The Original Micro Vascular Clamps by Acland Prof. Dr. Robert D. Acland, University of Louisville, Louisville. Ky. USA The Original What started as a laboratory instrument over thirty years ago, has become the most popular micro clamp due to the many advantages this clamp series has for its users: ■ light and compact design ■ extremely durable ■ corrosion resistant metallurgy ■ a unique gripping surface ■ smooth sliding bar action on all approximator clamps v clamp profile with parallel sided jaws ■ choice of matte or black finish Offering a range of 5 sizes, the clinical micro clamp series will meet the most exacting needs of small vessel surgery in the diameter range from 0.4 to 5 mm. Clamp Security All clamps are precisely calibrated to exacting standards. All clamps undergo a rigorous QC testing procedure. clamps are 100% inspected prior to shipment. ´s clinical micro clamps are the gentlest and least traumatic of all small vessel clamps. Slippage The flat and non-serrated „Ultra-Grip“ surface of these clamps ensures that the pressure is spread evenly over the entire area of the vessel wall. Minimizing overpressure peaks, which may lead to damage of the vessel interior.
Options Clamp size? In choosing the correct clamp size for your application, please refer to the section „Clamp Size and Clamp Pressure“ below. "A" or "V" Pattern? Throughout the series, the „V“ pattern is the all-purpose clamp, commonly used on all veins, and almost all arteries. The „A“ pattern, available in all sizes, is designed for exceptionally thick-walled vessels and slippery arteries. The slight incurve of the tips of the „A“ pattern jaw provides extra security against slippage. Black or Plain Finish? All clamps are now available in either a black or matte (dark gray) finish. The black finish helps minimize eye fatigue, and also helps avoid burned-out highlights in photography and on-screen. The matte finish features a dark gray, minimally reflective surface. The selection of a black or matte finish clamp is matter of preference.
Clamp Size and Clamp Pressure When choosing the right size of clamp for your work, clamp pressure is an important consideration. Clamp pressure is determined by the closing force of the clamp (in grams), divided by the area of the vessel wall that is compressed between the jaws (in square millimeters). Thus, the smaller the area, the higher the pressure is, inversely proportional to the vessel size. Each size of clamp has its own different and carefully calibrated closing force. Each clamp size is designed for a specific range of vessel diameters (Fig. 1).
Leakage Even on the largest, recommended diameter vessel (Fig. 2), each size of clamp will withstand blood pressure within the vessel up to 200 mm Hg, without leakage. Despite the wide range of closing forces, the pressure exerted by each clamp, big or small, remains consistent throughout the series. Each size of clamp exerts a pressure of 5gm/mm2 when used on the largest vessel in its range, and 15gm/mm2 when used on the smallest vessel. Even at the higher range, ’s clinical micro clamps have the gentlest working pressure of any small vessel clamp available. The table (Fig. 2) summarizes the relationship between clamp size, recommended vessel diameter and clamp pressure. „Vessel diameter“ refers to the external diameter of the vessel in its natural state of full dilation. There is a 50% overlap in the recommended vessel diameter range, between each clamp size and the next larger or smaller size. Thus, for every vessel diameter, with the exception of those at the extreme ends of the range, there will always be two suitable clamps. Whenever a choice arises, the smaller clamp should be selected to ensure a gentler, less pressured handling of the vessel.
Advantages ■ Marking shows the appropriate position of vessels ■ Border lines show the range of the vessel diameters - The outer lines designate the maximum vessel diameter - The inner lines designate the minimum vessel diameter ■ The logo: The certainty that you are using authentic vascular clamps!
B-Clamps Dimensions (in mm)
Single clamps Single clamps are used in situations where space is at a premium and you find it difficult to place an approximator clamp. Generally you will use single clamps when you are working on end-to-side anastomosis and you need safe haemostasis on the flap vessel. Approximator clamps Approximator clamps are the standard clamps for end-to-end anastomosis or if the recipient vessel on an end-to-side anastomosis is to be clamped and approximated. The ease with which vessel ends may be positioned as well as the exceptional access to the procedure site has made these clamps top sellers. Care of Clamps Micro clamps are prone to damage from the accumulation of blood clotting in tight places. With proper care and cleaning, this can be avoided. Blood should not be allowed to dry on the clamps during surgery. For cleaning after surgery, we recommend immersion for 30 minutes in hemolytic detergent (please also note the section on „Decontamination“). When immersing the clamps, hold them open for a moment to wet the inner surfaces. Be sure to slide approximator clamps along the bar, back and forth a few times, to clear the sliding units. After immersion, rinse vigorously with a fine, high-pressure water jet to remove any blood residue from spring interspaces, sliding units and suture cleats. Approximator clamps with frame These clamps are generally used in labs or in instances where there is no assistance available. The cleats on the frame are used for belaying the suture material, ensuring perfect positioning during an anastomosis. Note Do not use a clamp on a vessel below the recommended diameter range. Use of any clamp on a vessel too small will result in unacceptably high pressure, and risk of vessel damage. Clamps by Acland, angulated These handy clamps are recommended for use in places where straight clamps either are difficult to apply, or obstruct sight in the operative field.
Advantages of the single use clamps ■ Sterile, single use, disposable ■ atraumatic jaws ■ consistent and reliable closing pressure ■ designed for use on veins and arteries ■ light weight ■ blue finish provides excellent contrast in the field ■ radiopaque ■ eliminates cleaning and processing problems ■ economical
Clamp Applying Forceps
Forceps Art.-No. Description without lock, 13 cm CAF-4 00072 for clamp sizes B-1, B-2, B-3 CAF-5 00074 for clamp sizes HD-S, RD-S with lock, 13 cm CAF-4L 00071 for clamp sizes B-1, B-2, B-3 CAF-5L 00073 for clamp sizes HD-S, RD-S without lock, 15 cm CAF-3 00623 for clamp sizes B-1, B-2, B-3 Pener Nerve Approximator     PNA-3555 Pener Nerve Approximator Clamp box, 70 x 45 mm Ensures the safekeeping of your vessel clamps during the procedure and cleaning.   CB-1 Art. No. 00080