Based on the experience of some colleagues and personal preference, we have compiled a basic package with which one will be sufficiently prepared to perform minor surgical interventions [Figure 1].
Figure 1
Two complete sets of this basic package should be procured.
- 1 blade handle no. 3.
- 1 blade no. 10 or 15 (rounded form to allow good incisions).
- 1 needle holder.
- 1 pair of fine surgical tweezers (with sharp teeth).
- 1 pair of fine anatomical tweezers (without teeth).
- 1 pair of splinter tweezers.
- 1 pair of surgical scissors.
- 1 pair of bent dissecting scissors.
- 2 mosquito forceps.
- 1 pair of Kocher forceps.
- 2 three-pronged retractors.
- 1 curette (sharp surgical spoon) with an oval bowl (00, 0, or 1).
- 1 suture-removing knife.
- Atraumatic suture material.
- Gauze.
- Sterile tray in which NaCl can be poured to cleanse the wound.
Some of these instruments are discussed below.
Blade Handle
Number 3 has a small connecting piece that is suitable for blade numbers 10 and 15.
Needle Holder
The needle holder should have a lock that keeps the needle firmly in place. Some prefer the Gillies needle holder, which can also act as scissors. The disadvantage of this instrument is the lack of a lock, which makes the needle unstable. For all types of needle holder, the construction of the jaws is very important. Some jaws will not hold thin needles and sutures (5 x 0) firmly. This function should be tested when purchasing a needle holder.
Tweezers
Surgical tweezers are the tool most often used in minor surgery. They can be used to clasp the sides of a wound or skin lesions that will be removed. Anatomical tweezers can be used to grasp sutures when removing stitches.
Scissors
Surgical scissors are used to cut coarse materials (sutures, gauze, bandages). Dissecting scissors, due to their bent shape, are primarily suitable for removing a tumour, whereby the tissue surrounding the tumour must be excised. Because dissecting scissors have blunt ends, they can be used for gross dissection by inserting the closed scissors into tissue and then opening them.
Mosquito Forceps
Mosquito forceps are small clamps with a clasp and small teeth. They are used primarily to clamp blood vessels or to grasp material that will be removed (e.g. an keratinous cyst).
Kocher Forceps
These pointed forceps are used to handle coarse materials (preferably not tissue, which can be damaged by the sharp points). They are sometimes useful when removing a foreign object or holding a gauze swab in place.
Retractors
Of the diverse types and sizes of retractors available, the most practical and least damaging to tissue are small retractors with two teeth. Use of retractors requires assistance; in the absence of assistance, good results can be achieved with a wound spreader.
Curette
For wart removal, a curette with an oval bowl has the advantage of allowing for working on multiple planes. The bowl of the curette should not be greater than the skin lesion to be removed. A curette must be sharpened routinely by the instrument dealer.
When procuring your surgical instruments, you should not hesitate to buy high quality instruments. When purchasing, it is important to select the correct size with regard to length and, for example, the openings for scissors and forceps.