This document discusses the manufacturing, inspection, identification, and care of surgical instruments. It begins by outlining the objectives of reviewing instrument manufacturing processes and categories. It then describes the manufacturing steps including forging, grinding, heat treating, and passivation. It emphasizes the importance of Central Service Technicians and outlines proper procedures for instrument inspection, identification, lubrication, and tray assembly to maximize instrument lifespan.

1. Surgical
Instrumentation
Chapter 11

2. Objectives:
As a result of successfully completing this chapter, students
will be able to:
 Review the process by which surgical instruments are manufactured
 Define basic categories of surgical instruments based upon their
functions, and identify the points of inspection, anatomy (features) of,
and procedures to measure the following types of instruments:
 Hemostatic Forceps
 Needleholders
 Tissue Forceps
 Dressing Forceps
 Retractors
 Scissors
 Suction Devices
 Single and Double Action Rongeurs
 Kerrison/Laminectomy Rongeurs
 Nail Nippers
 Graves and Pederson Vaginal Speculums

3. Objectives:
 Identify solutions that can damage stainless steel instruments
 Explain procedures to test instruments for sharpness, and to
identify (mark) them
 Emphasize the importance of instrument lubrication, and
review tray assembly safeguards

4. Central Service Technicians…
 …are
responsible for
the quality of
instrument

5. Martensitic (400 Series)
Stainless Steel
 Hard, used when sharp cutting
edges are needed
 Often used for scissors,
osteotomes, chisels, hemostatic
forceps, and needleholders

6. Austenitic (300 Series)
Stainless Steel
 Highly Corrosion Resistant
 Not as hard as 400 Series
 Used for retractors, cannulas, rib
spreaders, suction devices

7. Instrument Manufacturing
 Forging
 Grinding and Milling
 Assembly
 Heat Tempering
 Polishing
 Passivation
 Final Inspection
 Etching
 Note:
Instruments are
inspected
throughout their
manufacturing
process

8. Passivation
A chemical process applied during
instrument manufacture that provides
a corrosion-resistant finish by forming
a thin transparent oxide film

9. Instrument Finishes
 The instrument on the
left has a matte, or
satin-finish
 The instrument on the
right has a shiny, or
mirror finish

10. Overview of
Surgical Instruments
 Pages 178 – 187
provide an overview
of basic surgical
instruments along
with tips and
techniques for
proper inspection

15. Post-Ooperative Care of
Surgical Instruments
 Keep instruments moist
 Transport to Central Service for
cleaning as soon as possible

16. Solutions that Damage Surgical
Instruments
 Saline
 Betadine
 Peroxide
 Dish Soaps
 Soaking in Water
 Soaking in Saline
 Bleach
 Iodine
 Hand Soaps
 Laundry Detergents
 Long-term Soaking in
Rust Remover
 Long-term Soaking in
Stain Remover
 Surgeon’s Hand Scrubs
 Household Lubricants
 Household Powder
Cleaners

17. Surgical Sharps
Testing

18. Scissors Guidelines
 NEVER use them
to cut other
products
 Protect Blades
 Test Between
Uses

19. Scissors Testing Material
 Use RED Test Material
for Scissors greater
than 4.5”
 Use Yellow Test for
Scissors smaller than
4”
 Use Single-Ply Facial
Tissue for
Laparoscopic Scissors

20. Bone Cutters
 Test with an Index
Card

21. Rongeur Testing
 Kerrison, Laminectomy
and Double Action
Rongeurs should be
tested using a 3” x 5”
index card
 Look for clean bites

22. Curettes, Chisels, and
Osteotomes
 Test each using a
plastic dowel rod
 Each should shave
off pieces of the rod

23. Instrument Identification
Procedures

24. Tape
 Clean hands thoroughly with alcohol to remove oils
and grease
 Wipe the part of the instrument where the tape will
be placed with alcohol
 Cut the tape at an angle
 Wrap the tape 1 to 1.5 times around the device
 Autoclave the instrument to allow the heat to help
bond the tape to the instrument

25. Acid Etching
Process that uses a stencil,
solution and electricity to
mark and instrument

26. Heat-fused Nylon
A process that leaves a thin
color-coded layer on nylon
on an instrument

27. Laser Etching
Permanent marking method
done by instrument
manufacturers and repair
vendors

28. Instrument Lubrication
 The use of a neutral pH lubricant extends the
life of instruments
 Use lubricants in according with instrument
manufacturers’ and the lubricant
manufacturer’s recommendations
 ALL Lubricants must be approved for use as
a surgical instrument lubricant

29. Tray Assembly Tips
 Place heavy instruments on the bottom or side of the tray
 Select an instrument tray that allows adequate space for weight
distribution
 Place all curved instruments in the same direction
 Nest Tissue and Dressing Forceps
 Protect Delicate Instruments
 Use Instrument Stringers (holders) to keep instruments open
and in place
 Avoid metal to metal contact between laser finish instruments