Comm Eye Health Vol. 16 No. 48 2003 pp 56 - 57. Published online 01 December 2003.

Care of ophthalmic surgical instruments

Sue Stevens

Ophthalmic Resource Coordinator/Nurse Advisor, IRC/ICEH, LSHTM, Keppel Street, London WC1E 7HT


Ingrid Cox

Training Advisor, CBM International, P.O. Box 58004, City Square 00200, Nairobi, Kenya

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Handling and Safety

Sharps

  • Protect the tips of all sharp instruments with silicone or rubber tubing.
  • Intravenous infusion tubing or tubing from “butterfly” intravenous needles may be used.
Sharps. © Ingrid & Maxine Cox
Sharps. © Ingrid & Maxine Cox

Needles

  • Discard used needles immediately after use.
  • Place in a receptacle used only for this purpose.
  • Do not over-fill.
  • Preferably use small receptacles and dispose of them daily.
  • Seal and incinerate the receptacle when almost full.
Needles. © Ingrid & Maxine Cox
Needles. © Ingrid & Maxine Cox

Remember!

  • Never re-sheath a disposable needle
  • Always use artery forceps to remove a blade from a Bard Parker handle
  • Provide a gallipot on the theatre trolley to collect used needles and blades
  • Do not touch the tips of any instrument
  • Never throw an instrument

Maintenance

Cleaning

  • Use a soft toothbrush and hot soapy water to thoroughly clean each instrument, individually, in its open position.
Cleaning. © Ingrid & Maxine Cox
Cleaning. © Ingrid & Maxine Cox

Lubricating

  • Use a lubricant immediately after cleaning hinged instruments to prevent stiff joints and inhibit rusting. Dip the instruments only and then rinse, but do not leave to soak. Down’s Surgical Instrument Lube or Dixey’s Surgi-Slip are recommended.
Lubricating. © Ingrid & Maxine Cox
Lubricating. © Ingrid & Maxine Cox

Drying

  • Instruments must be dried thoroughly before storing. Dry gauze (used cautiously), or a hairdryer may be used.
Drying. © Ingrid & Maxine Cox
Drying. © Ingrid & Maxine Cox
Drying. © Ingrid & Maxine Cox
Drying. © Ingrid & Maxine Cox

Oiling

  • Stored hinged instruments need oiling weekly. Use a 2 ml syringe and 21G needle to draw up the oil and a 25G needle to apply the oil to the joints. Surplus oil should be wiped off carefully with gauze. Ordinary sewing machine oil is recommended.
Oiling. © Ingrid & Maxine Cox
Oiling. © Ingrid & Maxine Cox

Inspection

  • Inspect instruments for alignment and sharpness under a good light and magnification. Check the lumen is patent (not blocked) by flushing through with clean hot water.
Inspection. © Ingrid & Maxine Cox
Inspection. © Ingrid & Maxine Cox
Inspection. © Ingrid & Maxine Cox
Inspection. © Ingrid & Maxine Cox

Storage, Transportation and Security

Silicone or rubber protectors must be used on sharp instruments when in storage or transit. Shelves

  • Glass shelves, in a lockable cupboard, provide for secure storage and checking. Never pile instruments on top of each other. A well ventilated room is recommended.
Shelves. © Ingrid & Maxine Cox
Shelves. © Ingrid & Maxine Cox

Trays

  • Individual slots in the tray hold a single instrument. Instruments must not touch each other. The tray can be used for storage, transportation and during sterilization procedures.
Trays. © Ingrid & Maxine Cox
Trays. © Ingrid & Maxine Cox

Cases

  • Cases may be metal or plastic and contain a protective silicone mat. The case can be used for storage, transportation and during sterilization procedures.
Cases. © Ingrid & Maxine Cox
Cases. © Ingrid & Maxine Cox

Rolls

  • Rolls, made of strong fabric, are inexpensive. Each pocket holds a single instrument. Secure the roll with ribbon or cord – not elastic. Use rolls for instrument storage and transportation only.
Rolls. © Ingrid & Maxine Cox
Rolls. © Ingrid & Maxine Cox