needed at the initial stage of the operation and will be most often used. We pull out cleaning tools, bowls, knife shank, tweezers, suture and preparation scissors, Kochery, peany, Mikulicze , hooks for different layers of tissue, vices.
It is a good idea to get into the habit of putting out the same number of even or odd tools:
e.g. 4 peans, 4 blankets, 4 Mikulicze.This makes it easier to remember how many tools I have on the table and what is missing, and to check the status of the tools at the end of the operation. In case the tools can always be selected from the side table. I always put the tools in the same order for each treatment, so when I need something quickly, I don’t look for it, I just know where it is. The second thing is putting tools in the same place.We don’t throw tools anywhere, because then it’s harder to find them, but where we took them. The tools cannot be layered – that is, we do not put one on top of the other because then you can not see what is underneath and in addition pulling it from the bottom we can cut ourselves. Another thing is
sharp tools, I usually put them away so that the operator who rests on the table or looks for something on it does not get caught and does not hurt. For the same reason, I place all needles and the scalpel after cutting the coatings on a side table or further from the operating field . Kochera and peany forceps are always divided and arranged in separate groups, giving you can quickly check whether we give what we were asked (by opening the Surgical Instruments and checking if it has a clove or not).
Be careful not to mistake the seams if you put them in one place.
On some blocks, friends have special boxes or magnets for needles, thanks to which they are protected and we can not be afraid that they will die or someone will stutter them. For this there are also boxes for surgical blades to prevent injury, or disposable scalpels with a latch, after using the blade, you can hide them. My strategy for order on the table is after the subsequent stages of the operation to place unnecessary Surgical Instruments on the side table, but so as not to stain the unused blood. I have the impression that this works only with specialized surgery when there are specialized Surgical Instruments, while in general surgery it is difficult to predict if something will not be needed. For example – placing the implant – after placing it, the Surgical Instruments used for this can be put on the side table –but never give it away or get dirty !!!
In addition to providing space for sharp instruments, you need to designate a place for swabs and dressing material. These things should also have their sector, be recalculated and clean separated from used ones. And it would be better if they were further away from the surgeon .. to control their number and be sure that no one at our inattention did not “help” with a gauze, and then during the counting do not get upset that something is wrong. Yes, there are many things we need to consider and remember.