Aspects of the SIGN Technique

Posted by on Jan 20, 2014 | Comments Off on Aspects of the SIGN Technique

During travel I have a chance to think about different aspects of SIGN technique. We are grateful to our friends in Vietnam and Laos for their hospitality during recent trip.

Points to ponder

  • During reaming, sometimes the reamer does not advance. Reason – the canal is oval and the reamer may be out of the track reamed by previous reamers. The surgeon should feel the reamer reaming the canal during most of the 360°. Regulate your pressure of reaming to allow the right speed of advancement. Sometimes the reamer must be removed approximately 4 cm and then restarted. Turn the reamer clockwise during removal as well as advancement.
  • When using the step drill, a similar mechanism occurs. The point of the step drill must follow the pilot hole from the small drill bit. Sometimes the step drill must be redirected. Look at the step drill and the reamer during use to be sure they remain on the proper course. Sometimes frequent changes of direction make reaming difficult.
  • If your program is short of nails, be sure reporting is up to date. Having a list of nail sizes available posted on the wall will make the surgery go faster. The nurses will not have to look through the nails that have been sterilized.
  • There are different ways to increase efficiency when choosing the proper size nail. These include sterilizing each nail separately so the surgeon can call for the proper size. Some programs have a cloth container for nails.
  • Care of instruments is important. When the cutting edges of the reamers, step drill and drill bit are struck against other metal, a small nick occurs. This leads to dullness of the instrument.
  • Use the technique of drilling recommended on our webpage. Pulse the drill and do not let it remain in the same area while trying to drill. The drill bit heats up and becomes dull.
  • Use a drill cover if you use a hardware drill for stability. We are looking for some enterprising group to make these drill covers from cloth in each country. We will be happy to supply the pattern.
  • If you have other points, please share them with us and we will place them on SIGNsurgeons.

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