2. Comedone expressor
Parts:
a. Central handle
b. 2 hemispherical cups at either
ends with perforation in centre
and blunt margins
Expressor is sinous in shape to
facilitate better handling of the
instrument and aid effective
extraction of contents by
localizing the force/pressure
3. • Sterilization: Autoclave, hot air oven, 2% glutaraldehyde, boiling
• Uses : 1. To express open and closed comedones in acne
2. To express contents of nevus comedonicus, senile
comedones
• Method of use:
The central perforation of the cup fits over the plugged follicular ostia
of open comedone and pressure is applied perpendicularly over the
lesion. The contents of comedone collect in the cup of instrument. In
case of closed comedones, an artificial opening is made using a sterile
lancet or needle and then it is expressed as said above
4. Molluscum extractor
• Parts: Central handle
Round/oval shaped loop
at either end
• Variants
Fox curette (round cutting edge)
Piffard curette (oval cutting edge)
• Size : 1-10mm
Commonly used : 3-4mm
5. • Uses:
1. Extraction of molluscum contagiosum
2. Curettage of seborrheic keratosis, stucco keratosis, verruca plana,
actinic keratosis
6. Scoop
• Parts: Central Handle; oval,
spoon shaped, shallow pointed
expansion at either ends
• Sterilization: Autoclave, hot air
oven, 2% glutaraldehyde, boiling
• Uses:
1. To scoop out contents of cyst,
abscesses, ulcers
2. To scoop out the granulation
tissue in & around ingrown toe
8. • Needle as an extractor : Milia, Comedones, Molluscum contagiousum
• Needle as a cutting instrument:
1. Drainage of paronychial abscess/small abscess
2. Ear and nose piercing
3. Subcision of scar as in acne
4. Drainage of pustular lesion in acne
5. For hair transplantation
6. Seroma/Hematoma drainage in skin grafting
9. 7. Intradermal tests : Prick test, Mantoux test(tuberculosis), Pathergy
test (Behcet's disease, Pyoderma gangrenosum, Sweet's syndrome),
Kveim test(Sarcoidosis), Frei test(Lymphogranuloma venereum), Ito
Reenstierna test(Chancroid), Montenegro test(Leishmaniasis),
Histamine or pilocarpine test, ASST(Autoimmune urticaria)
8. Chemical cauterisation of xanthelasma
9. Blisters/Vesicles drainage
10. To transfer minigrafts in vitiligo surgery
11. Intralesional cryotherapy
12. Fine needle aspiration cytology
13. Intralesional injection : corticosteroids, 5 fluorouracil, bleomycin,
interferons, sodium stibogluconate
• Needle as a hook : Nerve biopsy, knot opening, suture cutting
11. • Sterilization:
1.Metal Punches - Autoclave, Hot air oven, 2% glutaraldehyde, boiling
2. Plastic - 2% glutaraldehyde
Uses :
1. For doing skin biopsy which has diagnostic, therapeutic( excisional
biopsy of small nevus, tiny solitary molluscum, pyogenic granuloma,
digitate wart) and prognostic implication
For cosmetic purpose upto size 3 punches are used on face
2. For punch grafting in localised stable vitiligo
3. Lipoma excision by narrow hole etrusion technique
4. For hair transplantation surgery
5. Acne surgeries-Punch excision, punch elevation, punch graft
6. Punch excision of small tattoo and melanocytic nevus
13. • Sterilisation : Autoclave, hot air oven, 2% glutaraldehyde, boiling
• Variants : Size no.3 accomodates blades of no. 10,11,12 and 15
Size no.4 accomodates blades of no. 20 to 25
Uses : The surgical blade is mounted onto the grooved tip of handle for
use in various procedures
15. • Sterilization : Presterilized by gamma irradiation
• Parts: Belly with one sharp edge and one blunt edge. The body has a
linear slot to fit it snugly into the groove at the tip of a Bard-Parker
handle
SIZE OF BLADE SHAPE USES
11G Triangular with narrow tip For stab incision
15G Small with round belly -Slit skin smear in leprosy,
leishmaniasis
-For incision over areas with
thin skin eg Eyelids, face
20-24G Long with round belly -Incision and excision
-Prepar Tzanck smear
-Smear from molluscum
contagiosum, paring of
wart,corn
16. Forceps
• Parts : Forceps are V shaped metallic instruments with two
blades/arms, which are fused together at one end and free at the
other to clasp tissues. The free tips may be serrated, plain or toothed.
Serrated and toothed forceps aid better grip
• Sterilization: Autoclave, hot air oven, 2% glutaraldehyde, boiling
17. Plain forceps
• Less traumatic and used to hold
delicate structures like nerve or
biopsy tissue
18. Adson forceps
• Have wider blades with long
tapered ends bearing small
teeth and relatively less
traumatic. They can be used
for holding skin except
eyelids, suture removal and
punch graft of skin
19. Iris Forceps
• They have a plain tip with a lock
in the upper part of the
instrument. They have a narrow
blade with more gradual taper
than the Adsons forceps and are
used in miniature punch graft,
acne surgeries
20. Jewellers forceps
• They have elongated plain
handles which rapidly tapers to a
fine tip. They can be curved or
straight
• Used for atraumatic handling of
skin grafts, hair transplant,
suture removal and clasping
small bleeders during
electrocoagulation
22. Allis forceps
• Parts: Interdigitating tips for
better grip, which is aided and
secured by the lock present at the
upper end of the instrument. The
two prongs of the instrument are
riveted at the distal end and acts
as a fulcrum
• Uses: Corn enucleation, cyst
excision
23. Cheatles forceps
• Parts: L-shaped forcep without teeth or lock. Distal part is sinous and
always placed immersed in antiseptic solution
• Uses: to handle instruments, dressing materials
24. Artery Forceps
• Parts: Possess blunt, tapering
tips with serration for better grip
• Variants: Straight, curved.
Smallest are called mosquito
forceps
25. • Uses
Catch the bleeders
Hold the free end of suture
Blunt dissection of lipoma, cyst
Crushing pedicle of pedunculated neoplasm e.g. acrochordon
For removal of nail plate during partial nail avulsion
For three point traction during circumcision
To pluck hairs for trichogram
26. Sponge holding forceps
• Tips of these forceps are
fenestrated and serrated to aid
grasping cotton swab during
preoperative antiseptic
preparation of operative area
27. Needle holder
• Parts: tips can be
either smooth or
serrated and
provided with a
groove. Lock is
present in the
proximal part which
aids in grasping
needle
28. Iris Scissor
• These have long rivet-to-tip
ditance and a short shank with a
sharp tip. They can be straight or
curved. One of the blades can be
serrated to improve tissue grip
while cutting. They are used in
fine dissection; the serrated
variant is helpful during
procedures with thin skin
29. Castroviejo iris scissors
• Delicate scissor with small
cutting tips that can be straight
or curved. Used in surgeries
involving mucosa, areas with
thin skin e.g eyelids, harvesting
suction blister grafts
30. Straight scissors/Dressing scissors
• Used to cut dressing or suture. This has a thick blunt blade that is
introduced beneath the dressing and protects skin from injury and sharp
blade, which cuts the dressing
31. Curved scissors
• These are sharp curved used for cutting and curves aid negotiation
through difficult to access areas during deeper dissection
33. • Sterilization: Autoclave, hot air oven, 2% glutaraldehyde, boiling
• Variants : Fraizer(single hook)
Cottle(bipronged hook)
Rakes(multi-pronged hook)
These causes minimal trauma to delicate skin margins during suturing
and handling of tissues and hence preffered to forceps
Uses
• Hold skin margins during suturing especially when handling thin skin
e.g eyelids
• Retract skin margins during deeper dissections and undermining
• Hold vital structures like nerve during biopsy
• Rakes are used for retracting large wound areas
34. Nail nipper/Nail splitter
• Parts: Handle with stout, sharp
cutting edges
• Uses: cutting of nail plate during
partial nail avulsion
35. Nail spatula
• Parts: Central handle, flat
rectangular curved plates on
either ends
• Uses:
1. Separation of nail plate from
nail bed and proimal nail fold
2. Separation of dressing from the
skin or punch graft
37. • Parts: Consists of two arms attached at one end and free at other
end; screw to approximate the clamp and retain in that position; free
end are expanded and perforated with a large flat, thin rim
• Uses
1. Mucocele excision
2. As hemostat during excision of lip pyogenic granuloma or any
neoplasm
3. To prevent excess bleeding during tongue biopsy
38. Dermabrader
• Parts: Handle with or without
thumb rest, slightly curved
expanded rectangular tip with
sharp teeth arranged in
rectangular rows and columns
along conve surface of tip
39. • Uses
1. In Vitiligo - Dermabrasion of recipients are during suction blisters or
split skin grafting and to stimulate melanocyte proliferation and
migration
2. Dermabrasion of lichen amyloidosis, lichen simplex chronicus
3. Spot dermabrasion of acne scars
4. Full face dermabration for facial rejuvenation
5. Debulking of rhinopyma
6. Treatment of multiple adenoma sebaceum
7. Tattoo removal
8. Freshen the surface during ear lobe repair
40. Sim's anterior vaginal wall retractor
• Parts: central elongated metal
arm with expanded, oval,
fenestrated ends that make an
angle with the body of
instrument. Expanded ends have
serration for better grip
• Used along with Sim's speculum
for visualization of cervix and
fornix
41. Sim's speculum
• Smooth curved plate
with central depression
facilitates visualization
of cervi and posterior
fornix and aids
collection of vaginal
discharge from
posterior fornix
43. • Cusco's speculum is used for introducing an intrauterine
contraceptive device, taking a Pap smear, cauterization of
vaginal erosion and for colposcopic examination.
• It is preferred in cryosurgery because it protects the anterior
and posterior vaginal wall.
• The advantage of Cusco's speculum is that it is self-retaining.
• Therefore, an assistant's help is not needed to keep the
speculum in place. It also acts as the vaginal wall retractor.
• However, it reduces the space in the vaginal cavity and
therefore is not a preferred instrument for vaginal surgery.
• Since it covers most of the vaginal wall, small lesions on the
vaginal wall may be masked by the blades of the device
44. Humby's knife
• Parts: Handle at one end and a flat , long metallic blade with
adjustable screws and roller at other end. Screws facilitate
adjustment of thickness of skin graft and roller flattens the skin
surface before cutting the skin
45. Liposuction cannula
All liposuction cannulas have basically the same structure:
Distal Tip: This is the front part of the cannula that enters the skin and fat. It
will have one or more openings, which the fat will enter to be removed.
Hollow Metal Tube: This is the channel through which fat travels from the
body into the collection receptacle. The diameter of a cannula refers to the
width of the tube, while the length is a measurement of the cannula from end
to end. Shorter cannulas are used for areas such as the face, while longer
cannulas are used for procedures such as back liposuction and outer thigh
liposuction.
Proximal End. This is the back part that is attached to a syringe or suction
device, allowing the cannula to pull fat from the body.
