Hemostatic forceps are surgical instruments that can block blood by clamping blood vessels.It is a surgical instrument that rescues the patient in the case of bleeding, takes the hemostatic medicine, and clamps the major arteries of blood vessels with hemostatic forceps to prevent blood from flowing out.
The use principle of hemostatic forceps is to clamp blood vessels or fur like clamps, but they are sterilized.The hemostatic forceps can be large, small, toothed, toothless, straight or curved. Different types of hemostatic forceps are selected according to different operating parts.The teeth beside the handle of the hemostatic forceps help to fix the hemostatic forceps when clamping objects to prevent falling off.
The hemostatic forceps have different shapes and lengths to fit differentoperationAnd parts.In addition to straight and curved hemostatic forceps, there are also toothed vascular forceps, toothless hemostatic forceps, mosquito type straight and curved hemostatic forceps. The main structural difference of hemostatic forceps is the alveolar bed. Due to the needs of surgical operation, the alveolar bed is divided into straight, curved, right angle, arc, etc.When used for hemostasis, the tip should be perpendicular to the tissue, clamp the broken end of the bleeding blood vessel, and clamp as few nearby tissues as possible.
1. Non invasive hemostatic forceps: mainly used forblood vesselThe surgical hemostatic forceps have thin, shallow teeth and good elasticity, which have less pressure on the tissue and damage to the vascular wall and intima. Because the front end of the forceps is smooth, it is easy to insert into the fascia and not easy to puncture the vein, which can be used to separate anatomical tissues, but also can be used to draw sutures, pull out needles, or replace forceps, but it is not suitable to clamp the skinOrgans and fragile tissues.
2. Curved hemostatic forceps and toothed hemostatic forceps: as shown in Figure 1, the tip of curved hemostatic forceps is bent for separation and clampingorganizationOr blood vessel hemostasis, and assistancesutureIt is mainly used for hemostasis of deep tissues or viscera in surgery. Toothed hemostatic forceps are mainly used for hemostasis of strong and tough tissues, lifting the part of the incision, etc., to clamp blood vessels in thicker tissues and tissues prone to slipping, such as mesentery, greater omentum, etc. The front teeth can prevent slipping, but cannot be used for subcutaneous hemostasis, and should not be clampedblood vessel、nerveAnd other organizations.
Figure 1 Curved hemostatic forceps
3. Straight hemostatic forceps and toothless hemostatic forceps: as shown in Figure 2, they are used for hemostasis of subcutaneous tissue, mainly for superficial hemostasis and tissue separation at the surgical site.
Figure 2 Straight hemostatic forceps
4. Right angle pliers: as shown in Figure 3, used to free blood vessels, nervesureter、Biliary tractAnd the guidance of traction objects.
Fig. 3 Right angle pliers
5. Mosquito hemostatic forceps: as shown in Figure 4, they are small and suitable for separating small blood vessels and peripheral nervesconnective tissueIt is used for hemostasis of small blood vessels and is not suitable for clamping large or hard tissues.It is convenient to go deep into the treatment site to clamp articles or tissues when the external opening of the organ or the wound is small. The hemostatic forceps with elbows can clamp the surrounding tissues on the side.
4 Mosquito hemostatic forceps
Usage of hemostatic forceps
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The correct method of holding the scissors is shown in Figure 5. The thumb and the fourth finger are respectively inserted into the two rings of the handle of the hemostatic forceps. The middle finger is placed on the handle of the hemostatic forceps of the fourth ring, and the index finger is pressed on the shaft joint to stabilize and guide the operation.After use, when releasing the hemostatic forceps, hold one ring opening of the vascular forceps with your thumb and index finger, block the other ring opening with your middle finger and ring finger, and gently force your thumb and ring finger against each other.
Figure 5-1 Correct clamp holding method
Figure 5-2 Correct clamp holding method
Precautions for use of hemostatic forceps
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1. The hemostatic forceps shall not clamp the skin, intestines, etc. to avoid tissue necrosis.
2. When stopping bleeding, only one or two teeth should be buckled. Check whether the latch is out of order. Sometimes the clamp handle will automatically loosen, causing bleeding. Be alert.
3. Before use, check whether the two front transverse alveolar pages are anastomosed, and do not use them if they are not anastomosed, to prevent slipping of the tissue clamped by the vascular clamp.
4. During the operation, clamp the possible bleeding parts or the visible bleeding points first. When clamping the bleeding points, it is required to be accurate, and it is best to succeed at one time. Do not bring too much healthy tissue. The thickness of the ligation line should be selected according to the number of clamp tissues and the thickness of the blood vessels. When the blood vessels are thick, separate free ligation should be performed.
5. During ligation, the clamp tip of the upper vascular clamp must be rotated and put out. The ligature must completely cover the ligated tissue. When tightening the first knot, put down the raised vascular clamp and slowly loosen it. When the first knot is completely tightened, loosen the clamp and remove it.
Cleaning of hemostatic forceps
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After the operation, metal instruments such as hemostatic forceps used in the operation are difficult to clean, especially when the blood on the instrument is dry. Therefore, a piece of gauze poured with liquid paraffin can be used to wipe the metal instruments with blood stains, especially the joints of various instruments and the teeth of various forceps, and then gently brush them with a brush,Finally, dry it with clean gauze, and then follow the routineDisinfectionSterilization.Liquid paraffin has good oil solubility. After operation, the blood stains on the metal instruments are lubricated with liquid paraffin gauze, which is not only easy to clean, but also makes the sterilized metal instruments bright and the joints lubricated[1]。
Extended Reading
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[1] Wang Yanhui, Chen Zhuoyue, Wang Liping, etcAnalysis of fracture causes of 2Cr13 stainless steel hemostatic forceps [J]Physical and Chemical Inspection (Physical Volume), 2016, v.52 (01): 74-76
[2] Chen Xiuli, Lv Jian, Deng Xiaodong, etc. Improvement of rust removal method for joints of batch reused hemostatic forceps [J]. Chinese Journal of Nursing, 2014, 49 (07): 892-893
