Surgical cutlery refers to instruments that were once used mainly in surgery. Some instruments also bear the names of surgeons, including, for example, the Kocher clamp or the Overholt.
What is medical cutlery?
Surgical cutlery is also very often used for open wounds, so it is mainly made of titanium, stainless steel or tantalum. Medical cutlery serves a very specific purpose, which can be seen from the cut or construction of the particular instrument. It is very often used for open wounds, therefore it is mainly made of titanium, stainless steel or tantalum. In the past, silver was also used for this purpose, as it kills microorganisms and has a digodynamic effect. However, silver wears out within a very short time and corrodes relatively quickly, which leads to impaired sterility. In addition, mirror-smooth surfaces are no longer used nowadays, but roughened ones. Some instruments also have a golden handle, this indicates that there is a carbide insert in the working part.In addition, many instruments are named after their inventor (for example, Kocher clamp), while others are named after their intended use (for example, dissecting scissors).
Shapes, types and styles
Medical cutlery can be divided into different types. For example, there is the group of arresting instruments that keep wounds or body entrances open and allow access. These include spreaders, retractors, specula, retractors and trocar sleeves. Another group are the so-called grasping instruments, with which tissue can be gently grasped. These include clamps, forceps and grasping forceps. Clamping instruments are a subgroup in their own right, although clamps are very often classified as grasping instruments. They are differentiated according to their clamping force, such as the soft clamp, which is required for clamping fine vessels. In addition, dissecting clamps, which can be used to separate structures, are also classified in this group. Furthermore, there is the group of cutting instruments, such as scissors, scalpel, cautery, electrotome or ultrasonic knife, and the group of suture devices, to which all clamp suture devices are counted.
Structure and mode of operation
Medical cutlery is designed to fit well in the hand, have an ideal weight and be easily guided. Medical cutlery instruments may consist of one or more parts, with two-piece instruments connected by springs or screws. Generally, the instruments consist of the following parts:
- Rings: used to accommodate the physician’s fingers and may be of different or equal sizes.
- Branches: The part between the final part and the ring.
- Gripping surfaces: This part is where the instrument is gripped. It is usually grooved or roughened.
- Latch or lock: a device that allows the instrument to be closed.
- Mouth or working part: this part holds or grips the tissue.
The group of retractors (arresting instruments) includes various instruments, each of which also performs a different function. Thus, there are various forms of retractors, such as the Fritsch retractor, the Lagenbeck retractor or the Roux retractor, which differ in size and shape. They are used to hold aside organs such as the lungs, liver, intestines or delicate tissue. Specula are needed to hold open body orifices such as the nose, anus or vagina. They are often equipped with a special spreading mechanism or light source so that the physician has adequate visibility. Forceps and levers, such as the Verbruegge forceps or the Hohmann lever, ensure access to a bone and are very commonly used in trauma surgery. The scalpel, which can be used to cut through tissue, is also very well known. Blades of various sizes, shapes and materials are available for this purpose, and their use depends on where the incision is to be made. The blades are made of either titanium, stainless steel, obsidian or flint. Disposable scalpels must be disposed of properly after use. Care should also be taken when changing the blade, for which a needle holder is particularly suitable.The physician needs a cautery to destroy tissue or stop bleeding. Today, this instrument is mainly used as an electrocautery. This consists of a fine wire loop that is heated with the help of electricity. Basic instruments also include forceps, which are used to grasp the tissue. A forceps consists of two halves that can be pressed together to provide a delicate grip at the tip. When the pressure is released, they return to their original position. It has a roughened gripping surface on its leg so that it sits well in the hand. Surgical forceps are very sharp and have teeth that interlock when pressed together. The number and size of the teeth can vary and is based on what tissue needs to be gripped.
Medical and health benefits
Medical cutlery includes grasping forceps, scissors, forceps, retractors or suture needles, all of which serve a wide variety of purposes. For example, the physician can hold, cut, lock or clamp with the instruments. Depending on the type of use, it must be possible to close the instruments or fix them in a certain position. Overall, they serve the physician as an important aid for examinations or operations and are therefore also called “inactive medical devices“. Their materials must be well tolerated by the body and have no carcinogenic or inflammatory properties. In addition, they must not cause any changes in blood or tissue and must not trigger allergies.
