Handle with care: The Intraoperative Microsurgical instruments edition

Microsurgical instruments are some of the most precise and fragile pieces of equipment used in the operating field. They’re highly specialised, incredibly delicate and let’s be honest, they demand a bit more attention than the average instrument!

Due to their unique design and critical role they play for microsurgical operations, proper handling and care is essential for maintaining them to function at their best. S&T Microsurgical instruments and clamps are all handmade with humans, rather than machine produced.

Here we will walk through the key instruments found in a microsurgical instrument tray along with some practical tips to help keep them in optimal condition ensuring a long lifespan.

Introduction to a microsurgery instrument tray

Microsurgical instruments work together to support precise, delicate surgery and each one plays an essential role. 

While these trays contain familiar favourites like needle holders, scissors, and forceps (just in smaller, finer forms), they also house specialised tools unique to the microsurgical field including vessel dilators, Acland microvascular clamps and clamp-applying forceps.

Basic Microsurgical instrument tray set-up:

• Needle holders
• Scissors
• Forceps
• Dilators
• Acland microvascular clamps
• Clamp applying forceps
  

Tips and tricks to help maintain your instruments

Here are some important intraoperative handling practices that help protect your microsurgical instruments from damage and ensure they remain reliable. 
With consistent, careful handling in the theatre, these tools will continue to perform at their best and remain dependable members of your microsurgical kit for years to come!

Handle with gentle movements and used for intended purpose

Microsurgical instruments have extremely small, fine tips (some as small as 0.1 mm!) that require very gentle handling.

• Removing and placing of instruments out of the tray with care to avoid any tapping or clashing on hard surfaces
• Pass them carefully and deliberately when they are required
• Never stack them with heavier instruments, let them have their own area
• Each instrument is designed for a specific purpose; using it for anything else may cause damage or lead to blunting.

Inspect instruments for any signs of damage before and after surgery

Perform quick visual checks of the instruments before, during and after the procedure to ensure they are functioning correctly. 
Things to look for:

• Straight, well-aligned tips
• Smooth, consistent movement of hinges or springs
• No bending, distortion or irregularity in the handles or tips

If anything appears off or shows signs of damage, set the instrument aside and have it assessed. Severely damaged instruments can be damaged beyond repair and will require replacement.

Give them a wipe a good, gentle wipe after use

After extensive use during a procedure, instruments will need a little TLC. To support the cleaning process and minimise damage, give each instrument a gentle wipe using microsurgical instrument wipes (if available) or damp gauze. This helps prevent blood and tissue from drying on the instruments, which can be difficult to remove later. Excessive cleaning in CSSD can lead to extensive damage occurring.

Give them a soft, safe workspace

When instruments are no longer needed during surgery, place them in a designated zone that protects delicate tips from accidental damage. Suitable options include:

• A silicone mat
• A lint-free towel
• Soft gauze to cushion and protect the instrument tips
•  A dedicated area of the trolley or even a mayo table
  

Microvascular Clamps: Small but Mighty

Microvascular clamps may be tiny, but their precision is no joke. Each one is handmade and carefully calibrated to distribute pressure evenly and protect the vessel, so they deserve extra care.

Always use clamp-applying forceps to pick up, place, and remove the clamps. This ensures the correct pressure is applied and helps prevent damages.

To keep them clean, wipe the inner surfaces to prevent blood or tissue from drying on the tips. Use microsurgical instrument wipes or damp gauze and pass it through the clamp (while holding it with forceps) to remove any residue. This aids the cleaning process within CSSD.

Keep you, your team and your microsurgical instruments happy 😊

Caring for microsurgical instruments isn’t just about looking after equipment - it’s about maintaining precision, supporting great patient outcomes, and making sure every tool in your microsurgical tray performs just as it should. We understand how mad surgeons can get if their tools are damaged!

With gentle handling, regular checks and appropriate cleaning, these delicate instruments will stay sharp, reliable and ready for the next procedure. A few small habits can make a big difference, helping your microsurgical set stay in great shape for years to come!