Due to the differences in operation methods and degrees of trauma, various anorectal surgeries require targeted combinations of consumables. The following are the core consumable combinations for four typical types of surgeries:
1. Traditional external stripping and internal ligation (for mixed hemorrhoids
Core operation consumables
Basic instruments: hemostatic forceps (for separating hemorrhoids), tissue forceps (for holding hemorrhoid tissues), curved scissors (for trimming hemorrhoids), needle holders + round needle sutures (for ligating the root of hemorrhoids).
Hemostatic assistance: Absorbable hemostatic gauze (filling the wound of hemorrhoid resection to prevent bleeding).
Postoperative care consumables
Perianal care pads (to keep the wound dry), medical iodophor cotton swabs (for daily wound disinfection), hemorrhoid plugs (to relieve postoperative pain and promote mucosal repair).
The combination logic: Classic surgical instruments are used to complete the dissection and ligation of hemorrhoids, combined with absorbable hemostatic materials to reduce intraoperative bleeding, and basic postoperative care consumables are used to lower the risk of infection.
2. Mucosal resection of the hemorrhoids (PPH procedure, for moderate to severe internal hemorrhoids)
Core operation consumables
Pph-specific stapler (including circular knife and titanium nail, for completing mucosal circumferential resection and anastomosis), anal canal dilator (exposing the surgical field of view), anal endoscope suture ligation device (assisting in mucosal suture fixation);
Antibacterial and anti-adhesion gel (apply to the anastomosis site to prevent tissue adhesion and infection).
Postoperative care consumables
Disposable anoscope (for postoperative follow-up to observe the anastomosis), medical vaseline gauze (to cover the wound surface and reduce friction and irritation).
The logic of the combination: Rely on minimally invasive anastomotic instruments to achieve rapid mucosal resection, use anti-adhesion materials to reduce postoperative complications, and use consumables for follow-up to facilitate timely monitoring of the healing of the anastomosis.
3. Anal fistula resection (for simple anal fistula)
Core operation consumables
Probe (to explore the direction of the fistula), scraper (to remove necrotic tissue within the fistula), electrocoagulation hemostatic pen (for precise hemostasis during the operation and to reduce wound damage);
Silicone drainage tube (placed in the residual cavity of the fistula after surgery to drain the exudate).
Postoperative care consumables
Stoma bag (suitable for temporarily collecting secretions after high anal fistula surgery), normal saline irrigation device (daily fistula irrigation to keep clean).
The logic of the combination: Use instruments such as probes and scrapers to remove the fistula lesion. The electrocoagulation hemostatic pen reduces intraoperative trauma. The drainage tube and the stoma bag work together to ensure the discharge of postoperative secretions and reduce the risk of pseudo-healing.
4. Enterostomy (for rectal cancer, intestinal obstruction, etc.
Core operation consumables
Stoma positioning ruler (precisely marking the stoma position), electrocautery (cutting the skin and intestinal tract), absorbable sutures (fixing the intestinal tract and skin);
Stoma chassis adhesive (enhances the adhesion between the stoma bag and the skin, and prevents leakage).
Postoperative care consumables
Two-piece stoma bag (easy to replace regularly and reduce skin irritation), stoma skin protective film (applied to the skin around the stoma to prevent dermatitis), stoma measurement card (regularly measure the size of the stoma and match the appropriate base).
The matching logic: The precise position of the stoma is ensured through positioning and cutting instruments. Adhesives and dedicated stoma bags are used in combination to enhance the quality of life after surgery. Measurement cards and protective films extend the skin health cycle.
Ii. Key Points for Quality Supervision of Surgical Consumables in the Anorectal Department
Supervision of the production process
Qualification review: It is necessary to pass the approval of the National Medical Products Administration (NMPA) and obtain the "Medical Device Registration Certificate". For imported consumables, the "Imported Medical Device Registration Certificate" must also be provided.
Quality standards: Metal instruments (such as hemostatic forgetters, staplers) must comply with the GB/T 1220-2007 "Stainless Steel Rods" standard, and biological materials (such as hemostatic sponges, anti-adhesion gels) must pass biocompatibility tests such as cytotoxicity and sensitization (GB/T 16886 series standards).
2. Supervision of the circulation link
Storage conditions: Low-temperature sensitive consumables (such as some hemostatic enzymes and biological gels) should be transported under full cold chain (2-8℃) to avoid repeated freezing and thawing. Metal instruments should be stored in a moisture-proof manner to prevent rusting.
Traceability management: Each batch of consumables must be accompanied by a unique traceability code, recording information such as the production batch number, validity period, and manufacturer, facilitating traceability and problem recall in the circulation process.
3. Supervision of the usage stage
Hospital acceptance: When receiving consumables, it is necessary to verify the integrity of the packaging (no damage, no air leakage), the validity period (no less than 6 months from the expiration date), and conduct sampling tests on key performances (such as the release force of titanium nails in staplers and the water absorption rate of hemostatic materials).
Adverse event reporting: In the event of consumable failure during use (such as stapler nail compartment jamming, ostomy bag leakage) or adverse reactions in patients (such as allergies, delayed wound healing), it must be reported through the "National Medical Device Adverse Event Monitoring Information System" within 24 hours to prevent the spread of risks.
Iii. Core Principles of Consumables Matching and Supervision
Compatibility priority: The combination of consumables should be in line with the surgical operation procedures. For example, for minimally invasive surgical procedures, dedicated anastomectomy/ligation instruments should be preferred, while for traditional surgical procedures, the combination of classic instruments and basic nursing consumables should be emphasized.
Full-chain quality control: From the review of production qualifications to the tracking of postoperative adverse events, a closed-loop supervision of "production - circulation - use" is formed to prevent substandard consumables from entering clinical practice.
Individualized adjustment for patients: For instance, patients with allergic constitutions should replace latex gloves with nitrile gloves, and obese patients should choose large-sized stoma chassis to ensure the safety and comfort of consumables.