Page 9 - Manual of Equine Field Surgery

CHAPTER 2

Surgical Instruments

David A. Wilson

This chapter serves as a reference for the various scalpel handle is usually held in a "pencil-grip"

surgical instruments referred to throughout the fashion to allow for finer motor control. The No.

book. The equine surgeon should become famil- 4 handle and its associated blades are used for

iar with the instruments, how they handle, what larger areas where precision is not a major

procedures they should and should not be used concern.

for, and when they should be used. Using the right

instrument at the right time is essential to good Scissors

surgical technique. Selecting the appropriate

instrument ensures minimal trauma to tissues Many types of scissors are available depending on

and that the procedure will be performed in the the job to be performed. These include scissors

least amount of time with the least harm to the designed to cut various types of tissue and scis-

patient. Handling the instruments in practice sors designed to cut suture, wire, or bandage

cadaver or laboratory settings is essential to material. Operating scissors are classified accord-

become proficient enough to handle them effec- ing to the shape of the tips, for example, sharp-

tively in surgical situations. sharp, sharp-blunt, and blunt-blunt (Figure 2-3).

When using the appropriate scissors, the tip of the

scissors is used to cut tissue, the tip or body is used

INSTRUMENTS to cut sutures, and the heel is used to cut wire.

Metzenbaum scissors are relatively delicate and

Scalpel blades used for the No. 3 scalpel handle are are made for precise dissection, whereas Mayo

sizes 10, 11, 12, and 15 (Figure 2-1). Scalpel blade scissors are made for tissues with more substance,

sizes 20, 21> and 22 are made for the No. 4 scalpel Mayo and Metzenbaum scissors are available with

handle (Figure 2-2). The No. 10 blade on a No. 3 straight or curved blades. The straight blades are

Bard-Parker handle is used for most equine sur- designed for working close to the surface of the

gical procedures. However, the No. 11 and No. 15 wound, and the curved scissors are used for

blades are useful when very precise or small inci- working deeper in the wound (Figure 2-4). For

sions are required. The sharp tip on both the No. blunt dissection, the closed tips of the scissors are

11 and No. 12 blades is useful for lancing inserted into the tissue and then opened to spread

abscesses. Typically, the scalpel handle is held the tissue. Tissue scissors should not be used to

between the thumb and the third and fourth cut suture or wire.

fingers, with the index finger placed over the back Bandage scissors are designed with angled

of the handle to apply pressure on the blade. blades, and the lower blade has a small "button"

When using the No. 11 and No. 15 blades, the tip to protect the underlying structures and

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