Operating Room Nursing: Marissa S. Fernandez, RN, Man Clinical Instructor

OPERATING ROOM
NURSING
MARISSA S. FERNANDEZ, RN,MAN
CLINICAL INSTRUCTOR
• Cutting Instruments
- used to cut,
dissect, separate or
excise tissue
• >Blades
• >Scalpel Blade
handles
• >Knifes
• Scissors:
• The blades of scissors may be straight, angled or curved, as well as either
pointed or blunt at the tips. The handles may be long or short. Some
scissors are used only to cut or dissect tissues; others are used to cut other
materials. To maintain sharpness of the cutting edges and proper alignment
of the blades, scissors should be used only for their intended purpose.
• Tissue/ dissecting scissors must have sharp blades.
• The type and location of tissue to be cut determines which scissors the
surgeon will use. Blades needed to cut tough tissues are heavier than those
needed to cut fine, delicate structures. Curved or angled blades are needed
to reach under or around structures. Handles to reach deep into body
cavities are longer than those needed for superficial tissues.
Suture Scissors have blunt points to
prevent structures close to the suture
from being cut. The scrub person may use
scissors to cut sutures during preparation
if needed.
Wire Scissors have short, heavy blades.

Wire scissors are used instead of suture
scissors to cut stainless steel sutures.
Heavy wire cutters are used to cut bone
fixation wires.
Dressing/bandage scissors are used to
cut drains and dressings and to open it
such as plastic packets.
Tissue Forceps
Tissue Forceps are used to pick up or
hold soft tissues and vessels. Forceps
used to grasp and hold soft tissues and
organs are too numerous to allow further
elaboration. The collaboration of each is
designed to securely grasp but prevent
injury to tissues.
Smooth Forceps- Also referred to as
thumb forceps or pick-ups, smooth
forceps resemble tweezers. They are
tapered and have serrations (grooves) at
the tip. They may be straight or bayonet
(angled), short or long, and delicate or
heavy.
• Toothed Forceps differ from
smooth forceps at the tip.
Rather than being serrated,
they have a single tooth on
one side that fits between
two teeth on the opposing
side or they have a row of
multiple teeth at the tip.
Toothed forceps provide a
firm hold on tough tissues,
including skin.
• Grasping and Holding Instruments:
• Tissues should be grasped and held in position
so the surgeon can perform the desired
maneuver, such as dissecting or suturing
without injuring the surrounding tissues or
organs.
• Allis Forceps has a scissor action. Each jaw
curves slightly inward, and there is a row of
teeth at the end.
• Babcock Forceps: The end of each jaw of a
Babcock forceps is round to fit around a
structure or to grasp tissue without injury. This
rounded section is circumferentially
fenestrated.
• Stone Forceps: Either curved or straight forceps
are used to grasp calculi such as kidney stones
or gallstones. These forceps have blunt loops or
cups at the end of the jaws.
• Tenaculums
• The curved or
angled points on
the ends of the
jaws of
tenaculums
penetrate tissue to
grasp firmly, such
as when a uterine
tenaculum is used
to manipulate.
Clamping Instruments Clamping and Occluding – instruments that clamp and occlude
are used to apply pressure
Hemostatic forceps - Most clamps used for occluding blood vessels have two opposing
serrated jaws that are stabilized by a box lock and controlled by hinged handles
Hemostats – are the most commonly used surgical instruments and are used primarily to
clamp blood vessels. Hemostats have either straight or curved slender jaws that taper to a
fine point. The serrations go across the jaw
Crushing Clamps - Many variations of hemostatic forceps are used to crush tissues or
clamp blood vessels. The jaws may be straight, curved or angled and the serrations may go
across or along the jaws.
Crushing Instruments / Crushing Clamps
Mosquito Clamp curved/straight Kelly Clamp curved straight
Right Angled Mixter Forcep Rochester Pean Forcep
Retracting Instruments:
Exposing and Retracting – Soft tissues,
muscles and other structures should be
pulled aside for exposure of the surgical
site
Handheld retractors - Most retractors
have a blade on a handle. The blades vary
in width and length to correspond to the
size and depth of the incision. The curved
or angled blade may be solid or pronged
like a rake. These blades are usually dull,
but some are sharp. Some retractors have
blades at both ends rather than a handle
on one end. Other retractors have traction
grooves for slippery surfaces such as the
tongue. Handheld tractors are usually
used in pairs and they are held by the first
or second assistant.
1. Malleable retractors - is a flat length of
low carbon stainless steel, silver or
silver plated copper that may be bent to
the desired angle and depth for
retraction.
2. Self Retaining Retractors Holding
devices with two or more blades can be
inserted to spread the edges if an
incision and hold them apart. For
example, a rib spreader holds the chest
open during a thoracic or cardiac
procedure. A self retaining retractor
may have shallow or deep blades.
Some retractors have spring locks to
keep the device open; others have wing
nuts to secure the blades. Some
retractors have interchangeable blades
of different sizes.
• Viewing Equipment -
Surgeons can
examine the interior
of body cavities,
hollow organs or
structures with
viewing instruments
and can perform
many procedures
through them.

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OPERATING ROOM

Wire Scissors have short, heavy blades.

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