Codman MICROSENSOR 82-6632 Manual Del Usuario página 7

General Surgical Procedure
The following is a general guide for informational
purposes only. The surgeon may wish to alter
details in accordance with his or her own clinical
experience and medical judgment. This device
is not designed, sold, or intended for use as a
therapeutic device.
Installing the Skull Bolt
1. Connect and zero the transducer. Refer to the
Connecting and Zeroing the Transducer section.
2. Perform craniotomy using the CODMAN
Cranial Hand Drill, catalog number 82-6607. Use
the 5.8 mm drill bit when drilling hole. CAUTION:
Bolt fit can be compromised if used with other
drills. Perform retraction procedures to expose
skull. Make a cruciate puncture in the dura to
establish an assured path between the bolt and
the intraparenchymal area.
3. Select adult or pediatric bolt. NOTE: If
necessary, adjust the seating depth of the bolt.
Three spacing washers are provided with the
CODMAN MICROSENSOR Plastic Skull Bolt Kit.
Two washers may be used with the adult skull
bolt and one may be used with the pediatric skull
bolt to adjust for variations in skull thickness in
patients. Ensure accurate position of spacing
washers prior to insertion of the bolt. The range of
adjustment available to the surgeon is:
Pediatric: 3.5 mm to 5 mm
Adult: 5.0 mm to 10 mm
WARNING: Do not remove the thrust washer
and sealing washer which are preassembled on
the skull bolt, as this may result in a fracture of
the device or in an inadequate seal between the
washer and the skull (see Figure 3).
NOTE: Do not remove the obturator from the bolt.
4. Put the skull bolt in position and place the screw
handle on top of the bolt as shown in Figure 4. Turn
the screw handle clockwise until the spacing washer
beneath the screw flange rests close against the
outer table of the skull. Remove screw handle.
WARNING: Excessive torque applied to the
skull bolt during insertion may cause breakage.
This device is designed to break off at the area
between the hexagonals, if excessive torque is
applied. The lower portion of the screw can then
be removed, using the screw handle. To remove
bolt, turn screw handle counterclockwise.
5. Remove the obturator from the skull bolt.
6. Guide the transducer through the bolt until the
transducer tip is in the subdural or parenchymal
space, as shown in Figure 5.
7. Irrigate the channel with non-bacteriostatic
sterile saline.
8. Loosen the Tuohy-Borst adapter from the catheter
body by twisting the blue adapter counterclockwise.
Slide the Tuohy-Borst adapter into place as
shown in Figure 6. Turn the blue adapter
clockwise to secure.
9. Remove retractor and close up the skin incision
in one layer using interrupted sutures, as shown in
Figure 7. Apply appropriate dressing to wound site.
NOTE: If desired, the male LUER-LOK cap
may be used to occlude the bolt outlet when
monitoring is discontinued.
Removing the Skull Bolt
1. Remove all connections from the CODMAN
MICROSENSOR Plastic Skull Bolt.
2. Remove the dressing around the bolt and one or
two of the sutures that are closest to the stem.
3. Using the sterile CODMAN Disposable Plastic
ICP Handle, turn the screw counterclockwise until
screw is free.
CAUTION: Make certain that all the washers have
been removed from the incision area before closing.
4. Apply pressure with a sterile gauze until hemostasis
is achieved. Close the incision again in one layer, with
uninterrupted sutures. Apply a dry sterile dressing.
Electrostatic Discharge (ESD) Information
CAUTION: Exposure to electrostatic discharge
(ESD) energy could damage this device. High
levels of ESD could damage the electronic
components and cause the transducer to be
rendered inaccurate or inoperable. Take all
precautions to reduce the buildup of electrostatic
charge during the use of this product.
• Provide patient grounding, e.g., grounding
straps on gurneys.
• Avoid the use of materials that could generate
ESD during patient movement and transport,
e.g., nylon transfer boards with bedding.
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