Handling of Surgical Instruments
By Magnus Avnstorp, MD and Bo Sonnich Rasmussen, MD, PhD
When performing a surgical procedure, it is essential to be familiar with the standard surgical instrument assortment and the correct handling of these. In standard procedures, the scrub nurse will provide the necessary instruments and assist during the procedure. Should the surgeon need a special instrument for the procedure, it is recommended to inform the scrub nurse of this in time before commencing surgery.
The scalpel may be a single-use disposable one or a re-usable one with changeable blades.
The scalpel is differentiated into numbers according to its characteristics. Below are the three most commonly used types for surgical procedures:
Number 10 (#10): Standard scalpel with a rounded contour blade for incisions on the body.
Number 11 (#11): Sharp-tip scalpel blade for stabbing incisions.
Number 15 (#15): Smaller, rounded contour blade for smaller delicate incisions, as in facial surgery.
Forceps come in three types:
The tissue forceps (Adson) have teeth in the distal tip, allowing a better hold. The Adson is less traumatic for the tissue as the cells are not crushed. The Adson is the standard forceps when suturing skin.
The dressing forceps (blunt-nosed forceps) with or without serrated tips distribute the pressure over a wider area, but also crush the tissue and increase the risk of necrosis. They are used for handling softer tissue, such as when performing intra-abdominal surgery and when handling full-thickness skin transplants.
The DeBakey forceps (blunt-nosed forceps), with vertical lines, are the most atraumatic forceps and are used for handling vessels in vascular procedures. They can be found in both straight and angled versions and should not be used to handle skin.