آشنایی با ابزار جراحی
انجام عمل جراحی بدون استفاده از ابزار جرحی تقریباً ناممکن است. ابزار جراحی فراوانی وجود دارد که عمومی ترین آنها عبارتند از:
ابزارهای برش:
جهت بریدن و پاره کردن بافتها یا وسایلتیغهای جراحی(اسکالپل): پس از نصب روی دسته مخصوص جهت بریدن بافت
قیچی ها:
انواع مختلف جهت بریدن بافت نرم،سخت و نخ و.. وجود داردقیچی های رایج بافتی: متزنبام، مایو
قیچی بانداژ،قیچی نخ، سیم بر،
وسایلنگهدارنده:
جهتنگهداشتنبافتویااشیاءکاربردداشتهومتنوعترینوسایلجراحیاندانواعمعمولورایج:
· پنست ها: برای گرفتن بافت هنگام بخیه کردن
· با دندانه: بافت سخت (پوست ، فاسیا)
· بدون دندانه: بافت نرم (پریتوئن، چربی)
· پنسها (فورسپسها):
· پنس آلیس: گرفتن بافتهای نرم بدن ایجاد آسیب
· پنس ببکاک: گرفتن اندامهای لوله ای شکل(حالب، لوله رحمی)
· هموستات: گرفتن عروق خونی
· تناکولوم : در جراحی زنان برای گرفتن جسم رحم مورد استفاده قرار می گیرد .
· کوخر: گرفتن بافت سخت (مانند هموستات ولی دندانه دار)
· سایر پنسها:سوزنگیر،شانگیر،اسپانج فورسپس و…
ابزارهای نمایانگر: (رتراکتورها )
برای اکسپوز محیط عمل و ایجاد دید بهتر برای جراح استفاده می شود و انواع خودکار و دستی دارد مانند:
پارابوف
هوکها، شن کش
چنگکی
بالفور و…
روشهای استریلیزاسیون و اصول ضد عفونی
نحوه نگهداری ابزار جراحی
چندنکته طلائی نحوه نگهداری ابزار جراحیابزارهای جراحی بنا به تنوع و تفاوتهای موجود در آنها و میزان کاربرد، در بخشهای مختلف پزشکی از اهمیت بسیاری برخوردار است. خرید ابزارهای جراحی قسمت مهمی از هزینههای بخشهای پزشکی را تشکیل میدهد و نحوه خرید و انتخاب این ابزارها، نگهداری و آماده سازی آنها به روش صحیح میتواند منجر به کاهش استهلاک و افزایش عمر آنها و در نهایت موجب صرفهجویی در هزینههای پزشکی شود. امروزه ابزارهای جراحی تقریباً منحصراً از فولاد ضدزنگ ویژه ساخته میشود. انواع این فولادها براساس قواعد ملی و بینالمللی مانند ISO وDIN مشخصههای ویژه و نیازهای وسایل جراحی با معیارهای کاملاً متفاوتی ساخته میشود و به طور کلی نوع فولاد مورد استفاده بستگی به نوع کاربرد ابزارها دارد.آشنایی با مواد و خصوصیات آنها و چگونگی نگهداری و کاربرد و آماده سازی ابزارهای جراحی در افزایش عمر مفید آنها بسیار موثر است. در این مقاله ضمن مرور تعاریف تمیزکردن وضدعفونی واستریل ابزاربه نکات ضروری و مهم در این خصوص اشاره میشود
تعاریف
1- تمیزکردن: این عمل موجب از بین رفتن تعداد زیادی از میکروارگانیسمها میشود و به منظور پاک نمودن خون و ترشحات بدن از روی وسیله قبل از ضدعفونی یا استریل کردن ضروری است.
2- ضدعفونی: طی این فرآیند مقادیر متنابهی از میکروارگانیسمهای بدون اسپور از جمله ویروسها از نظر کمی کاهش یافته و تعداد آنها به سطح ایمنی خواهد رسیدضدعفونی به سه روش انجام میگیرد:
الف) بخار با درجه حرارت پایین(با استفاده یا بدون استفاده از فرمالویید)
ب) جوشانیدن
ج) روشهای شیمیایی.
3– استریل کردن: طی این عمل کلیه میکرو ارگانیسمهای زنده از جمله ویروسها و اسپورها از بین میرود.
نکات ضروری جهت تمیز کردن و ضدعفونی کردن ابزار
لازم است وسایل پس از استفاده در اسرع وقت تمیز و ضدعفونی شود. پسماندهها نباید روی وسایل باقی بماند تا خشک شود ابزار هرگز نباید در محلولهای نمک فیزیولوژی فرو برده شود زیرا به مرور زمان سوراخ و خوردگی در آنها ایجاد خواهد شد.پس از شستشو و تمیزکاری، وسایل باید با چشم غیرمسلح تمیز باشد یعنی عاری از هر پسمانده پروتئین و سایر آلودگیها گردد. وسایل داندانهدار و مفصلدار روغنکاری شود، همچنین وسایلی که خورده شده است باید فوراً دورانداخته شود تا از خوردگی تماسی سایر وسایل جراحی پیشگیری شود. هنگام شستشو با آب آشامیدنی، وجود املاح و مواد مختلف مانند کلر (با توجه به غلظت آن) باعث آسیب دیدن وسایل جراحی در طی مراحل تمیز کردن میشود. جهت جلوگیری از خوردگی، توصیه میشود از آب مقطر استفاده شود. وجود لکهها برروی ابزار جراحی پس از آبکشی، وجود املاح در آب مصرفی را نشان میدهد. از مواد ضدعفونی کننده مناسب جهت تمیز کردن ابزارها استفاده شود که این محلولها نباید بالاتر از دمای اتاق گرم شود هم چنین این محلولها باید به میزان مصرف روزانه تهیه شود.
باید توجه داشت هرگونه تماس ابزار جراحی با محلولهای آلکانیلی یا اسیدی خواص محافظتی سطوح ابزار را از بین برده به نحوی که در اکثر موارد منجر به خوردگی، شکستگی و ایجاد خلل و خرج در سطوح ابزار میشود. در این خصوص، ترکیبات خاصی موجب خوردگی سطح استیل میگردد که حتی با وجود خواص محافظتی سطح استیل، خسارت جدی به آن وارد میسازد. اگر ابزاری به صورت تصادفی درمعرض یکی ازمواد زیرقرارگیرد بایدسریعاً آن را شستوشو داد. هم چنین بهتر است که ابزارها جراحی در معرض مواد زیر قرار بگیرد:
شستوشو و ضد عفونی
1- شستوشوی دستی
نکته: هنگام شستشو و پاکسازی دستی ابزار جراحی لازم است با استفاده از پارچهای نرم آغشته به محلول ضدعفونی، کاملاً سطح ابزار را شسته یا آنها را در یک محلول ترکیبی پاک و ضدعفونی کننده فرو برده شدهسپس با برس نرم کاملاً میان آجها و دندههای ابزار را پاکسازی گردد.
2- شستوشو و ضد عفونی با ماشین
شستشو وضد عفونی از طریق ماشین به دو روش انجام میشود:
ا- فرآیند حرارتی که وسایل در حرارت بیش از 80 درجه ضدعفونی و شستشو میگردد در این روش وسایل در دو مرحله با استفاده از آب گرم یا سرد شستشو میشود و در مرحله سوم در درجه حرارت 93-80 در مدت زمان مناسب ضدعفونی میگردد.
2- فرآیند CHemothermal که وسایل در دمای حداکثر 60 درجه و با یک ماده ضدعفونی کننده مخصوص ماشین ضدعفونی میگردد در هر دو روش وسایل با خشک شود.در تمیزکاری با استفاده از ماشین باید تمام رسوبها به طور اطمینان بخشی در مرحله آبکشی خارج شود در غیر این صورت بر روی وسایل لکه باقی مانده یا تغییر رنگ ایجاد میشود.
3- روش التراسونیک شستشو با دستگاه التراسونیک برای تمیز نمودن وسایل فولادی مناسب است و بیشتر در موارد زیر مورد استفاده قرار میگیرد:
– به عنوان یک روش موثر به فرآیند پاکسازی دستی کمک مینماید،
– جهت از بین بردن قشرهای چسبیده قبل یا پس از پاکسازی با ماشین و
– قطعات Option با طراحیهای خاص و چندحفرهای.
برای تمیز کردن با دستگاه التراسونیک، وسایل جراحی در سبدهای مخصوص باید بهصورت باز باشد. دمای محلول شوینده باید بین 40 تا 45 درجه سانتیگراد باشد. اگر این دما کم شود، تأثیر آب تضمین نمیشود و اگر از این دما بیشتر شود، پروتئینها ممکن است لخته شود. اصولاً وسایل تمیز شده با این روش باید بعداً بهطور کامل به وسیله ماشین یا دستی آبکشی شده و بلافاصله بهطور مناسب خشک شود.
نکته 1) هنگام تمیزکاری و شستشو به هیچ وجه از برس سیمی یا پاک کننده هایی که دارای خواص سایندگی است، استفاده نکنید.
نکته 2)اگر ابزاری به خون آغشته شود، ضروری است قبل از خشک شدن، بهوسیله آب شسته شود. توجه به این نکته ضروری است که خون و خونابه به تنهایی لکههایی را بر روی ابزار ایجاد مینماید که بهسختی از بین میرود. بنابراین ضروری است ابزارها را پس از استفاده به صورت نمناک نگهداری نمود. برای این منظور از یک وان آب مقطر استریل یا حوله نمناک استفاده میشود.
نکته 3) حتیالامکان جهت شستشو از محلولهایی که حاوی PH نزدیک 7 (خنثی) باشد استفاده نمایید. در این خصوص استفاده از آب مقطر مطلوبترین روش است. مواد موجود در آب معمولی به خودی خود لکههایی را روی ابزار ایجاد مینماید که این لکهها وقتی با مواد عفونت زدا مخلوط شود و باعث ایجاد نخاله روی ابزارمی شود که به سادگی از بین نخواهد رفت.
نکته 4) رعایت اصول کامل شستشو و پاکسازی ابزار جراحی در اولین استرلیزاسیون، بسیار حائز اهمیت است. در این مرحله لازم است با استفاده از پارچهای نرم آغشته به محلول ضدعفونی، سطح ابزار را کاملاً شسته سپس با برسی نرم میان آجها و دندههای ابزار را پاکسازی نمود بهگونهای که لک و چربی خشکیده حاصل از گرد و غبار هوا به طور کامل از سطوح صاف و آجدار ابزار زدوده شود.
جلوگیری از خوردگی
– لکههای قهوهای تیره و قهوهای مایل به زرد روی اقلام فلزی استریل شده که معمولاً در جاهای غیرقابل دسترسی مشاهده میشوند، غالباً با زنگ زدگی اشتباه میگردد. چنین لکههایی بر اثر باقی ماندن کلر زیاد بر روی وسایل به وجود میآید و اگر این لکهها به سرعت از بین نرود باعث ایجاد خوردگی میشود.
– لکههای آبی معمولاً در لبههای تیز وسایل دیده میشود و در اثر غلظت و مواد آلی زیاد، آبی است که برای شستشو یا استریل کردن (توسط بخار آب) مورد استفاده قرار میگیرد، ایجاد میشود. برای جلوگیری از ایجاد این چنین لکهها باید از آب بدون املاح استفاده استفاده کرد.
– وسایل تنها در صورتی دچار خوردگی میشود که با آب یا محلولهای آبدار در تماس باشد و عمدتاً سوراخ شدنها بر اثر کلر بهوجود میآید. خوردگی منجر به سوراخ شدن، بهصورت فرورفتگیهایی در سطح ابزار نمایان میگردد. این نوع حفرهها منبعی برای زنگ زدن است. تنها راه جلوگیری از این نوع خوردگی تمیز کردن ابزار بلافاصله پس از استفاده از آنها در تماس با کلریدها یا سایر یونهای هالوژنی است.
– برخی از خوردگی به آسانی بر اثر محلولها به وجود میآید. بنابراین غوطه ور نمودن ابزار در محلول نمک فیزیولوژی باعث خسارت خورندگی جبرانناپذیر در کوتاه مدت خواهد شد.
– خورندگی تماسی مخصوصاً در مواردی که در یک قطعه اتصال بین فولاد معمولی و فولاد ضدزنگ وجود دارد، شدید است. بهطور کلی خورندگی، سطح کلیه ابزاری را که فلزی است از طریق شیمیایی، الکتروشیمیایی مورد آسیب قرار میدهد، که این سطوح به دلیل تغییر رنگ به آسانی ازسایر قسمتهای آسیب ندیده قابل تشخیص است. در فولاد این تغییر زنگزدگی است. خورندگی عمومی حتی در ابزار ساخته شده از فولاد ضدزنگ نیز مشاهده میشود.
– در فولادهای معمولی یا فلزات رنگی که پوشش گالوانیزه دارد، خورندگی در سطوحی مشاهده میشود که سطح آنها دارای نقص باشد. در صورت مجاورت ابزار با یکدیگر هنگام ضدعفونی کردن، تمیزکردن یا استریلیزه کردن زنگ زدگی اولیه ابزار زنگزده موجب زنگزدگی ابزار دیگر خواهد شد و در صورتی که ابزار زنگ زده به صورت مجزا در بسته بندی نگردند موجب افزایش زنگ زدگی در سایر ابزار گردیده و این عمل بهصورت یک چرخه ادامه پیدا میکند.
– بخار مورد استفاده در استریلیزاسیون که از لولههای زنگ زده عبور مینماید نیز میتواند موجب خوردگی ابزار شود. زنگ زدگی لولههای بخار در استریلیزاسیون موجب زنگ زدگی دیواره داخلی دستگاه استریلیزاسیون و هم چنین قسمت دندههای دستگاه میشود (زنگ زدگی ثانویه).
– خوردگی ناشی از فشار (ترک) که معمولاً بر اثر اشکال ساخت ابزار یا حمل نادرست بهوجود میآید.
– هرگونه خوردگی، منجر به زنگ زدگی استیل میشود. در خلل انجام مأموریت ضدعفونی، پاکیزه سازی یا استریلیزاسیون، برادهها و میکرارگانیسمهای حاوی رنگ، از یک ابزار به ابزار دیگر منتقل میشود. لذا جداسازی ابزارهای زنگزده و فاسد از دیگر ابزارها نه تنها از انتقال زنگ زدگی، بلکه از تأثیرات نامطلوب ظاهری ابزارهای دیگر نیز جلوگیری مینماید.
– مهمترین راه جلوگیری از انتقال پدیده خوردگی به ابزارهای نو، معدوم کردن ابزارهای فاسد و زنگ زده است.
– قبل از پوشاندن ابزارها جهت نگهداری، باید آنها را کاملاً خشک نمود زیرا رطوبت باقی مانده در درون قفل دندههای ابزار، ممکن است به ایجاد لک و خوردگی منجر گردد و به ضعیف شدن مقاومت ابزار و شکستگی آن در خلال عمل جراحی بیانجامد.
نگهداری و آماده سازی ابزار
* ابزارهایی که دارای قفل یا گیره باشد به هنگام استریل کردن در اثر تغییرات درجه حرارت دچار ترک خوردگی خواهد شد (ترک در محل اتصال) جهت جلوگیری از این پدیده کافی است این نوع ابزار در هنگام استریلیزه کردن در حد دندانه اول بسته شود،
* برای نگهداری ابزارهای جراحی از روان کنندهها یا روغنهایی با قابلیت حل شدن در آب (حاوی پارافین) گامی موثر در طول عمر ابزار جراحی است. هرگونه روغن کاری نه تنها از اصطکاک دوفلزی که بر روی هم قرار دارد ممانعت به عمل میآورد بلکه با ایجاد نوعی نرمی در عملکرد ابزار، از هرنوع خوردگی ناشی از سایش و اصطکاک نیز جلوگیری مینماید،
توجه: به هیچ عنوان نمی توان ابزار جراحی آغشته به روغنهای غیرقابل حل در آب را استریل نمود بنابراین نباید از این گونه روغنها در روغن کاری ابزار جراحی استفاده کرد.
* ابزارهای جراحی بسیار حساس و آسیب پذیر است، از ضربه زدن به آنها جلوگیری نموده و از روی هم گذاشتن ابزار و تماس آنها با یکدیگر خودداری نمایید. عدم توجه به این موضوع، موجب ایجاد خراشیدگی در پوشش ابزار نموده و به میزان زیادی از عمر آنها میکاهد،
* از هر قطعه ابزار جراحی صرفاً جهت مقاصد جراحی همان قطعه استفاده نمائید. در غیر این صورت خساراتی به ابزار وارد خواهد شد که بعضاً تعمیر و بازسازی آن نیز امکان پذیر نخواهد بود.
* در خلال فرایند استرلیزاسیون، حرارت به صورت شدیدی افزایش و کاهش مییابد. اگر دراین حالت ابزارهای جراحی قفلدار به صورت کاملا قفل شده استریل گردد، ممکن است تحت تأثیر شوک ناشی از تغییرات شدید حرارتی، از ناحیه لولا دچار ترک خوردگی شده یا قفل ابزار، استحکام خود را از دست دهد،
توجه: توصیه میشود ابزارهای قفلدار را در خلال عملیات استریلیزاسیون از حالت قفلشدگی رها سازید یا حداکثر آن را روی پله اول قفل نمایید.
* در طول فرآیند حفاظتی و نگهداری ابزارهای جراحی، کوششها باید معطوف به محافظت از لبههای تیز نواحی برش، نوک تیزو ظریف ابزار که در معرض کار است، گردد. در این راستا از گذراندن ابزار و وسایل سنگین بر روی ابزارهای ظریف و توخالی جداً اجتناب نمایید،
* ناحیه قفل دار ابزار جراحی باید همواره تمیز بوده و عاری از هرگونه نخاله باشد. یک ماده مزاحم در این منطقه منجر به خشکی شدید ابزار و شکستگی ناگهانی آن میشود. هرگونه نخاله قابل رویت باید در مرحله تمیزکاری توسط برس نرم از بین رود،
* توصیه میشود تا حد امکان از حک هرگونه حروف و نام بر روی ابزار جراحی توسط دستگاههای حک زنی به روش شیمیایی خودداری شود؛ با این کار ناخواسته موجب آسیب رساندن به سطح محافظت کننده ابزار جراحی میشوید و این امر مشکل لک زدگی و نقطه نقطه شدن محل مربوطه را به همراه خواهد داشت،
* وسایلی که برای استریل کردن به اتوکلاو فرستاده میشود باید طوری بستهبندی گردد که بخار اتوکلاو بتواند به آسانی از لابه لای وسایل عبور نماید. حتما در قسمت داخل پک یا ست جراحی اندیکاتور استریل گذاشته شود،
* هیچگاه از برس یا اسفنج فلزی برای پاک سازی دستی استفاده نکنید و
* استریلیزاسیون جانشین تمیز کردن نخواهد شد.
این قسمت برای شما ست های جراحی را معرفی می کنیم . اگر ستی در این قسمت نبود در قسمت نظرات ثبت کنید تا ظرف ۲۴ ساعت آینده در وبلاگ تخصصی اتاق عمل آن را مشاهده کنید . با تشکر
جنرال ظریف
تعداد |
مشخصات کالا |
ردیف |
1 |
قیچی استاندارد 5/14 |
1 |
1 |
قیچی متسن بام –فینو کرو 5/14 |
2 |
1 |
قیچی ظریف کرو 12 |
3 |
1 |
پنست آدسون بی دندانه 12 |
4 |
1 |
پنست آدسون با دندانه 12 |
5 |
1 |
پنست سمکین با دندانه 15 |
6 |
4 |
پنس بیبی موسکیتو هارتمن کرو 10 |
7 |
3 |
پنس موسکیتو هالستد کرو 5/12 |
8 |
2 |
پنس موسکیتو هالستد مستقیم 5/12 |
9 |
2 |
پنس موسکیتو هالستد مستقیم دندانه دار 5/12 |
10 |
1 |
پنس جمینی (رایت انگل ) 14 |
11 |
5 |
پنس شان بکهاوس 11 |
12 |
1 |
پنس اسپونچ (رینگ )فورستر 18 |
13 |
1 |
سوزنگیر مایو –هگار 14 |
14 |
1 |
سوزنگیر مایو –هگار 16 |
15 |
1 |
دسته بیستوری استاندارد 3 |
16 |
1 |
دسته بیستوری استاندارد 4 |
17 |
1 |
اکارتور سن –مولر 5/8*7 16 کند |
18 |
1 |
اکارتور سن –مولر 5/8*7 16 تیز |
19 |
1 SET |
اکارتور فارابوف 12 |
20 |
1 |
پنس آلیس 4*5 15 |
21 |
1 |
پنس ببکاک 16 |
22 |
1 |
گیره وسایل 14 |
23 |
ست جنرال ارولوژی
تعداد |
مشخصات کالا |
ردیف |
1 |
قیچی استاندارد مستقیم 5/18 |
1 |
1 |
قیچی مایو کرو 17 |
2 |
1 |
قیچی متسن بام –نلسون کرو 18 |
3 |
1 |
قیچی متسن بام –نلسون کرو 23 |
4 |
1 |
پنست استاندارد بی دندانه 16 |
5 |
1 |
پنست استاندارد بی دندانه 20 |
6 |
1 |
پنست استاندارد بی دندانه 25 |
7 |
1 |
پنست استاندارد با دندانه 16 |
8 |
1 |
پنست استاندارد با دندانه 20 |
9 |
1 |
پنست دو بیکی مستقیم 20 |
10 |
2 |
پنس موسکیتو هالستد مستقیم 5/12 |
11 |
6 |
پنس موسکیتو هالستد کرو 5/12 |
12 |
2 |
پنس کرایل مستقیم 14 |
13 |
6 |
پنس کرایل کرو 14 |
14 |
4 |
پنس بنگولا کرو 26 |
15 |
1 |
پنس روچستر پین مستقیم 20 |
16 |
1 |
پنس روچستر پین کرو 20 |
17 |
2 |
پنس کوخر مستقیم 2*1 16 |
18 |
1 |
پنس کوخر مستقیم 2*1 24 |
19 |
1 |
پنس جمینی (رایت انگل ) 18 |
20 |
1 |
پنس جمینی (رایت انگل ) 20 |
21 |
1 |
پنس رایت انگل لیهی (واسکولار ) 23 |
22 |
8 |
پنس شان بکهاوس 13 |
23 |
ست جنرال ارولوژی
تعداد |
مشخصات کالا |
ردیف |
1 |
پنس اسپونچ کولین مستقیم 25 |
23 |
2 |
پنس اسپونچ (رینگ )فورستر 25 |
24 |
1 |
سوزنگیر مایو –هگار 16 |
25 |
1 |
سوزنگیر مایو هگار 20 |
26 |
1 |
سوزنگیر مایو –هگار 24 |
27 |
1 |
دسته بیستوری استاندارد 7 |
28 |
1 |
دسته بیستوری استاندارد 4 |
29 |
1 |
سر آسپیراتور یانکوئر 27 |
30 |
1 |
اکارتور روکس |
31 |
1 |
اکارتور روکس |
32 |
1 SET |
اکارتور فارابوف 15 |
33 |
1 |
اکارتور دیور 50 30 |
34 |
1 |
اکارتور دیور 75 30 |
35 |
1 |
اکارتور نواری 50 33 |
36 |
1 |
اکارتور بالفور بزرگسالان کامل 180 |
37 |
2 |
پنس آلیس 5*6 15 |
38 |
1 |
پنس آلیس 5*6 19 |
39 |
2 |
پنس ببکاک 18 |
40 |
1 |
پنس ببکاک 24 |
41 |
2 |
گیره وسایل 14 |
42 |
ست جنرال ظریف اورولوژی
تعداد |
مشخصات کالا |
ردیف |
1 |
قیچی استاندارد مستقیم 5/14 |
1 |
1 |
قیچی مایو- کرو 14 |
2 |
1 |
قیچی متسن بام –نلسون کرو 14 |
3 |
1 |
قیچی متسن بام –نلسون کرو 18 |
4 |
1 |
پنست استاندارد بی دندانه 16 |
5 |
1 |
پنست آدسون بی دندانه 12 |
6 |
1 |
پنست استاندارد با دندانه 16 |
7 |
1 |
پنست آدسون با دندانه 12 |
8 |
2 |
پنس موسکیتو هالستد مستقیم 5/12 |
9 |
6 |
پنس موسکیتو هالستد کرو 5/12 |
10 |
2 |
پنس کرایل مستقیم 14 |
11 |
6 |
پنس کرایل کرو 14 |
12 |
2 |
پنس بنگولا کرو 20 |
13 |
2 |
پنس کوخر مستقیم 2*1 14 |
14 |
1 |
پنس جمینی (رایت انگل ) 14 |
15 |
1 |
پنس جمینی (رایت انگل ) 18 |
16 |
8 |
پنس شان بکهاوس 11 |
17 |
2 |
پنس اسپونچ (رینگ ) فورستر 18 |
18 |
1 |
سوزنگیر مایو –هگار 14 |
19 |
1 |
سوزنگیر مایو –هگار 16 |
20 |
1 |
دسته بیستوری استاندارد 7 |
21 |
1 |
دسته بیستوری استاندارد 4 |
22 |
1 |
سر آسپیراتور یانکوئر 27 |
23 |
ست سنگ کلیه و حالب
تعداد |
مشخصات کالا |
ردیف |
1 |
اکارتور پلکی کوشینگ 20 |
1 |
1 |
اکارتور پلکی کوشینگ 20 |
2 |
1 |
پنس سنگ رندال 23 |
3 |
1 |
پنس سنگ رندال 22 |
4 |
1 |
پنس سنگ رندال 22 |
5 |
1 |
پنس سنگ رندال 22 |
6 |
ست یوروتروپلاستی
ست یورتروپلاستی شامل ست جنرال ارولوژی است به اضافه اقلام ذیل :
تعداد | مشخصات کالا | ردیف |
1 | اکارتور چنگکی خودکار ویلتنر | 1 |
ست نفرکتومی
ست نفرکتومی شامل ست جنرال ارولوژی بزرگ است به اضافه اقلام ذیل :
تعداد |
مشخصات کالا |
ردیف |
1 |
پنس رایت انگل لیهی (واسکولار ) 23 |
1 |
1 |
پریوست الویتور لامبوت 15 |
2 |
1 |
پریوست دوین چپ گرد 17 |
3 |
1 |
پریوست دوین راست گرد 17 |
4 |
1 |
دنده یرگرتز –استیل 27 |
5 |
ست U.D.T
تعداد |
مشخصات کالا |
ردیف |
1 |
قیچی استاندارد مستقیم 5/14 |
1 |
1 |
قیچی مایو کرو 14 |
2 |
1 |
قیچی متسن بام- نلسون کرو 18 |
3 |
1 |
پنست استاندارد بی دندانه 16 |
4 |
1 |
پنست آدسون بی دندانه 12 |
5 |
1 |
پنست استاندارد با دندانه 16 |
6 |
1 |
پنست آدسون با دندانه 12 |
7 |
2 |
پنس موسکیتو هالستد مستقیم 5/12 |
8 |
6 |
پنس موسکیتو هالستد کرو 5/12 |
9 |
2 |
پنس کرایل مستقیم 14 |
10 |
6 |
پنس کرایل کرو 14 |
11 |
1 |
پنس بنگولا کرو 20 |
12 |
2 |
پنس کوخر مستقیم 2*1 14 |
13 |
1 |
پنس جمینی (رایت انگل ) 14 |
14 |
8 |
پنس شان بکهاوس 11 |
15 |
1 |
پنس اسپونچ (رینگ) فورستر 18 |
16 |
1 |
سوزنگیر مایو –هگار 14 |
17 |
1 |
سوزنگیر مایو –هگار 16 |
18 |
1 |
دسته بیستوری استاندارد 7 |
19 |
1 |
دسته بیستوری استاندارد 4 |
20 |
1 |
سر آسپیراتور یانکوئر 27 |
21 |
1 |
اکارتور روکس 15 |
22 |
1 |
اکارتور روکس 16 |
23 |
1SET |
اکارتور فارابوف 15 |
24 |
2 |
پنس آلیس 5*6 15 |
25 |
2 |
پنس ببکاک 16 |
26 |
1 |
گیره وسایل 14 |
27 |
پلاستیک زنان
تعداد |
نام وسایل |
ردیف |
1 |
قیچی مدسن ظریف |
1 |
1 |
قیچی سوچر ظریف |
2 |
4 |
موسکتیو |
3 |
2 |
پنست ادسون |
4 |
1 |
پروپ |
5 |
1 |
کتینگ کوتری |
6 |
1 |
سر ساکشن ظریف |
7 |
1 |
دسته نایف شماره 3 |
8 |
1 |
سوزنگیر |
9 |
1 |
تره ورشو |
10 |
ست رترکتومی
تعداد |
نام وسایل |
ردیف |
2 |
رینگ |
1 |
4 |
بلید |
2 |
2 |
رابط |
3 |
6 |
پیچ بلید ( پایه بلند ) |
4 |
4 |
پیچ بلید |
5 |
ست آمپوتیشن
تعداد |
نام وسایل |
ردیف |
3 |
پری استیوالویتور |
1 |
1 |
چکش |
2 |
1 |
کورت متوسط |
3 |
1 |
کورت دو طرفه |
4 |
1 |
بن کترو بن اکشن |
5 |
1 |
رونژور |
6 |
1 |
اره استیل |
7 |
1 |
سینی |
8 |
1 |
سوهان |
9 |
1 |
اره ژیگلر |
10 |
1 |
دسته اره ژیگلر |
11 |
ست جراحی مغز
ردیف | مشخصات کالا | تعداد |
1 | قیچی استاندارد مستقیم 5/16 | 1 |
2 | قیچی مایو کرو 17 | 1 |
3 | قیچی متسن بام –نلسون کرو 18 | 1 |
4 | قیچی تایلور دورا 17 | 1 |
5 | پنست استاندارد بی دندانه 16 | 1 |
6 | پنست آدسون بی دندانه 12 | 1 |
7 | پنست تایلور بی دندانه 5/17 | 1 |
8 | پنست استاندارد با دندانه 16 | 1 |
9 | پنست آدسون با دندانه 12 | 1 |
10 | پنست دو بیکی مستقیم 20 | 1 |
11 | پنس موسکیتو هالستد مستقیم 14 | 2 |
12 | پنس موسکیتو هالستد کرو 5/12 | 3 |
13 | پنس کلی کرو 14 | 5 |
14 | هموستات دندی کرو 14 | 10 |
15 | پنس کوخر مستقیم 2*1 16 | 1 |
16 | پنس کوخر کرو 2*1 16 | 1 |
17 | پنس شان بکهاوس 11 | 5 |
18 | پنس شان بکهاوس 13 | 5 |
19 | پنس اسپونچ (رینگ )فورستر 20 | 1 |
20 | سوزنگیر مایو –هگار 14 | 1 |
21 | سوزنگیر مایو –هگار 16 | 1 |
22 | سوزنگیر مایو –هگار 18 | 1 |
23 | پنس میشل آگراف 12 | 1 |
24 | دسته بیستوری استاندارد 3 | 1 |
ست جراحی مغز
ردیف | مشخصات کالا | تعداد |
25 | دسته بیستوری استاندارد 4 | 1 |
26 | دسته بیستوری بلند 7 | 1 |
27 | سر آسپیراتور فریزر 10 میلیمتر 19 | 1 |
28 | سوند کانوله مغزی 12 | 1 |
29 | اکارتور چنگکی خودکار ویتلنر تیز 13 | 1 |
30 | دسته اره ژیگلی | 2 |
31 | اره ژیگلی 50 | 1 |
32 | کاید اره ژیگلی 33 | 1 |
33 | دایسکتور دو طرفه الیور کرونا 18 | 1 |
34 | هوک دورا کوشینگ 19 | 1 |
35 | اکارتور مغزی الیور کرونا | 1 |
36 | اکارتور مغزی الیور کرونا | 1 |
37 | اکارتور مغزی الیور کرونا | 1 |
38 | اکارتور مغزی الیور کرونا | 1 |
39 | اکارتور مغزی الیور کرونا | 1 |
40 | کریسون پانچ سر بالا 45 درجه | 1 |
41 | رانژور لامینکتومی (پنس دیسک ) 3*10 18 | 1 |
42 | پریوست الویتور لانگبک 19 | 1 |
43 | پریوست الویتور فارابوف 15 | 1 |
44 | کورت استخوان برانز 00 | 1 |
45 | کورد استخوان برانز 1 | 1 |
46 | کورت استخوان برانز 1 | 1 |
47 | گوژ دبل اکشن سر کلاغی استیل 23 | 1 |
48 | گیره وسایل 14 | 1 |
ست لامینکتومی
ردیف | مشخصات کالا | تعداد |
1 | قیچی استاندارد مستقیم 5/16 | 1 |
2 | قیچی مایو کرو 17 | 1 |
3 | قیچی متسن بام –نلسون کرو 18 | 1 |
4 | پنست استاندارد بی دندانه 16 | 1 |
5 | پنست استاندارد با دندانه 16 | 1 |
6 | پنست آدسون با دندانه 12 | 1 |
7 | پنست دو بیکی مستقیم 16 | 1 |
8 | پنس موسکیتو هالستد کرو 5/12 | 3 |
9 | پنس کلی کرو 14 | 6 |
10 | پنس کوخر مستقیم 2*1 16 | 1 |
11 | پنس شان بکهاوس 11 | 4 |
12 | پنس شان بکهاوس 13 | 2 |
13 | پنس اسپونچ (رینگ )فورستر 20 | 1 |
14 | سوزنگیر مایو –هگار 14 | 1 |
15 | سوزنگیر مایو –هگار 18 | 1 |
16 | دسته بیستوری استاندارد 3 | 1 |
17 | دسته بیستوری استاندارد 4 | 1 |
18 | دسته بیستوری بلند 7 | 1 |
19 | سر آسپیراتور فریزر 10 میلیمتر 19 | 1 |
20 | اکارتور چنگکی خودکار ویتلنر تیز 13 | 1 |
21 | اکارتور چنگکی خودکار آدسون کند 5/26 | 1 |
22 | اکارتور ریشه عصب اسکوریل 20 | 1 |
23 | دایسکتور یکطرفه دورا پنفیلد 5/21 | 1 |
ست لامینکتومی
ردیف | مشخصات کالا | تعداد |
24 | دایسکتور دو طرفه الیور کرونا 18 | 1 |
25 | هوک دورا کوشینگ 19 | 1 |
26 | کریسون پانچ سر بالا 40 درجه 3 میلیمتر 20 | 1 |
27 | کریسون پانچ سر بالا 40 درجه 5 میلیمتر 20 | 1 |
28 | رانژور لامینکتومی (پنس دیسک ) 3*10 18 | 1 |
29 | رانژور لامینکتومی بالا (پنس دیسک ) 3*10 18 | 1 |
30 | رانژور لامینکتومی پائین (پنس دیسک) 3*10 18 | 1 |
31 | پریوست الویتور لانگبک 19 | 1 |
32 | پریوست الویتور سدیلوت 19 | 1 |
33 | کورت استخوان برانز 1 | 1 |
34 | کورت استخوانی سیمون 24 | 1 |
35 | گوژدبل اکشن سر کلاغی استیل 23 | 1 |
36 | رانژور استخوان استیل –لوئر مستقیم 26 | 1 |
37 | بن کاتر استیل –لیستون کج 27 | 1 |
38 | گیره وسایل 14 | 1 |
ست جراحی توراکس
تعداد |
مشخصات کالا |
ردیف |
1 |
سوزنگیر مایو –هگار 20 |
25 |
1 |
سوزنگیر مایو –هگار 24 |
26 |
1 |
دسته بیستوری استاندارد 3 |
27 |
1 |
دسته بیستوری استاندارد 4 |
28 |
1 |
دسته بیستوری بلند 3 |
29 |
1 |
سر آسپیراتور یانکوئر 27 |
30 |
1 SET |
اکارتور فارابوف 15 |
31 |
1 |
دنده بر گرتز–استیل 27 |
32 |
1 |
پریوست الویتور لامبوت10میل 21 |
33 |
1 |
اکارتور توراکس فینو چینو |
34 |
1 |
دنده جفت کن بیلی 18 |
35 |
1 |
کلامپ ساتنسکی 5/20 |
36 |
2 |
پنس آلیس 5*6 19 |
37 |
1 |
پنس ببکاک 20 |
38 |
1 |
پریوست دوین چپ گرد 17 |
39 |
1 |
پریوست دوین راست گرد 17 |
40 |
2 |
گیره وسایل 14 |
41 |
ست جنرال کوچک
تعداد |
مشخصات کالا |
ردیف |
1 |
قیچی استاندارد مستقیم 5/16 |
1 |
1 |
قیچی متسن بام –نلسون کرو 18 |
2 |
1 |
پنست استانداردبی دندانه 14 |
3 |
1 |
پنست استاندارد بی دندانه 18 |
4 |
1 |
پنست استاندارد با دندانه 14 |
5 |
1 |
پنست استاندارد با دندانه 18 |
6 |
2 |
پنس موسکیتو هالستد کرو 5/12 |
7 |
2 |
پنس کلی مستقیم 14 |
8 |
3 |
پنس کلی کرو 14 |
9 |
1 |
پنس کوخر مستقیم 2*1 16 |
10 |
1 |
پنس جمینی (رایت انگل ) 14 |
11 |
3 |
پنس شان بکهاوس 11 |
12 |
1 |
پنس اسپونچ (رینگ )فورستر 18 |
13 |
1 |
سوزنگیر مایو- هگار 14 |
14 |
1 |
سوزنگیر مایو –هگار 18 |
15 |
1 |
دسته بیستوری استاندارد 3 |
16 |
1SET |
اکارتور فارابوف 12 |
17 |
1 |
پنس آلیس 5*6 15 |
18 |
1 |
پنس ببکاک 16 |
19 |
گفتگو ها308 دیدگاه
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