Surgical Instruments pptx - جراحة عملي

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Surgical Tools

Mohammad kadhim

Nasogastric Tube (Gastrocath)

Features:-
For nasogastric introduction of nutrition and aspiration of intestinal secretion
Closed distal end with radio-opaque material for accurate placement

Different size N-G tube

For neonatal and paediatric

Nutritional feeding
Infant N-G tube

N-G tube

Uses of N-G tube
Acute intestinal obstruction.
Acute peritonitis.
Gastric hemorrhage for instilling sclerosing agent or cold vasopressin drip.
For feeding and avoiding aspiration in comatose patient.
Following facio-maxillary surgery or injury.

Complications of N-G tube
Injury to the upper respiratory tract injury and bleeding.
Trauma to the pharynx and esophagus.
May be introduced to the trachea leading to aspiration pneumonia.
Obstruction to the stomach.
Kinking of the tube.
Damage to the mucosa.

I.V Canula

is used to give medical personnel access to a patient’s vein for the withdrawal of fluid
(blood) or insertion of medicine or other fluids.

The size depends on the color

Proper sites for insertion I.V canula

Central venous catheter

used to:
Give long-term medicine treatment for pain, infection, or cancer, or to supply nutrition.
Give medicines that affect the heart, especially if a quick response to the medicine is wanted.
Give large amounts of blood or fluid quickly.
Take frequent blood samples without having to "stick" someone with a needle.
To receive kidney dialysis if you have kidney failure.

Central venous catheter

Triple lumen
Double lumen
Single lumen

Indications of I.V canula
Giving blood and I.V fluid.
Administration of drugs.
Parenteral feeding.

Complications

Bleeding.
Infection.
Thrombophlebitis.
Air embolism.
Obstruction by clot.

Foley’s Catheter

Different size
Adult size
Pediatric size
balloon capacity:
30 ml
balloon capacity:
30 ml
(2-ways type)
1 for urine, 1 for
Inflation using
Normal saline
Self retaining catheter, can be left in place
For 2-3 days.
It is composed of the main channel for drainage
And side channel for infiltration connected to a bulb
Which can be inflated with saline or water.

Foley’s Catheter

(3-ways type)
1 for urine, 1 for inflation,
1 for drainage.
This catheter mainly used
After prostactomy.

malecot’s catheter
Self retaining catheter, made of rubber, the tip is bulbous & winged.
It is not used a urethral catheter.
Uses:-
• Suprapubic cystostomy drainage.
• Gastrostomies & cholecystostomies.
• For drainage of empyema.
• For relieving pneumothorax.
• For drainage of nephrostomy.

Malecot’s catheters

Plain catheter

Plain tube made of rubber.
The terminal end of the tube is blunt and rounded
(An urological catheter)

Plain catheter

Gibbon’s catheter

Urological catheter

Indications of foley’s catheter

To relieve acute or chronic urine retention.
To relieve clot retention.
In all pelvic and perineal operations for emptying the bladder.
To drain after prostatectomy or bladder operation.
Irrigation the bladder with antiseptic solution.

Contraindications of foley’s catheter

Local urethral sepsis.
Apply with pressure in urethral stricture.
Apply with pressure in urethral injury
Complications
Infection.
Urethral injury.
Urethral stricture may developed when the catheter introduce rapidly and forcefully.

Collecting bag

Collecting bag (urine bag)

Collecting bag connecting to Foley’s catheter

Under Water Seal Drain

underwater seal drain (UWSD) is the specialized drain, which
is attached to the chest tube

A chest drain is used to drain air, blood, fluid or pus from the pleural space

Under Water Seal Drain & Chest Tube

Proper site for insertion of chest tube

Under Water Seal Drain & Chest Tube

Face Mask

Features
Suitable for oxygen therapy
Swivel connector for patient comfort
Elongated facemask for long term use
Clear and soft mask for patient comfort
Adjustable elastic strip and integrated nose clip for proper positioning of mask
210 cm long star lumen tubing to ensure continuous flow of oxygen
Proximal end of tube is connected with funnel shape connector for easy connection with
Oxygen source.
(Oxygen Mask)

Face Mask

Nebulizer Mask

Specially designed nebulizer

Chamber.

Ambu-Bag

Is used to breathe for the baby if she/he
Is not breathing, is having difficulty breathing
Or when suction the baby.

Ambu-Bag

Infusion giving set

Blood bag

Blood bags

Blood giving set

Volumetric Drip Set

Used to calculate the amount of I.V
Fluid.

Volumetric Drip Set

Infusion set
Micro-drip set

Disposal Syringes

Disposal syringes

Insulin Syringe

Different types of I.V fluid

do not depend on the color, read the name on the bottle

5% Dextrose(glucose water)

Sterile water for injection

A drug in vial form with sterile water for injection

citoswab

For sample collection

One-Piece Colostomy Bag

Two-Piece Colostomy Bag+Skin Barrier

Colostomy bag with skin barrier

Standard & Extended Wear Skin Barrier (Flange)

For colostomy

Surgical tape

Zinc oxide blaster tape for dressing wound

Silk plaster tape

brown cotton medical bandage with plastic cover

Permeable Surgical Hydrocolloid Dressing Medical Surgical Tape For Wounds

Elastic bandage

A sterile adhesive bandage.

Gauze dressing

Paraffin gauze

Paraffin gauze is one of the simplest dressings for a burn

Gloves

Surgical protective mask

Surgical gowns

Penrose drain

(Corrugated drain)
It is an open drain which is made of soft latex rubber
Tubing and is used as a wick (drain pus, serum , blood,
Or other fluids from body cavity)

Penrose drain

Closed suction drain

Used to drain serous
Or bloody fluid from
Dissections sites or from
Around intraperitoneal
anastomosis.

Closed suction drain

Sump drain

Large caliber, multi- lumen tubes that provided for both
Continuous irrigation and aspiration.

Sump drain

Indications for drains
Drainage of pus
Remove transudate from a wound
To provide early warning of complications like
bleeding.
Irrigation of serous lined cavities & joint spaces
Life saving indications such as using the chest tube in tension pneumothorax.

Contraindications for drains

the peritoneal cavity is difficult or impossible
to drain so we put the drain on the localized area of surgery.
Pancreatitis.
Appendicitis.

Complications of drains

Allergic tissue reaction.
Trauma during insertion.
Soft tissue bleeding.
Infection.
Slipping of drain inside the wound or inside the abdomen.
Obstruction or kinking of the tube.
Herniation through the opening.
Failure to drain adequately.

T-tube

Indications
A-diagnostic;-
T-tube cholangiogram, a method by which a contrast medium is given by
The tube to the biliary system and then take x-ray film.
B-therapeutic:-
• Exploration of the common bile duct in dilation, stone, obstructive jaundice……
• Injury to the ureters.
• Injury to the fallopian tubes.
Complications:
• Infection.
• Hemorrhage.
• Slipping.
• Fibrosis & stricture.
• Adhesion.
• Ischemic necrosis.
• Kinked in common bile duct or in peritoneal cavity.

T-tube

Endotracheal tube

Advantages:-
• Provide patent airway.
• Can do suction through it.
• The cuff will prevent inhalation.
• We can do assisted ventilation.

Disadvantages:-

• Can not be kept more than 48 hours.
• May be blocked or irritated.
• Can not be kept in conscious patient.
• Pressure necrosis.
• Descending infection.
• Atelectasis.

Endotracheal tube

Tracheostomy tube

Indications:-
• upper airway obstruction.
• Decrease the dead space (from the nose to the trachea).
• Comatosed patient.
• Weak patient with collection of pus in the bronchial tree.
• Neurological problems that affect respiration.

Tracheostomy mask

Upper midline incision

Lower midline incision

Paramedian incision

Pfannensteil’s incision

used for caesarian section

Rutherford’s Morrison’s incision

Used for appendicular abscess
Hockey stick

Subcostal incision

(Kokher’s incision)
The right incision used for hepatobiliary surgery
While the lift one used for surgery of the stomach and spleen.

Muris incision

Used for renal surgery

Plain cat gut sutures

It is an absorbable monofilament suture which is indicated
For bowel anaestamosis and suturing the subcutaneous tissue.
(اصفر)

Chromic cat gut suture

(قهوائي)
Cat gut sutures are natural
Used in infection.

Polydiaxanon suture

It is an absorbable synthetic monofilament suture
Used in bowel anaestamosis.

Vicryl suture

(بنفسجي)
It is an absorbable synthetic multifilament suture
With good knotting, little tissue reaction and expensive.
Used in bowel anaestamosis as in incisional hernia.