I am a professional pharmacist. These slides provide for pharmacy department students. These slides describe hospital pharmacy topics.

1. DISTRIBUTION OF SURGICAL SUPPLIES

2. “INTRODUCTION”

3. Surgical supplies involves all the
instruments tools or devices that
perform functions such as
dissecting, holding, retracting, or
suturing.

4. WHAT DOES IT INCLUDE??
DISSECTING
Different types of scissors, blades and scalpels.
HOLDING
All types of forceps.
RETRACTING
Bone or skin hookers, self-retaining and hand-
held retractors
SUTURING/ LIGATING
Suture needles and clips, ligating instruments
All those tools or instruments that performs different functions like…..

5. SURGICAL
SUPPLIES
Surgical
Dressings
Primary
wound
dressing
Secondary
wound
dressing
Adsorbents
Bandages
Adhesive
tapes
Combined primary
and secondary
wound dressing
Operating
Room
Supplies
Haemostatic
products
Thrombin
solution
Disposable
sterile packs
Face masks
Sutures and
ligatures
Absorbable
sutures
Non
absorbable
Surgical
needles
Eyed needles
Eyeless
needles

6. Enhanci
ng the
prestige
of
hospital
pharma
cist
Promotio
n of
Economy
within the
hospital
Sterlity
Provision
of high
quality +
appropriait
e product
Quick
Access

7. “TYPES OF SURGICAL
DRESSINGS”

8. “Materials used for covering and protecting a
wound.”

9. ADEGREE OF
EXUDATION
PRESENCE OF
INFECTION
PRESENCE OF
NECROTIC TISSUE

10. SURGICAL
DRESSING
TYPES
PRIMARY
WOUND
DRESSING
PLAIN GAUZE
FILM
DRESSING
IMPREGNATED
GAUZE
SECONDARY
WOUND
DRESSING
ABSORBENTS
SURGICAL
COTTON
ABSORBENT
NON
ABSORBENT
BLEACHED
UN-
BLEACHED
RAYON

11. “Primary dressing directly contacts the wound
and may prevent wound dryness.”

12. • Used as a primary dressing to reduce
infected wounds
• Its removal is painful often cause removal
of new epithelium
PLAIN GAUZE
• Its adherence to wound is reduce due to
subs such as petroleum, paraffin,
vaselline
• It prevent entrance of pathogen in wound
IMPREGNATED
GAUZE
• Transparent film dressings provide a
moist, healing environment
• Protect the wound from mechanical
trauma
FILM DRESSING

13. Plain gauze Impregnated gauze
Film gauze

14. Non
absorbent
unbleached
cotton:
It is raw
cotton fibers,
mechanically
clean from
dirt and
carded into
layers
Non
absorbent
bleached
cotton:
It is
prepared
from raw
cotton by
bleaching
process,
wherein the
natural oil n
waxes are
Absorbent
cotton:
It is
prepared
from raw
cotton fiber
by removal
of impurities.
It is pure and
white
cellulose
fiber
Rayon:
It is known
as
regenerated
cellulose
It is softer
than cotton

16. “Medical Gauze, A Bleached
White Cloth Or Fabric Used In
Bandages, Dressings, And
Surgical Sponges.”

17. RAW COTTON
COTTON FIBRES
OPEN MESH CLOTH
(Gray Colour)

18. OPEN MESH
CLOTH AFTER
BLEACHING
(White colour)
FOLDED AND
ROLLED
PACKAGING

19. Gauzes are classified according to the mesh
number.

20. FILMATED
GAUZE
MEDICATED
SURGICAL
GAUZES
SELVAGE-
EDGE GAUZE
STRIPS
DRESSING
COMBINES
X-RAY
DETECTABLE
GAUZE
GAUZE
SPONGES
LAPAROTOMY
SPONGES
SANITARY
NAPKINS
EYE PADS
COTTON-
TIPPED
APPLICATOR

21. Folded absorbent gauze for quick absorption.
In between these folds, a film of cotton or
Rayon is distributed.

22. Also called antiseptic surgical gauze.
Example:
“IODOFORM GAUZE FOR PACKING AND DRAINAGE
MATERIAL”

25.  Treated with barium sulphate
 Contain non-abrasive Vinyl plastic mono filament that can
be detected by x-rays

26. Absorb large
quantities of
fluids
Warmth
Protection

27. Also called abdominal packs and
Gauze mops

28. Used for:
 Obstetrical and gynecological purposes
 Greater fluid holding capacity
Available in Sterile & non-sterile packages

29.  Made up of non-woven fabrics and provides protection to
eyes.
 Sealed in individual sterile envelops.

30.  Used to apply medications & cleanse an area.

31. “BANDAGES”

32. Pressure Support Inelastic
Elastic Rigid

33. 1. Gauze roll
bandage
2. Muslin bandage
3. Elastic bandages
4. Orthopedic
bandages
5. Stockinett
bandages
6. Cast bandages

34. One
continuous
piece
Free
from
shedding
Tightly
rolled

35. Made of heavier
unbleached material
Used where gauze
bandage not provide
support
Hold bulky
compression dressing

36. Support,
pressure,
bandaging
injuries,
dressing
stability
Woven
elastic
bandage
High-
bulk
bandage
Crepe
bandage

37. Heavy
elastic
webbing
containing
rubber
thread
Special
weave
allow it to
stretch
twice its
length
Made of
multiple
layers at
crimped
cotton
gauze

38. Also called ESMARCH
BANDAGES
Corner to corner cutting of muslin
Used in first aid

39. FUNCTION
• Immobilization
• Support to
broken bones
MATERIAL
• Plaster of Paris
• Synthetic cast
material
• Plastic sheets
FABRICATING
MATERIAL
• Plaster that
firmly bound to
fiber
• Polyester
• Fiberglass
casting

40. Use prior to
application of
plaster of
Paris
Provides
comfortability
STOCKINETTE
Apply before
application of
cast
Absorbs
moisture and
allow skin to
breath
CAST
PADDING

41. “ADHESIVE TAPES”

42.  Medical adhesives
are widely used in
hospitals to secure
medical dressings,
life support
equipments, and
monitoring devices
onto skin, which
requires careful
consideration and
knowledge about
skin and adhesives.

43. NATURAL
SEMI SYNTHETIC
SYNTHETICS

44. NATURAL
Starch
Gelatin
Natural rubber
Resins
SYNTHETIC
Vinyl
Acrylics
Synthetic rubbers
Resins(aldehyde,
amine base,
epoxide etc )
SEMISYNTHETIC
Cellulosics
Cellulose nitrate
Methyl cellulose
etc

45. The characteristics of skin
composition, construction,
and function make the
adhesion to skin very
challenging

46. Skin is a self renewable and
replenishable surface.
Skin is a low surface tension
surface.
Skin is a rough surface with hair,
folds, pores for sweat and oil
glands, and wrinkles.

47. • Widely used in surgical dressings where reduced skin trauma is
required
• Non-woven or fabric backing is used due to hypoallergenic material
• Based on adhesion, cohesion and flow properties of monomers used
• Porous backing material used are RAYON TAFFETA CLOTH , well
suited for heavy dressings
• Paper backed is used for lighter dressings
• Others: cloth backing , elastic cloth or foam
• backing

48. WHY USE IN SURGERIES??
•Not affected by heat, light or air. Thus has
excellent shelf life
•Properly stick to skin (long term adhesion)
•Permeable to water vapor so are non-
occlusive
•Hypoallergenic
•Repeated use with minimal damage

49. Used where strength, adhesion,
support and economy is required
Cloth backed or plastic backed.
Composed of elastomer
(synthetic, natural)
Crepe rubbers (natural)
Isobutylene, alkylacrylate
(synthetic)

50. ADVANTAGES DISADVANTAGES

51. PHARMACIST’S
ROLE:
Advise on reactions caused by
tapes consisted of
heterogenous and complex
mixtures of organic
compounds
Erythema, edema, papules
can occur to patients so firstly
patch testing should be done.

52. “COMBINED PRIMARY-
SECONDARY WOUND
DRESSINGS”

53.  Also called
composite dressing.
 Have primary and
secondary
components.
 Degree of occlusion
depend upon
dressing type.

54. Bottom layer
Middle layer
Outermost
layer

55. USES OF
COMPOSITE
DRESSINGS
Simplicity
of use
Comfortabl
e
Inexpensiv
e

56. DRESSING TYPES
Hydrogels
Hydrocolloid
dressings
Calcium
alginate
dressings

57. These are
Cross linked
polymer
Ex: PVP.
Non-adherent
dressings.
Used as burn
treatment.
Useful in hairy
areas.
These are hydrophillic
colloid particles.
Fluid absorption
occurs.
Mass of these dressings
consists of gum-like
materials ex: pectin.
Bound by an adhesive
ex: poly isobutylene.
Useful for low to
moderate wounds.
Alginic acid is a
naturally occuring
polysaccharide.
Derived from brown
seaweeds.
Highly absorbent.
Used on moderate to
highly wound.
Used to pack
wounds.

58. INDICATION
• Necrotic wounds
• Painful wounds
ADVANTAGES
• Reduce wound
pain
• Non-adherent
DISADVANTAGES
• Macerate wound
skin
• Secured by a
secondary
dressing

59. FORMS OF
HYDROGEL
DRESSINGS
Amorphou
s hydrogel
Sheet
hydrogel
Im-
pregnated
hydrogel

60. INDICATION
• Necrotic wounds
• As Secondary
dressings
ADVANTAGES
• Self-adherent
• comfortable
DISADVANTAGES
• Bad odor
• Injured the fragile
skin

61. INDICATION
• For hemostasis
• Surgical incisions
ADVANTAGES
• Non-occlusive
• Reduced
Frequency of
dressing changes
DISADVANTAGES
• Distinctive odor
• Secondary dressing
needed

62. “PROTECTIVES”

63. A semi-permeable
dressing can
provide the
appropriate oxygen
tension for wound
repair to proceed
efficiently

64. Why protectives are used?
• Moisture suppresses
tissue desiccation and
decreases the amount
of lost dermis
To create
Moist
Environment
• Inert material that does
not shed fibers or
compounds into the
wound which may evoke
a foreign-body, irritant, or
allergic reaction
Ideal
Dressing
Composition

65. Hemostatic
products
Disposable
sterile packs
Face masks

66. Hemostatic are applications designed
to stem blood-flow through the
accelerated promotion of clotting.

67. TYPES OF
HEMOSTATIC
PRODUCTS
Mechanical
Chemical
Thermal

69. THERMAL
Monopolar
electro surgery
Bipolar
electro
surgery
sealing
technology
Bipolar
electro
surgery

70. CHEMICAL METHODS
Pharmacological
Agents
Topical hemostatic
agents
•Bovine Thrombin
•Epinephrine
•Protamine
•Vitamin K

71. • The packs and drape
sheets are made of
disposable fluid‐resistant
material, which acts as a
bacterial barrier against
microbial infiltration.

72. • These are available
where control
contamination is
required.
• These are
autoclaved.
• They have high
retention of
particulate matter.

73. “SUTURES,
LIGATURES &
THEIR MATERIALS”

74. SUTURE
A strand
used to hold
wound edges
with the help
of a needle
LIGATURE
Material,
without a
needle used to
stop bleeding
by tying off
severed blood
vessels

76. NEEDLES
Metals
Silver Copper Bronze
Bone
SUTURE
MATERIAL
Animal
Hair Arteries Muscles Tendons Nerves
Plant
Cotton Hemp

77. Proteolytic Enzymes are
responsible for their Digestion
and Disappearence from the
wound area.
Proteinaceous in
nature
Derived from
Collagen rich
animal tissues
2
3
1

78. ABSORBABLE
SUTURE
Surgical
Gut
Synthetic
Absorbable
Suture
Fascia Lata

80. The intestines from freshly killed sheep
are cleaned and split longitudinally into
ribbons.
The Submucosa is separated by
mechanical process (rich in Collagen)
From 1-5 such ribbons are stretched,
spun and dried under tension to form a
uniform strand.
These strands are polished and cut for
packaging and sterilization.
METHOD NO. 1:

81. METHOD NO.2:
Collagen derived from
Beef Tendon
The Tendons are then
dispersed
The dispersed
Collagen is extruded,
precipitated as
reconstituted as fine
strands
Then these strands
are twisted, stretched
and treated to give
absorbable sutures

82. PLAIN
SURGICAL
GUT
TREATED
SURGICAL
GUT

83. • They are made-up of Polymeric Polyesteres
• Have high Tensile strength
• Are packaged without fluid
• They are sterilized with ethylene oxide to avoid
degradation
• Suture is broken down by simple hydrolysis as it
resides in tissues

84.  Fascia lata is obtained from
OX fascia
 Used as a heavy suture or
repair like hernia
 Supplied in the form of sterile
strips ½ inches wide 8
inches long and also in
sheets about 3×5 inches

85. “NON-ABSORBABLE
SUTURES”

86. NON
ABSORBABLE
SUTURES
NATURAL
SILK
DERMAL SILK
SYNTHETIC
NYLON
POLYESTER
FIBER
POLYOLEFIN
FIBERS

88.  Consists chiefly of protein fibroin as extruded by the
silkworm.
 Used in eye & lip skin surgeries, intraoral surgeries,
vasectomy.

89.  Many fibers are twisted together into a single strand.
 Possesses firmness & strength.
 Braided silk is dyed & treated to make it non capillary.

90. Minimize the
rise of tissue
fluids to the
surface
Impart a degree
of stiffness
Minimize the
attachment of
tissue cells
Lubricate the
implantation &
removal of silk
suture

91. Natural twisted silk encased in an insoluble
coating of tanned gelatin or other protein.
This coating withstands autoclaving.
Prevents in-growth of tissue cells.

92.  Silk suture is a non-absorbable suture.
 Braided to improvise the knot security.
 Coloured black to have a very good visibility during
surgical procedures.
 Coated with bee’s wax for easy pull out suture.
 They are classified as non absorbable but they are
subjected to a slow (e.g., two year) process of proteolysis
absorption.

93. ADVANTAGE DISADVANTAGE

96. ADVANTAGES DISADVANTAGES

98. ADVANTAGES DISADVANTAGES

100. ADVANTAGES DISADVANTAGES
Slippery (requires 4
knot throws to hold)
High plasticity (loose
after wound edema
resolves)
Expensive
High tensile strength
Minimal tissue
reactivity
Slippery (allows for
easy removal from
tissues)

101.  Monofilament suture
 Improved pliability
 Fabricated from polytetrafluoroethylene.

102. “METALLIC SUTURES,
SURGICAL NEEDLES &
OTHER SUTURING
TECHNIQUES”

104. In the form of
wire or foil
Readily
available
Antiseptic
action
Irritation in
some tissues

105. Natural,
monofilament/mult
ifilament,
nonabsorbable.
Alloy of iron,
chromium and
nickel.
Good TS even in
infection.
Difficult to handle
and tendency to
cut through
tissues.
Very hard to tie
and knot ends
require special
handling.
Potential to
corrode or break at
points of twisting,
bending or
knoting.
Not to be use with
the prosthesis of
another alloy.
Used in abdominal
wall, sternum
closure, retention,
tendon repair etc..

106. More
traumatic.
Wide
opening of
tissues.
Eyed
Needles

107. Much less
traumatic.
More
expensive
suture
material.
Eyeless
Needles

108. SURGICAL
STAPLING
DEVICES
Used for skin closure.
Made up of S.S
Placed uniformly to span the
incision line
Minimal tissue reaction
Does not penetrate the skin 
Excellent cosmetic results.
Speed and efficacy
is more as
compared to
sutures
Advancement 
Introduction of
absorbable staples
(Lactomer)

109. Staple Staple Gun
Staple Remover

110.  LIGATING CLAMPS AND CLIPS
 V shaped steel, tantalum or tiatnium clips.
 Strips of fabric or plastic material coated with
suitable adhesive.
 Essentially “clips” to replace sutures when
occluding (closing) the lumen (central canal) of a
vessel or tubular organ: Blood vessels,
Gynecological & Urological (GU) procedures

111. Absorbable
material 
polydioxanone
and lactomer
Absorb after
their function
is completed
No
interference
with X-rays
and CAT scan

112. Speed
Convenience
Reduced infection rate
Lower cost
If done properly, no cosmetic
difference

113.  http://www.surgeryencyclopedia.com/St-Wr/Surgical-Instruments.html
 http://i01.i.aliimg.com/photo/v0/50008272673/Straight_forcep_handheld_hinged_instrument_used_for.j
pg_350x350.jpg
 https://heateliz.files.wordpress.com/2013/03/needle-driver-basic.jpg
 http://www.teleflex.com/en/usa/pdf/KMedic_Surgical_Instruments_101.pdf
 http://www.slideshare.net/DrAyeshaMaxfac/suture-materials-suturing-techniques-drayesha
 http://www.slideshare.net/UDDent/sutures-materials
 http://slideplayer.com/slide/4461792/
 http://www.pstc.org/files/public/Liu,%20Jacob2012.pdf
 http://nzic.org.nz/ChemProcesses/polymers/10H.pdf
 https://en.wikipedia.org/wiki/List_of_adhesive_tape
 http://www.fpnotebook.com/Surgery/Pharm/Prln1.m
 http://www.bioline.org.br/pdf?dv09140
 http://www.totalskinandbeauty.com/about-us-our-doctors-wound-closure-suture-technique.shtml
 http://www.fpnotebook.com/surgery/pharm/SlkStr.htm
 http://blog.wcei.net/tag/disadvantages-of-hydrocolloid-dressings/
 https://www.google.com.pk/search?q=impregnated+hydrogels&biw=1152&bih=725&source=lnms&tbm
=isch&sa=X&vd=0ahUKEwjgr9y8tJ7JAhXCMhoKHUPaD2MQ_AUIBigB#imgrc=Q5NRKmXMrHDaBM
%3A
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Hospital Pharmacy by Nadeem Irfan Bukhari