Frequently Asked Questions?

Surgical instruments are predominantly crafted from martensitic stainless steel, chosen for its excellent balance of strength, corrosion resistance, and ease of cleaning. This material allows for the rigorous sterilization necessary in medical environments, which is crucial for preventing infection and maintaining hygiene. Beyond stainless steel, specialized instruments may incorporate other materials like titanium or titanium alloys, chromium, vanadium, or molybdenum, each selected based on the specific requirements of the surgical procedure and the environment of use. For instance, titanium is preferred in certain delicate procedures such as neurosurgery and microsurgery due to its lightweight nature, while tungsten carbide is used in areas requiring extreme hardness and durability, like the jaws of needle holders.

A variety of instruments are considered essential in general surgery and are frequently used across different specialties. These include:
  • Cutting and Dissecting Instruments: Scalpels, surgical scissors and saws are fundamental for making incisions and separating tissues. Scalpels, categorized by size and shape, are chosen based on the desired incision type.
  • Grasping and Holding Instruments: Forceps, clamps, and needle holders are crucial for securely holding tissues, objects, and needles during suturing. Forceps can have straight or curved tips, with straight tips providing more grip and curved tips enhancing visibility. Locking forceps, also known as hemostats, are designed for secure gripping and are often used to control bleeding.
  • Retracting and Exposing Instruments: Retractors, which can be either hand-held or self-retaining, are used to hold back tissues and organs, providing better visibility and access to the surgical site.
Proper cleaning and sterilization of surgical instruments are paramount for preventing infections and ensuring patient safety. Adhering to manufacturer guidelines and established protocols is essential. The process typically involves:
  • Immediate Post-Use Treatment: Rinsing instruments immediately after use to remove blood and debris, potentially using a plastic or nylon brush, according to Diamond Surgical.
  • Soaking: Soiled instruments are often soaked in an enzymatic solution to further loosen and break down organic matter.
  • Cleaning Methods:
    • Manual Cleaning: Delicate instruments or those with intricate features may require manual cleaning using a three-bay sink method: rinsing, soaking in a detergent, and final rinsing.
    • Automated Cleaning: Ultrasonic cleaning and automated washer/disinfectors are common. Instruments should be sorted by metal type before automated cleaning to prevent galvanic corrosion.
  • Drying: Thorough drying is crucial to prevent microbial growth and maintain sterility. This can involve using a clean towel or compressed air for hard-to-reach areas like joints and hinges.
  • Sterilization: Once cleaned, instruments must be sterilized using appropriate methods based on material and compatibility, such as steam sterilization (autoclaving), chemical sterilization (ethylene oxide gas or hydrogen peroxide vapor), or dry heat sterilization. Choosing the wrong sterilization method can damage instruments or fail to achieve sterility, notes Symec Engineers (India) Pvt. Ltd..
  • Storage: Sterilized instruments must be stored in clean, dry environments and protective cases to prevent damage and contamination.
Following manufacturer instructions for lubrication is crucial. Lubrication can help prevent metal-on-metal wear on articulated joints, which is generally recommended for maintaining instrument functionality. However, it is imperative to use only surgical instrument lubricants, as oil-based lubricants can impede proper sterilization. Water-based lubricants are generally preferred due to their compatibility with sterilization processes.
Avoiding common pitfalls in instrument handling is as critical as following best practices. These mistakes can compromise patient safety and lead to operational inefficiencies:
  • Using damaged or worn instruments: Always inspect instruments for signs of damage or wear before use, cautions The Association for Perioperative Practice.
  • Improper cleaning and sterilization methods: Adhere strictly to the manufacturer’s cleaning and sterilization instructions for each instrument to avoid corrosion or sharpness loss, says Diamond Surgical.
  • Neglecting instrument maintenance history: Implement robust tracking systems to monitor instrument usage, maintenance, and sterilization records, ensuring timely replacement or repair of instruments.
  • Insufficient staff training: Comprehensive training programs are essential to ensure staff are competent in handling, cleaning, sterilizing, and storing surgical instruments correctly.
  • Overlooking routine preventive maintenance: Regular maintenance checks help keep instruments in optimal condition, reducing the risk of malfunctions during procedures and extending their lifespan. This can also lead to longer instrument lifespan and lower long-term costs.
By prioritizing proper handling, meticulous maintenance, and adherence to safety protocols, healthcare facilities can enhance patient safety, optimize surgical outcomes, and ensure the longevity and reliability of their surgical instrumentation.