OPERATING ROOM


INSTRUMENTS



Classifications of Surgical Instruments
! Cutting and Dissecting (Sharps)
! Clamping and Occluding (Clamps)
! Grasping and Holding (Graspers)
! Exposing and Retracting (Retractors)
! Suturing and Stapling
! Viewing
! Suction and Aspirating
! Dilating and Probing
! Measuring
! Accessory Instruments

Cutting and Dissecting (Sharps)

Cutting and Dissecting (Sharps)
1. Knife / Scalpel
! Handle #4 is the first knife used to cut tough
tissues.
! Handle #3 is the second knife used to cut
delicate tissues, and is used for minor surgeries.

 Cutting and Dissecting (Sharps)

2. Scissors
! Mayo Scissors (Straight / Curved)
– used to cut tough tissues.

Straight Curved

 Cutting and Dissecting (Sharps)

2. Scissors
! Metzenbaum Scissors (Straight / Curved)
– used to cut delicate tissues.

Straight Curved

 Cutting and Dissecting (Sharps)

2. Scissors
! Bandage Scissors
– used to cut the uterus and umbilical cord.

Clamping and Occluding (Clamps)

Clamping and Occluding (Clamps)
1. Hemostatic Forceps
! used temporarily clamp and occlude bleeding
vessels.

Kelly Crile Mosquito

Clamping and Occluding (Clamps)

1. Hemostatic Forceps
! can be straight or curved

Straight Curved

 Clamping and Occluding (Clamps)

! Kelly Forceps
- longest; used for deep abdominal layers and
cavities
! Crile Forceps
- medium; used for shallow layers
! Mosquito Forceps
- shortest; used for minor surgery, pediatrics, and
superficial layers

Clamping and Occluding (Clamps)
2. Mixter Forceps
! used to reach around and ligate blood vessels.

Clamping and Occluding (Clamps)

3. Ochsner Forceps
! used to grasp medium to heavy tissue or
occlude heavy, dense vessels

Straight Curved

Grasping and Holding (Graspers)

Grasping and Holding (Graspers)
1. Adson Forceps (Toothed)
! used for handling dense tissue, such as in skin
closures

Grasping and Holding (Graspers)

2. Adson Forceps (Toothless)
! used for fine surgical procedures to hold delicate
or superficial tissues

Grasping and Holding (Graspers)

3. Thumb Forceps
! used for grasping, holding or manipulating body
tissue

Grasping and Holding (Graspers)

4. Tissue Forceps
! used in surgical procedures for grasping tissue
! designed to minimize damage to biological
tissue

Grasping and Holding (Graspers)

5. Allis Forceps
! used to hold or grasp heavy tissue like bones,
tendons, uterus, and fascia

Grasping and Holding (Graspers)

6. Pennington Forceps
! used for grasping tissue, particularly during
rectal operations

Grasping and Holding (Graspers)

7. Babcock Forceps
! used to grasp delicate tissue and hold tubular
organs
! used with intestinal and laparotomy procedures

Grasping and Holding (Graspers)

8. Ovum Forceps
! used to remove placental fragments inside the
uterus

Grasping and Holding (Graspers)

9. Towel Clips
! used to hold drapes in place, to keep only the
operating field exposed

Exposing and Retracting (Retractors)

Exposing and Retracting (Retractors)
1. Self Retaining Retractors
! Balfour Abdominal Retractor
- used in laparotomy procedures, and for specific
abdominal procedures where the abdomen
needs to be held open for examination or
evaluation, such as cesarean sections and
bowel resection

Exposing and Retracting (Retractors)

1. Self Retaining Retractors
! Mastoid Retractor
- used to retract the external canal skin anteriorly
for better visualization of external canal and
middle ear.

Exposing and Retracting (Retractors)

1. Self Retaining Retractors
! Gelpi Retractor
- used for holding back organs and tissues while
accessing areas below an incision during lumbar
spine procedures

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Army Navy Retractor
- used for shallow or superficial wounds, and to
retract skin or bones

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Richardson Retractor
- used to retract, expose or push tissue,
muscles, organs or bones during surgery

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Deaver Retractor
- used to hold back the abdominal wall during
abdominal or thoracic procedures, and to move
or hold organs away from the surgical site

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Murphy Rake Retractor
- used to gently retract tissue and give better
visibility to the surgical field

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Senn Retractor
- used to retract fat tissue in minor sugery

Exposing and Retracting (Retractors)

2. Non-Self Retaining Retractors
! Malleable Retractor
- used to retract deep wounds, and may be bent
to various shapes.

Suturing and Stapling

Suturing and Stapling
1. Needle Holder
! used to hold a suturing needle for closing
wounds during suturing and surgical procedures

Suturing and Stapling

2. Skin Stapler
! used to close incisions after surgery

Viewing
Viewing
1. Speculum
! used to see inside a hollow part of the body

Nasal Vaginal

Viewing
2. Endoscope
! used to look deep into the body and used in
procedures called an endoscopy

Suction and Aspirating

Suction and Aspirating
1. Suction
! used to remove substances such as blood,
saliva, mucus, and vomit

Yankauer

Frazier

Connecting Tube

Dilating and Probing

Dilating and Probing
1. Urethral Sounds
! used in urological surgery for dilatation of
strictures or for obtaining access to the bladder

Dilating and Probing

2. Surgical Probes
! a blunt-ended surgical instrument used for
exploring a wound or part of the body

Measuring
Measuring
1. Caliper
! used in plastic surgery procedures to ascertain
precise measurements

Measuring
2. Ruler
! used to obtain precise measurements during
orthopedic surgical procedures

Accessory Instruments
Accessory Instruments
1. Mallet
! used with a chisel to split teeth and reshape or
remove bones

SUTURES



Edna Co RN MAN
SUTURES
! a stitch or row of stitches holding together the
edges of a wound or surgical incision
! can classified into Absorbable and Non-
Absorbable
! Absorbable sutures are broken down by the body
via enzymatic reactions or hydrolysis. The time in
which this absorption takes place varies between
material, location of suture, and patient factors.
Examples:
! Vicryl
! PolyDioxanone Suture (PDS)
! Monocryl
SUTURES
! Non-Absorbable sutures are used to provide long-
term tissue support, remaining walled-off by the
body’s inflammatory processes (until removed
manually if required). Examples:
! Nylon
! Prolene
! Silk
SUTURE SIZE
! The diameter of the suture will affect its handling
properties and tensile strength.
! The larger the size ascribed to the suture, the
smaller the diameter is, for example a 7-0 suture
is smaller than a 4-0 suture.
SURGICAL NEEDLES
! The surgical needle allows the placement of the
suture within the tissue, carrying the material
through with minimal residual trauma.
! Characteristics
! rigid enough to resist distortion, yet flexible
enough to bend before breaking
! as slim as possible to minimize trauma
! sharp enough to penetrate tissue with minimal
resistance
! stable within a needle holder to permit
accurate placement.
 SURGICAL NEEDLES – 3 PARTS

1. Swaged end - connects the needle to the suture

SURGICAL NEEDLES – 3 PARTS
2. Needle Body or Shaft - the region grasped by the
needle holder, and can be round, cutting, or
reverse cutting.
! Round bodied needles are used in friable
tissue such as liver and kidney.
! Cutting needles are triangular in shape, and
have 3 cutting edges to penetrate tough tissue
such as the skin and sternum, and have a
cutting surface on the concave edge.
! Reverse cutting needles have a cutting surface
on the convex edge, and are ideal for tough
tissue such as tendon or subcuticular sutures,
and have reduced risk of cutting through tissue.
SURGICAL NEEDLES – 3 PARTS
3. Needle point - acts to pierce the tissue,
beginning at the maximal point of the body and
running to the end of the needle, and can be
either sharp or blunt.
! Blunt needles are used for abdominal wall
closure, and in friable tissue, and can
potentially reduce the risk of blood borne virus
infection from needlestick injuries.
! Sharp needles pierce and spread tissues with
minimal cutting, and are used in areas where
leakage must be prevented.
SURGICAL NEEDLES – SHAPES
! The needle shape vary in their curvature and
are described as the proportion of a circle
completed – the ¼, ⅜, ½, and ⅝ are the most
common curvatures used.
! Different curvatures are required depending on
the access to the area to suture.

PRINCIPLES OF 

ASEPTIC TECHNIQUE



PRINCIPLES OF ASEPTIC TECHNIQUE
1. ONLY STERILE ITEMS ARE USED WITHIN
THE STERILE FIELD.
PRINCIPLES OF ASEPTIC TECHNIQUE
2. GOWNS ARE CONSIDERED STERILE ONLY
FROM THE WAIST TO SHOULDER LEVEL
INFRONT AND THE SLEEVES.
Unsterile

Sterile
PRINCIPLES OF ASEPTIC TECHNIQUE
3. TABLES ARE STERILE AT TABLE LEVEL.
PRINCIPLES OF ASEPTIC TECHNIQUE
4. STERILE PERSONS TOUCH ONLY STERILE
ITEMS OR AREAS . UNSTERILE PERSONS
TOUCH ONLY UNSTERILE ITEMS OR AREAS.
PRINCIPLES OF ASEPTIC TECHNIQUE
5. UNSTERILE AVOID REACHING OVER
STERILE FIELD. STERILE PERSONS AVOID
LEANING UNSTERILE AREAS.
PRINCIPLES OF ASEPTIC TECHNIQUE
6. EDGES OF ANYTHING THAT ENCLOSES
STERILE CONTENT ARE CONSIDERED
UNSTERILE.
PRINCIPLES OF ASEPTIC TECHNIQUE
7. STERILE FIELDS IS CREATED AS CLOSE AS
POSSIBLE TO TIME OF USE.
8. STERILE AREAS ARE CONTINUOUSLY KEPT
IN VIEW.
9. STERILE PERSONS KEEP WELL WITHIN THE
STERILE AREA.
PRINCIPLES OF ASEPTIC TECHNIQUE
10. STERILE PERSONS WEAR GOWN AND
GLOVED.
PRINCIPLES OF ASEPTIC TECHNIQUE
11. UNSTERILE PERSONS AVOID STERILE
AREA.
12. DESTRUCTION OF INTEGRITY OF
MICROBIAL BARRIERS RESULTS IN
CONTAMINATION.
PRINCIPLES OF ASEPTIC TECHNIQUE
13. MICROORGANISMS MUST BE KEPT TO AN
IRREDUCIBLE MINIMUM.
THANK YOU!