BULLDOG Clamps

   The bulldog clamp is a surgical tool used to clamp off or close blood vessels. Made of stainless steel or titanium, the most common bulldog clamp is a spring-loaded crossover clamp. It has serrated blades that when pressed together become an effective tool to cut off blood supply.

There are clamps made for arteries and veins. The structure and function of arteries and veins are different. The arteries carry blood away from the heart. All arteries, except for the pulmonary, or the respiratory arteries, and the umbilical artery, the blood vessel in the abdomen and pelvic area that extends to the umbilical cord during pregnancy, carry oxygenated blood. Veins carry blood towards the heart. Veins carry deoxygenated blood, except for the pulmonary and umbilical arteries, which carry oxygenated blood.

The main purpose of the bulldog clamp is to stop the blood flow and prevent excessive bleeding in the area of the surgical procedure, and to prevent the patient from losing an unnecessary amount of blood. The most common type of clamp opens when the handles are squeezed, and conversely, shuts when the pressure is released from the handles. 

Slight variations to these clamps can be found, depending on the location of the surgical procedure and the needs of the surgeon. For example, the glover bulldog clamp utilizes a tension-adjusted screw to replace the standard handle-operated opening and shutting of the clamp. This tension-adjusted screw allows for a controlled amount of pressure to be placed on the blood vessel.

The bulldog clamp comes in a variety of sizes and shapes. Clamps typically range from one inch (2.5 cm), commonly used for smaller blood vessels or areas which require a delicate touch, to two inches (5 cm) in length. They can be straight or curved. The curvature of the blades can also range from curved to strongly-curved. This allows the surgeon to access those blood vessels which are difficult to reach.

The bulldog clamp can also come with an amplifier. An amplifier resembles an extended handle. This allows the surgeon to use clamping techniques when distance is an obstacle. An example of a surgical procedure where an amplifier may be needed to secure a blood vessel is endoscopic procedures. 

An endoscope is an instrument which allows the surgeon to see deep body structures and organs where there is no direct line of sight. Examples of surgical procedures that may require an endoscope are inside the colon or bowel. This is where a bulldog clamp amplifier can effectively utilize the necessary clamping techniques without difficulty.

UMBILICAL CORD Clamp

     In many births, it is routine to separate the baby from the placenta by cutting the umbilical cord. This procedure usually first involves clamping the cord. The umbilical cord clamp thus refers to the devices used to hold the cord in place when the cut is made, and the clamp may stay on for several days while the remaining cord attached to the baby dries.

There can be some variance in appearance of the umbilical cord clamp. Many are plastic and look slightly like a barrette. They usually have teeth that fit together as the cord is clamped, and they may have different fittings on the open side that click in place so a secure fit is achieved. Many medical companies that make the clamps are located in places like India or China, but clamps may be made elsewhere too.

Sometimes an umbilical cord clamp is sold with a cutter of some sort, and they're usually sold in volume supply. People can’t just buy one but may need to buy hundreds at a time. This may be helpful for hospitals, but could be an issue for midwives who attend home births, as they simply may not need that many clamps, or a supply might last several years at least. 

Not every child who is born has an umbilical cord clamp. Some parents cut the cord and prefer to let the whole cord fall off in the ensuing days. Other times the umbilical cord is secured by tape instead of an umbilical cord clamp. There are disputes about which procedure is most healthful.

One thing that is currently at issue is when to apply an umbilical cord clamp and when to cut the cord. It used to be standard for babies to have the clamp and cut at one minute. Now there is some evidence suggesting that waiting until three minutes may be more beneficial to newborns because it allows continued blood communication between the placenta and the newborn, which may affect blood clotting time or iron in blood levels. 

This brings up the very nature of the umbilical cord clamp. In addition to providing stability to cut the cord, it cuts off communication with the placenta. This is the natural round of life, but there are some who find this a deeply sentimental aspect of the birth of a child. The connection between mother and child on an elemental level is severed with a clamp and cut, though at the same time, birth brings the opportunity for knowing the child in ways not possible when that baby was in the womb.

CLAMP Forceps

     Clamp forceps are a type of tool that can hold, compress, or grasp an item while locking in place. They are also called locking forceps. For instance, clamping forceps allow a heart surgeon to clamp off an artery to prevent bleeding, while the locking mechanism keeps the forceps in place. These types of forceps are used primarily in the medical field in both veterinary and human medicine. There are many variations of sizes, materials, and designs, with some forceps engineered to perform specific functions. 

Most of these forceps are shaped like an X and use a lever principle. A hinge at or near the center of the forceps allows the user to squeeze one end to apply pressure at the opposite end. They are similar in action to ordinary scissors, except that the forceps lock in place once they are closed. The clamping, or locking, mechanism is a set of opposing serrated tabs located between the openings for the thumb and forefinger. When the clamp forceps are squeezed, the serrated tabs come into contact with each other and hold the forceps at that pressure; with another slight squeeze, the user breaks the contact, and the forceps open.

The simple locking mechanism, unlike spring clamps, allows for various clamping pressures. A light squeezing pressure can compress delicate tissues without damaging them. Stronger squeezing pressure can be used to compress surgical tubing or hold a tooth during extraction. This variable pressure feature and the ease with which they are placed, locked, and released make clamp forceps one of the most commonly used surgical instruments.

Forceps that are used to clamp off blood vessels are called hemostats. Many forceps are named for the surgeon who designed them. Surgeons sometimes develop these tools to use on specific tissues or during a particular type of procedure. Doctors use Allis forceps to hold intestinal tissue, while Carmalt forceps clamp ovarian pedicals. Adson forceps have long, tapered ends, allowing them to handle delicate tissue.

Several different materials are used to fabricate forceps. Those that are to be used once and then disposed of are made of plastic. Others are made of stainless steel or carbon steel, metals that will survive repeated sterilization. A number of specialty clamp forceps are made of titanian, a durable and lightweight metal. Depending on the use, the grasping end of the forceps may be rubber coated, angled, or grooved.