Adson Tissue Forceps
Fine, short, spring-action thumb forceps often used for skin and superficial-tissue handling in reconstructive-urology and urogynecology closure.[1][4] Catalog variants include toothed (1×2), smooth-serrated, and Brown-Adson (7×7 fine teeth) tips; select the actual tip for the tissue and exposure.[1][4]
Design
- Length. About 12 cm (4.75 in). Short enough for fine bimanual skin work, too short for deep pelvic exposure.
- Profile. Wide flat thumb grip tapering to narrow, finely tapered tips.
- Mechanism. Spring-action thumb forceps; the two arms are joined proximally and held open by the metal's spring.
- Material. Surgical-grade stainless steel, autoclavable; disposable variants also widely available.
Working-Surface Variants
| Variant | Working surface | Best tissue |
|---|---|---|
| Adson-toothed (1×2) | Single tooth interlocking between two opposing teeth | Skin edges, dartos, fascia during closure |
| Adson smooth-serrated | Fine transverse serrations, no teeth | Selected delicate superficial tissue; finer dedicated instruments may be preferable for vessels, nerves or mucosa |
| Adson-Brown (7×7) | Multiple fine interlocking teeth across a wider platform | Plastic / reconstructive skin handling where 1×2 teeth slip |
| Double-ended Adson | Toothed jaws on one end, smooth on the other | Hand and head-and-neck cases requiring frequent switching[2] |
The Toothed-vs-Smooth Trade-Off
Toothed Adson tips can secure dermis with less squeezing than a smooth tip, but tooth puncture and traction still cause injury. Smooth/serrated tips avoid tooth punctures yet can slip and tempt excessive compression.[5] In an in-vitro sheep-stomach jaw experiment, larger teeth improved grip but increased measured tissue trauma relative to wave-pattern jaws.[5] Match the jaw to the tissue, use the least force that controls it, and avoid implying that smooth tips are inherently safe on nerves, small vessels or vasal/ureteral mucosa.
The Brown-Adson variant has a broader 7×7 fine-tooth platform used in some plastic-surgery skin handling.[4]
Technique
- Grip. Use a pencil grip between thumb and index, stabilized by the middle finger.
- Match the variant to the tissue layer and exposure. Fine teeth may help on skin; use appropriately delicate, often dedicated instruments for vessels, nerves and urethral or ureteral mucosa.
- Brief, focal grasp. The goal is to evert and present the wound edge for needle passage, not to crush it. Repeated regripping at the same point compounds focal trauma.
- For dermal skin closure, a toothed Adson can be paired with a fine needle driver and appropriate suture. In a split-wound randomized trial of 48 patients undergoing Mohs surgery or cutaneous excision, adhesive strips added to buried subcuticular sutures showed no significant difference in patient or observer scar scores or scar width at 3 months.[3]
Reconstructive-Urology and Urogyn Uses
- Scrotal and penile-shaft-skin closure after hydrocelectomy, varicocelectomy, vasectomy / vasovasostomy, IPP and AUS scrotal incisions, penile-prosthesis exposure, and skin-bridge revision.
- Suprapubic skin closure for open BNR, augmentation, diversion, and AUS abdominal pouch incisions.
- Vaginal introital and perineal closure for prolapse repair, perineorrhaphy, fistula repair, episiotomy-defect revision, and post-defibulation closure.
- Inguinal incisions for groin-flap harvest, lymph-node dissection, and orchiopexy.
- Microsurgical setup: a smooth Adson may help with superficial setup or adventitial exposure, but very fine vasal or epididymal layers generally call for dedicated microsurgical forceps under magnification.
Distinctions from Adjacent Forceps
| Forceps | Profile vs Adson | Best layer |
|---|---|---|
| Adson (this page) | Short, fine, 1×2 teeth or smooth-serrated | Skin, dartos, subcutaneous tissue |
| Gerald | Longer, narrower, finer; microsurgical | Vasal / epididymal / ureteral mucosa, tunica |
| DeBakey | Longer, atraumatic, parallel ridged platform | Vessels, ureter, bowel serosa |
| Bonney | Heavier, larger, 1×2 deep teeth | Rectus fascia, abdominal wall, dense scar |
| Russian | Concentric serrated cup tips, no teeth | Handling bulkier tissues; tissue trauma remains possible under excessive pressure[5] |
| Singley | Long, fenestrated, ring-handled | Bowel, packing |
Historical Context
Named for Alfred Washington Adson (1887–1951), the first chair of the Section of Neurological Surgery at the Mayo Clinic and one of the founders of American neurosurgery. Adson described operations across spinal-cord tumors, peripheral nerve, and cerebrovascular disease, designed multiple instruments still in daily use, and lent his name to both the Adson test for thoracic outlet syndrome and the Adson-Brown forceps.[1]
See also: Gerald, DeBakey, Bonney, Russian.
References
1. Griessenauer CJ, Tubbs RS, Shoja MM, et al. "Alfred W. Adson (1887–1951): his contributions to surgery for tumors of the spine and spinal cord in the context of spinal tumor surgery in the late 19th and early 20th centuries." J Neurosurg Spine. 2013;19(6):750–8. doi:10.3171/2013.9.SPINE13220
2. Tegtmeier RE. "A double-ended Adson-type forceps." Ann Plast Surg. 1979;2(4):352. PMID 19341007
3. Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB. "Effect of adhesive strips and dermal sutures vs dermal sutures only on wound closure: a randomized clinical trial." JAMA Dermatol. 2015;151(8):862–7. doi:10.1001/jamadermatol.2015.0174
4. CooperSurgical. Euro-Med Adson-Brown grasping forceps: 7×7 interlocking-tooth specification. Manufacturer catalog.
5. Marucci DD, Cartmill JA, Walsh WR, Martin CJ. "Patterns of failure at the instrument-tissue interface." J Surg Res. 2000;93(1):16–20. doi:10.1006/jsre.2000.5906.