INSTRUMENT WHISPERER

Scissor and Needle

Holders 101
BY RICK SCHULTZ

M
ost surgical procedures over sharpen scissors, which decreases must cut through to the tip because the
begin with a scissor the life of the instrument. distal portion of a scissor dulls first. After
and end with a needle testing the scissor’s sharpness, visually
holder. To the surgeon, Scissor Testing inspect the tips, blades and screw hinges
the first impression of surgical set’s The industry standard for scissor for cracks, burrs, dents and bioburden.
quality is the scissor’s sharpness and sharpness testing is to use red scissor test The final quality check is called “taking
their final perception is the needle material for scissors longer than 4 1⁄2” the scissor for a walk.” This involves
holder’s ability to hold the needle to in overall length, and yellow scissor test opening and closing the scissor three to
close the incision. Because these material for scissors 4 1⁄2” and shorter. five times and determining whether the
instruments are frequently used, they cutting action is smooth. When opening
require the most attention when it and closing a scissor, it should have a
comes to not only cleaning, but smooth sliding feel, with no grinding.
ensuring they maintain the highest A proactive approach would be to plan
standard of functionality and sharpness. two days a week for scissor testing. For
An important part of every Sterile example, every Monday and Wednesday,
Processing (SP) professional’s job is to each scissor that passes through the tray
be proactive and have a quality system in assembly process would be tested on
place to check scissors and needle holders correct scissor sharpness test material.
prior to their arrival on the sterile field. This proactive approach will keep the
Every scissor goes dull, regardless of its scissor inventory in top condition.
size, specialty, manufacturer or design. In Using an instrument tracking system
addition, every needle holder will wear will ensure all scissors are being tested
out over time. regularly and will also allow the facility
When sending instruments out for to track which instruments have been
repair, it is essential to use an experienced sharpened and how frequently.
repair technician, and to ask questions When testing scissors in a set, one may
and verify their experience. On average, find that not every scissor in a set needs
a repair technician needs a minimum to be sharpened. It is important to test
nine to 12 months of training. When the scissors and only send out the ones
choosing a repair vendor, a hospital in need of sharpening. Note: Every scissor
should inquire about the extent of can be re-sharpened, including serrated-
experience their technicians have and edge scissors. Serrated-edge scissors require
verify that these experienced technicians a special technique to sharpen. Ensure
will be at the facility every day. Hospitals the repair vendor is properly trained to
should specify that repair technicians sharpen these types of scissors.
will not earn their training by working SuperCut (black-handled) scissors
on the facility’s expensive instruments. Scissors should be tested once a week, if have a knife edge that typically requires
Inexperienced repair technicians can also possible. For all scissor testing, the scissor more frequent sharpening (three to four

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 INSTRUMENT WHISPERER

times per year). When inspecting black-

handled scissors, special attention should
be given to the knife edge. The scissors
should be sent out for sharpening, when
needed.
Gold-handled scissors stay sharper
longer because the blades contain
tungsten carbide. They will not require
sharpening as often as other scissors;
however, sharpness should be tested with
appropriate scissor test material.

Even the most popular needle holders

made with tungsten carbide jaws
(designated by gold-ringed handles) will
wear out. Tungsten carbide jaws may
last longer than stainless steel jaws, but
they will eventually require repair. The
difference is with a gold-handled needle
holder, the jaws can be replaced by an
experienced repair technician instead of
having to replace the entire instrument.
A standard non-gold, German needle
holder cannot be re-jawed once the jaws
wear out; it must be replaced.
Black handles on a needle holder
indicate diamond dust jaws. Diamond
dust needle holders have jaws that are
Needle Holder Inspection impregnated with tungsten carbide
Just as all scissors eventually going dull, particles; it is applied using an electrical
all needle holder jaws will eventually applicator with a carbide electrode.
wear out. SP professionals should Diamond dust needle holders are
inspect all needle holder jaws prior to designed to grasp and hold very fine see if the needle holder firmly engages.
placing them in the surgical tray. A quick needles. When jaw wear is discovered, If it does not, put the needle holder on
inspection technique is simply to separate the instrument should be sent out to the first ratchet and gently tap it on a flat
the rings and visually inspect both jaws an experienced repair vendor who can work surface (not the palm of the hand).
for wear, as well as blood and tissue. The reapply the diamond dust surface. If after three to four taps the ratchet
only place a needle holder shows wear is Other important parts of the needle holds, flip the instrument over and
at the very tip, where the needle holder holder that require regular inspection repeat the test. If the ratchet springs open
grasps the needle. If the needle holder’s are the box lock (inspect for cracks) during either test, the instrument should
jaw is chipped upon inspection, it should and the ratchets (perform ratchet test). be sent out for repair.
be immediately removed from service When inspecting needle holders, be sure Needle holders can crack in the neck
and repaired/replaced. to inspect these areas closely, as well. To when a large needle is used in a small
test ratchets, click each ratchet slowly to needle holder. Also, a needle holder is

www.iahcsmm.org JANUARY / FEBRUARY 2020 PROCESS 83

 INSTRUMENT WHISPERER

Q Our repair vendor used to send the same repair

team to our facility every time. Now, I’m getting
different technicians and more instruments are being
marked “beyond repair” than before. Why is this?

A
sometimes incorrectly used like a pair I suspect the biggest reason is inexperienced repair technicians and their
of pliers to pull pins and twist wire. lack of supervision by the repair team’s managers. To have a large increase
This type of crack is not repairable. The in instruments being marked “beyond repair” with different technicians seems to
instrument must be replaced. indicate that the repair vendor will do the simple repairs but is marking difficult-to-
repair instruments as “beyond repair” because they don’t have the parts or skills to do
the repair. Another sign of a weak repair team/company is sending instruments off site
to be repaired. Again, the reasoning for this is lack of repair technician training and a
lack of parts on the repair vehicle.

RICK SCHULTZ, the Instrument Whisperer™, is an author, inventor and lecturer, and the retired Chief Executive Officer
of Spectrum Surgical Instruments Corp. He served as contributing editor of IAHCSMM’s Central Service Technical
Manual (Fifth, Sixth, Seventh, Eighth Editions). Rick authored the textbooks Inspecting Surgical Instruments: An
Illustrated Guide and The World of Surgical Instruments: The Definitive Inspection Textbook, which was released in
June 2018. Schultz was named IAHCSMM’s Educator of the Year in 2002, and in 2006, was named American Hospital
Association Educator of the Year. In 2007, he was named by Healthcare Purchasing News as one of the 30 Most
Influential People in Healthcare Sterile Processing. Schultz currently provides educational lectures to Central Service
professionals at IAHCSMM’s annual conferences and conducts operating room personnel lectures across the country.

The StopperCare System

#5988 Stopper® #7100 Stopper® Foot

By reading this Edge Protector

• Elevates the complete tray
from the Blue Wrap.
and Corner Shield
• Large Flexible Edge Guards.
• Can be used on Round

book you will increase • Provides for easier sliding

of tray.
Corner trays.
• Large base to protect

patient safety.
• Helps prevent tears under- recessed or offset Feet
neath trays and along on Trays.
horizontal edges. • Reduces “Blue Wrap” use.
• Elevation of tray allows for • Can be used in Steam,
TO ORDER: better air circulation for EO and Plasma Sterilization.
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FOR QUESTIONS: 20 Sable Dr, Unit 9 | Bluffton, SC 29910

SALES@RICKSCHULTZ.ORG OR 330-714-9092 Ph: 843.757.2900 | Fax: 724.449.3201 | www.velmedinc.com

84 PROCESS JANUARY / FEBRUARY 2020 www.iahcsmm.org