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ICVP - Instruments

Maintenance Of Surgical Instruments

QuestionAnswer
Why Is Instrument Maintenance Important? -Longevity of instruments -Efficacy/effectiveness of instrument. -Infection control. -Welfare.
What Are The Three Stages Of Instrument Cleaning? 1) Manual cleaning - remove all contamination with brush and instrument cleaning product, rinse. 2) Ultrasonic cleaning - soak in instrument cleaning product (enzymatic cleaner), rinse. 3) Lubrication - via an oil, spray or milk bath.
How Does The Ultrasonic Cleaning Of Surgical Instruments Work? Via the process of cavitation (tiny bubbles collect on the surface of the instruments).
What Checks Can Be Carried Out On Surgical Instruments To Monitor Their Efficacy? -Check hinges for stiffness. -Check alignment of jaws and teeth. -Check sharps for nicks burrs. -Check all screws and pins. -Check forceps – tips should meet/no overlap. -Check ratchets close securely. -Check tips of towel clips for damage.
How Can Certain Surgical Instruments Be Sharpened? -Scissors, Drill Bits, Dental Instruments, Saws. Scissors - Must be sent back to manufacturer. Drill Bits - Can be sharpened but new ones are more reliable. Dental Instruments - Can be sharpened in house with a sharpening stone. Saws - Cannot be sharpened require replacement.
What Are The Advantages/Disadvantages Of Using Self Seal Sterilisation Pouches For Surgical Instruments? -Cheap. -Available in a wide range of sizes. -Single use. -Easily damaged. -Susceptible to strike through.
What Are The Advantages/Disadvantages Of Using Drape Wraps For Surgical Instruments? -Cheap. -Can be made to fit any item. -Single use. -Easily damaged. -Susceptible to strike through dependent on material.
What Are The Advantages/Disadvantages Of Using Metal Containers For Surgical Instruments? -Not susceptible to strike through. -Not penetrable. -Reusable. -Available in a wide range of sizes. -Expensive when compared to other methods.
What Methods Can Be Used To Monitor Sterility Of Instruments Undergoing Sterilisation? -TST (temperature, steam, time) chemical test strips. -Browne's tubes. -Bowie dick tape. -Spore tests. -Thermocouples.
What Are Some Considerations For Packaging Surgical Instruments? -Place instrument in correct way up. -Leave rachets and edges open. -Cover sharp edges. -Seal carefully. -Fold along dotted/perforated edge. -Label.
What Is The Purpose Of Double Bagging In Instrument Packaging? -Precaution in case of outer packaging losing integrity or accidents such as dropping. -To allow the entire bag and contents to be placed into the sterile field.
What Are The Typical Contents Of A Standard Surgical Kit? -Scalpel handle. -Metzenbaum's. -Mayo scissors. -Rat toothed forceps. -Dressing forceps. -Towel clamps (backhaus/cross action). -Suture needles. -Artery forceps (usually 4-6). -Needle holder (Olsen hagar/ mayo hagar/ gillies).
Describe The Step By Step Process Of Packaging A Surgical Kit? -Stack instruments on top of each other. Place TST at the centre of the kit. -Lay swabs underneath instruments. -Wrap kit in drape, roll neatly and tightly. -Seal with tape or autoclave pouch. -Initial, date, contents.
If the mouth is not clean, and can never be truly disinfected, why do we autoclave dental instruments? To prevent spread of disease and cross contamination.
What Are The Advantages/Disadvantages Of Using Reusable (Fabric) Drapes? -Can get plain or fenestrated (with a hole or window). -Require ongoing maintenance. -Absorbent/porous – strike through.
What Are The Advantages/Disadvantages Of Using Single Use Drapes? -Waterproof – no strike through. -Can get plain or fenestrated. -Not environmentally friendly. -Cost of buying drapes greater than cost of autoclave pouches, running the autoclave. -Reduced infection control risk.
What Are The Steps Of Maintaining Reusable Surgical Drapes? 1) Soaking and rinsing - in cold water. 2) Laundering - separately from other items, high temp, soluble laundry bag. 3) Drying - ensure fully dry. 4) Routine checks - for damage, wear, etc, remove lint. 5) Folding and packaging - concertina style.
How Should Sterile Items Be Opened? -Loosen any tabs. -Open the package without touching inside surface. -Pack opened slowly and carefully. -As the pouch is opened, cover hands with the two sides of bag.
Why Is Cold Water Used When Rinsing Drapes? -To remove gross contamination. -Hot water will cause blood etc. to coagulate and become more difficult to remove.
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