Tissue and Dressing Forceps: Adson, Brown-Adson, DeBakey, Gillies and Bayonet
Instrument guides
Tissue and Dressing Forceps: Adson, Brown-Adson, DeBakey, Gillies and Bayonet
How dressing and tissue forceps differ, what 1x2 teeth and Brown-Adson rows are for, and which pattern and length suits skin, soft tissue and the nose.
Thumb forceps come in two kinds. Dressing forceps have serrated tips without teeth and hold dressings, sutures and delicate tissue. Tissue forceps have teeth, usually one tooth meeting two (1x2), that hold skin and fascia firmly with less pressure, which crushes less. The Adson is the standard fine forceps for skin in plastic surgery. Brown-Adson adds rows of small teeth, the DeBakey has long atraumatic jaws for vessels and delicate tissue, and bayonet forceps keep your hand out of your line of sight in the nose.
Who were Adson and DeBakey?
Alfred Washington Adson was a neurosurgeon at the Mayo Clinic, where he was invited in 1914 to build a section of neurological surgery and led it until 1946, according to his biography. Fine Adson forceps are widely used in neurosurgery, ENT and plastic surgery. DeBakey forceps were developed by the cardiovascular surgeon Michael DeBakey at Baylor College of Medicine. Their fine, lengthwise atraumatic teeth hold vessels without damaging them. The Gillies forceps carry the name of Sir Harold Gillies, whose wartime facial surgery founded plastic surgery as a specialty, as his Te Ara biography records.
Which forceps do which job?
| Job | Patterns | Our lengths |
|---|---|---|
| Skin and fine soft tissue | Adson 1x2, Adson with tying platform, Micro Adson 0.8 mm, Gillies, Semken | 12 to 18 cm |
| Broader grip on skin | Brown-Adson 9x9, 7x7, curved | 12 or 15 cm |
| Vessels and delicate tissue | DeBakey 1.5 mm, DeBakey 2 mm, plain or insulated, micro forceps | 11 to 20 cm |
| Dressings and sutures | Adson dressing, standard dressing, slim dressing, Semken | 10.5 to 25 cm |
| Deep work | Cushing, Waugh, Potts Smith, Nelson, Bonney TC | 15 to 23 cm |
| Nose and ear, bayonet | Gerald bayonet, Gruenwald Jansen, Walter, Troeltsch Wilde angular | 11.5 to 19 cm |
| Coagulating | Adson Crow insulated, Crow TC insulated 23 cm, anatomic monopolar | 12 to 23 cm |
Teeth, serrations or TC tips?
- 1x2 teeth: one tooth on one side fits between two on the other. It holds skin firmly with little pressure.
- Brown-Adson rows (7x7, 9x9) spread the hold over many small teeth, which suits skin edges.
- Serrated, no teeth: for dressings, sutures and tissue that teeth would damage.
- Tungsten carbide tips on the Adson TC and Bonney TC keep their grip pattern for longer.
- Insulated coagulating forceps carry current to the tips for coagulation while the handle stays insulated.
How should forceps be cleaned?
Brush the tips and teeth straight after use, where tissue packs in. Check that the tips meet evenly and the teeth mesh when closed. Check the insulation on coagulating forceps every time. Never leave instruments in saline, because it causes corrosion. Our instrument care guide gives the full routine, and the CDC guidance on cleaning instruments before sterilization explains why cleaning comes before the autoclave.
Frequently asked questions
What does 1x2 teeth mean?
One tooth on one tip fits between two teeth on the other, so the forceps holds tissue firmly without slipping.
What is the difference between Adson and Brown-Adson forceps?
Adson forceps usually have 1x2 teeth. Brown-Adson forceps have rows of small teeth along the tips, which spread the grip on skin.
What are DeBakey forceps used for?
Holding vessels and delicate tissue with little damage, thanks to their fine, lengthwise atraumatic teeth.
Why use bayonet forceps in the nose?
The bayonet bend keeps your hand below your line of sight, so you can see the tips inside the nasal cavity.
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