Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 44:
The Microsurgical Laboratory
  The choice of the microscope used should be based primarily on the quality of its optics. Amenities such as power zoom and focus are helpful, but are not necessary in the laboratory. In a teaching laboratory, it is necessary that the microscope have two viewing heads. Viewing tubes are not of much use because they allow only monocular vision and are very tiring to the eyes.

The few supplies routinely used in the laboratory are 2 x 2 gauze sponges, cotton-tipped applicators, normal saline, syringes (1, 3, 5 and 35 cc), needles (18, 25, and 30 gauge), and scalpel blades (No. 15).

Instruments used in the laboratory fall into two groups, regular surgical instruments and microsurgical instruments. The regular surgical instruments include scissors, forceps, scalpel handles, and needle drivers. They need not be of the highest quality for laboratory use; inexpensive ones work very well. The second group, microsurgical instruments, should be of high quality, although not necessarily the most expensive. With the possible exception of dilators, the instruments should be at least 14 cm long. The forcep tip size is chosen with regard to the size of the needles used in the laboratory, that is, 140u, 70u, 50u, and 30u. The diameters of vessels and nerves used in the laboratory are 1 mm or less. Therefore, forcep tip sizes chosen are heavy (0.8 mm), medium (0.6 mm), and fine (0.3 mm). The dilator tip should be 0.2 mm.


Listed in Table 44-1 are the microsurgical instruments required for minimal practice kits, complete practice kits, and kits suitable for research work.

Table 44-1. Microsurgical Instruments for the Microsurgical Laboratory

Table 44-2. Drugs Used in the Microsurgical Laboratory

Equipment common to all kits includes a clamp applier or 6" thumb forceps, a polished 30-gauge needle, a piece of background material, and several microretractors fabricated from paper clips and rubber bands.

Jeweler's forceps have been and in some cases still are in use in the laboratory. Before use, they should be modified by increasing the handle length, grinding, dressing, and polishing the tips. The drugs routinely used in the microsurgical laboratory are listed in Table 44-2.

Experimental animals may also require analgesics and antibiotics.

Sutures used in the laboratory (4-0, 9-0, 10-0 and 11-0 nylon) are, with the exception of 4-0 cuticular, purchased in nonsterile laboratory packs.

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