Hand Surgery Instruments Set: Small Retractors, Fine Scissors, Bone and Tendon Tools

Hand surgery instrument list: the core groups

A typical set contains: scalpel handles with small blades, fine tissue forceps and skin hooks, small self-retaining and hand-held retractors, fine dissecting scissors, haemostatic mosquito clamps, needle holders, small bone instruments (rongeur, curettes, osteotomes, bone-holding forceps), wire instruments and tendon instruments.

The hand is a compact area with nerves, vessels and tendons closely packed, so all instruments are shorter and finer than general surgery equivalents. The tray is usually opened on a small hand table with a tourniquet, and nurses should arrange items by phase: incision and exposure, dissection, bone work, tendon work, and closure.

Plan the number of sets around the list, not the surgeon. Hand lists often contain several short cases in a row, such as carpal tunnel, trigger finger and small tendon repairs, so a pool of identical sets that rotate through reprocessing is more flexible than one large set.

Fine scissors, forceps and haemostats for hand surgery

Dissection depends on fine scissors and forceps. REDA's plastic surgery section lists instruments for fine soft-tissue work in aesthetic and reconstructive surgery, and its scissors and tissue forceps ranges include iris, micro and titanium micro scissors, and Adson, Adson-Brown, micro and ring-tip micro forceps. Mosquito haemostats allow control of small vessels. For plastic-surgery overlaps read plastic surgery instruments.

Select instrument lengths so that the hand rests comfortably on the table while the tips reach the target. Short, light instruments reduce tremor and fatigue during long reconstructions.

Handle design matters in fine work. Round, knurled handles let the surgeon roll the instrument between the fingers, while flat handles give a stable grip for longer manoeuvres. Ask the surgeons which they prefer.

• Tissue forceps with fine teeth (1x2) and atraumatic tips.
• Iris and micro scissors for nerve and tendon sheath work.
• Mosquito haemostats for small vessels.
• Skin hooks and small retractors to keep the field open.

Tendon instruments and bone tools

Tendon repair needs tendon-holding forceps, tendon passers, fine needle holders and fine sutures. REDA's orthopedic section lists tendon instruments and meniscotomes among its extensive range, along with Lambotte osteotomes, Bruns and Volkmann bone curettes, Luer and Stille bone rongeurs, bone-holding forceps, Kirschner wire instruments and wire twisters.

For fractures and arthrodesis of the hand, small bone-holding forceps, rongeurs and Kirschner wire tools are central. See bone-holding forceps and osteotomes, chisels and gouges for more detail.

Tendon work in particular rewards dedicated pieces, such as small tendon-holding forceps and passers, since improvised tools can damage the tendon surface and lead to adhesions.

What is hand microsurgery?

Hand microsurgery is the repair of small nerves and vessels, often under an operating microscope or loupes, for example in replantation, nerve repair and free tissue transfer. It requires micro instruments: micro needle holders such as Castroviejo patterns, micro scissors, jeweller's forceps and vessel clamps.

Keep micro instruments in a separate protected tray to avoid damage to their delicate tips. To select micro items, read the microsurgery instruments guide and the notes on the Castroviejo needle holder.

Buying and care

Ask your supplier for item-level lists, lengths and tip dimensions, materials, and repair services. Hand sets are small, so each item counts and replacements should be easy to source. Check current MOHAP, DHA or DOH requirements.

Beckfinity can help you shortlist items from the REDA range and prepare a quote for a hand surgery set for your theatre.