How to Set Up Surgical Instruments

Setting up surgical instruments correctly is a vital part of the surgical process. Correct surgical tray arrangement allows the physician to be more efficient during the surgical procedure, without worrying if she has everything needed to perform the procedure. Strict adherence to sterile setup is critical for the health of the patient and knowing exactly how to prepare sterile surgical trays is imperative. All surgical procedures require different instruments and preparation, though basic steps can be followed for minor surgical tray setup.

1

Drop a sterile tray drape onto a Mayo stand or table. Open the drape by unfolding the first flap toward yourself and cover one end of the stand first. Unfold the remaining drape, continuing to open each side toward you, until the stand is covered. Refrain from touching the inside of the sterile drape.

2

Open sterile instruments packs by pulling the package apart at the appropriate end. Drop the instruments, handle first, onto the sterile drape. Ensure that your clothing or the instrument packaging does not touch the sterile field.

3

Open surgical towels and a fenestrated sheet and drop onto the sterile tray. Place sterile gauze onto the tray by opening the package and dropping it onto the tray. Add additional sterile equipment to the tray with the same technique, as needed.

4

Put on sterile gloves in the approved technique. Arrange surgical instruments, gauze and towels on the surgical tray in an order most appropriate to use during the surgical procedure. Place bowls or basins near the outer edge of the tray for easy filling. Place instruments handle first in the direction of the physician for easy handling during the procedure. Avoid covering or overlapping scalpel blades or sharp instruments with other items on the tray for safety.

5

Avoid overcrowding the surgical tray. Consider having additional instruments on hand, unopened, for easy addition to the tray during the surgical procedure if warranted.

Tips & Warnings

• When dropping items into a sterile field, hold the packaging about three inches above the sterile tray.
• Prepackaged instrument trays or kits may have all surgical instruments, towels and gauze already included. In most cases, opening these trays allows the packaging to become the sterile drape.
• If you contaminate the sterile tray, you must discard the tray and start over with a new setup.
• If there will be a lapse between setting up the tray and performing the surgical procedure, remove your sterile gloves and put on a fresh pair when the procedure begins.
• Preparing surgical instruments, for both minor and major surgery, requires in-depth knowledge of surgical assisting and correct instrument-handling technique.