CA1219560A

CA1219560A - Pivotally mounted surgical instrument holder

Info

Publication number: CA1219560A
Application number: CA000380344A
Authority: CA
Inventors: John D. Eldridge, Jr.
Original assignee: Individual
Current assignee: Allegiance Corp
Priority date: 1980-06-23
Filing date: 1981-06-22
Publication date: 1987-03-24
Also published as: AU7209081A; GB2078677B; DE3124587A1; GB2078677A

Abstract

PIVOTALLY MOUNTED SURGICAL INSTRUMENT HOLDER
Abstract of the Disclosure A surgical instrument container has a top and bottom whose opposing surfaces are bordered by sidewalls and articulately connected to form an enclosed box. A planar substrate having upper and lower surfaces adapted to receive surgical instruments is pivotally mounted between the top and bottom. When the box is open, the substrate can be pivoted between the top and bottom to provide easy access to both upper and lower substrate surfaces. The substrate is positioned within the sidewalls of the top and bottom surfaces to effect enclosure of the substrate when the box is closed and thereby prevent retained surgical instruments from protruding through or falling out of the box. The substrate may be a porous foam or magnetic material or combination of each. The box may be mechanically or magnetically latched. The box may be composed of transparent material to permit visual inspection of the retained instruments when the box is closed.

Description

'I 667-A PIVOTALLY MOUNl'ED SURGICAL INSTRU~IENT HOLDER
Bac~ground of -the ~ _ention The inven-tion is directed to holders for suryical 5 instruments and more specifically to holders which securely encase such instruments prior to disposal thereof.
Virtually every surgical procedure requires the use of small, sharp implements such as suture needles, blades, staples, knives and the li~e. These instruments which are 10 utilized in a sterile condition must be placed on a readily accessible sterile retainer during an operation to maintain the sterility of the operating area.
Secondly, instruments, such as needles, require a sys-tem for providing a strict and accurate accountability 15 ~or each implement used. Thus, the operating nurse must have a reliable system for precisely determining how marly instruments were used in surgery and for insur;ng that all such instruments have been accounted for before surgical closure of the patient.
Finally, many of these instruments are disposable and there is therefore a need for a safe, effective means to discard the instruments which may be contaminated with bacteria or virus after surgery without risking injury to operating room personnel.
Several disposable surgical instrument holders have been developed in the past. For example, U.S. Patent No.
3,727,658 to Eldridge discloses a receiver for implements utilizing a plurality of magnets which are secured to the surface of a foldable, foamed, elastomeric 30 backing sheet. U.S. Patent No. 4tO08,802 to Freitag discloses a needle retainer formed oF a pad o~ resilient material having upstanding ridges through which needles are inserted. Each needle receiving zone is consecutively numbered to provide a method for maintaining an accurate count of the number o~ needles 9~:i60 utilized during a surgical procedure. Although such devices are quite useEul, the sharp instruments are exposed at the lateral edges of the devices when they are in a Eolded disposable condition. This is undesirable since the instruments may become detached and fall out of the device or possibly pierce or protrude through the assembly.
Attempts have been made to solve this problem by ~- 10 providing receivers which completely enclose the instruments. For example, U.S. Patent 4,013~109 to Sandel discloses a disposable container formed from a non-deformable casing which has magnetic sheets covering the entire surfaces of both hhe upper and lower portions of the case. Although the instruments are enclosed, the container does not provide a count system for the sharp instruments, nor does it allow for visual inspection of the implements after the container is closed. U.S. Patent ~,167,230 a-ttempts to alleviate this problem by providing a transparent tray having a bottom whose upper surface is adapted to receive the surgical instruments. The cover of the tray nests above the bottom halE and securely encloses the receiver. Although an improvement in some respects, the device provides only a solitary receiving surface. Such a device has a low instrument holding capacity. Since the devices are disposable, it is critical that they be manufactured and sold at low cost and provide the maximum implement holding capacity possible.
There is therefore a defini-te need for a device which completely encases the implements~ provides an accurate counting system and permi-ts viewing of the implements when the device is in its disposable configuration. Moreover, the device must provide maximum holding capacity and be manufactured at low cost.

~Z~956(:11 Sum~ary of the Invention The disclosed invention is a surgical instrument container having a top and bottom whose opposing surfaces are bordered by sidewall.s. A substrate having upper and lower surfaces adapted to receive surgical instruments is located bet:ween the top and bottom. The top, substrate and bottom are articulately connected along .: a common hinge line and are movable between open and closed positions. In the closed position, the top and bottom form an enclosed hox which completely encases instruments retained by the substrate. In the open position, the top and bottom are spaced to allow the substrate to be pivoted back and forth between them.
This.allows~ easy access to both surfaces of the substrate and permits both sides of the substrate to retain implements.
The substrate can take a variety of implement receiving configurations. In general, the substrate may contain magnets to magnetically hold the implements or be a porous foam which is pierced by the sharp implements to provide retention. In one preferred embodiment, the substrate is a planar magnet which has numbered needle receiving areas to provide a system to accurately count each instrument used. The top and bottom surfaces of the box may also be adapted to retain surgical implements.
Thus, the unique structure of the pivotally mounted substrate produces a container which has four potential implement receiving surfaces. This large implement receiving capacity is provided in an uncomplicated device which requires no more volume than the size of the box. Moreover, the substrate is completely encased within the box to prevent instruments ~rom falling out~

lZ19560 ~he box is advantageously formed of rigid material to prevent sharp instruments from piercing through the exterior.
The box may be mechanically or magnetically latched.
In a preferred embodiment, each of the top and bottom surfaces has a magnetizable member mounted thereon, at least one of the members being magnetized. The members are positioned to be in mutual contact when the box is closed to magnetically secure the box.
If a mechanical latch is employed with a planar magnetic substrate, magnetizable members may be affixed to the top and bottom surfaces to hold the substrate against the top or bottom surface.
These and other advantages of the invention will be clarified in the discussion below with reference to the drawings in which:
Figure 1 is a perspective view of the box in its open position with the substrate pivotally mounted between the top and bottom;
Figure 2 is a perspective view of the box of Figure 1 in its fully opened position showing the substrate held against the bottom by a magnetic ~trip;
Figure 3 is a perspective view of the box of Figure 1 in its fully opened position showing the substrate held against the top by a magnetic strip;
Figure 4 is a perspective view of the box in its closed position;
Figure 5 is a fragmentary sectional view of the box taken through line 5-5 of Figure 4 showing the hinge area;
Figure 6 is a perspective view of an alternate embodiment of the box and substrate of Figure 1 showing a magnetic latch;

~LX~5~0 Figure 7 is a perspective view of a second alternate embodiment of an implement receiving substrate;
Figure 8 is a sectional view of the second alternate substrate taken through line 8-8 of Figure 7;
Figure 9 is a perspective of a third alternate embodiment of an implement receiving substrate;
Figure 10 is an enlarged fragmentary perspective view of the third alternate substrate;
Figure 11 is a perspective view of a fourth alternate embodiment of an implement receiving substrate;
Figure 12 is an enlarged f-agmentary perspective view of the fourth alternate substrate;
Figure 13 is a perspective view of a fifth alternate embodiment of an implement receiving substrate; and Figure 14 is an enlarged fragmentary perspective view of the fifth alternate substrate.
Detailed Description of the Preferred Embodiment _._ Referring to Figure 1, a surgical instrument holding device 10 is shown having a top 11 and a bottom 13.
The top 11 is formed by a top surface 12 having four sides which are bordered by four sidewalls 14. The bottom 13 is formed by a bottom surface 16 which has four sides which are bordered by four sidewalls 18. The top 11 and bottom 13 are an essentially egual size and shape and are articulately connected between adjacent sidewalls by two hinges 20. The hinges 20 may be of any suitable type which permits the top 11 and the bottom 13 to pivot with respect to each other.
An elongate magnetizable strip 34 is mounted upon the top surface 12 adjacent to one of the sidewalls 14.
Similarly, a magnetizable strip 36 is positioned adjacent to one of the bottom sidewalls 18 and is affixed to the bottom surface.16. The strips 34, 36 may be affixed by an adhesive or any other suitable means. .

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Pivotally mounted between the top surface 12 and the bottom surface 16 is a planer substrate 22.
Referring to Figures 1, 2, 3 and 5 the substrate 22 is essentially rectangular. One side has a pair of laterally spaced extensions 23 which each have an opening 25 extending there-through. The openings 25 are bordered on each side by the substrate 22 forming a rectangularly shaped slot. In addition, another side of 10 the substrate 22 has a recess or notch 27 and ' -one corner 29 is chamfered The substrate 22 is formed of a thin coating material 31 which envelops a planar magnet 32. The material 31 can be elastomeric, cloth, paper or other suitable material. The material :~ ~ 15 31 prevents magnetic dust from entering the area of ; surgery and also may be chosen to provide suppor-t to the magnet 32 to prevent it from bowing.
The coating material 31 of the substrate 22 has a lower surface 2~ and an upper surface 26 which are 20 adapted to receive surgical instruments. In a preferred embodiment each surface 24, 26 is identical and has two co]umns of sequentially numbered instrument receiving zones 33 which are divided by a blade receiving zone 35.
Since the substrate 22 is composed of a planar magnet, it 25 will magnetically hold magnetizable instruments such as needles, blades, knives, and the like. Thus, in Figures 1 and 2, surgical needles 28 are shown retained in several of the numbered zones 33. The zones 33 allow operating room personnel to accurately account for every needle 30 used in a surgical opera-tion. In Figure 2 a blade 30 is shown retained in the blade receiving zone 35.
The substrate 22 is pivotally mounted to the top surface 12 and the bo-ttom surface 16 by positioning the hinges 20 within the openings 25. The top 11, the bottom 35 13 and the substrate 22 have a common hinge ~ine. When the device 10 is in its open position, the subs-trate 22 ~L2~1956~

is free to move articulately back and forth between the tsp surface 12 and the bottom surface 16. The recess 27 or chamfered corner 29 provide space for the finger so that the substrate 22 can be easily grasped and pivoted between the top and bottom surfaces 12, 16.
Referring to Figures 2 and 3 the device 10 is shown in its fully open position. As shown in the drawings, the hinges 20 extend from one marginal edge of the hinged side of the box further than any other part thereof, to permit the box to be fully opened, with the top surface 12 and the bottom surface 16 essentially co-planar. In order to utilize both the upper surface 26 and lower surface 24 of the substrate 22 as implement receivers, the substrate 22 is pivoted between the top surface 12 and the bottom surface 16. In a first position shown in Figure 2, the substrate 22 is located above and essentially parallel to the bottom surface 16. In this first position, the upper surface 26 is exposed and oriented upward to permit the placement of surgical instruments, such as the blade 30, on the substrate 22. The substrate 22 is held in its first position by the magnetizable strip 36. The strip 36 also spaces the substrate 22 above the bottom surface 16. A space is therefore created between the lower surface 24 of the substrate 22 and the bottom surface 16 of the box. This space is of a sufficient size to accommodate the needles 28 or other surgical instruments which may be attached to the lower surface 24 of the substrate 22.
In order to expose the lower surface 24 of the substrate 22, the substrate 22 can be pivotally moved from its first position shown in Figure 2 to a second position shown in Figure 3 in which the substrate 22 is located above the parallel to the upper surface 12. In this second position, the magnetizable strip 34 holds the substrate 22 and provides a spacing between the upper surface 26 of the substrate 22 and the top surface 12. This space is of a sufficient size to permit 95~;q:) - - -surgical implements, such as -the blade 30, to be retained on the upper surface 26. Thus, the unique structure of the pivotally mounted substrate 22 allows the device 10 to provide a-t least two implement receiving surfaces 24, 26 which are easily accessible to operating room personnel when the device 10 is in its opened position.
Referring again to Figure 1, an optional adhesive 0 strip 38 is shown affixed to -the bottom surface 16. The strip 38 is covered by a peel-away strip 40 made of a paper material as is well known to those in the art.
Thus, by peeling away the paper strip 40, the adhesive 38 is exposed and can be used to retain additional -15 surgical instrumënts~ Both the top surface 12-and the bottom surface 16 have a mechanical latch element 42 which mechanically latches the box in its closed position.
It should be understood that a plurality of implement receiving substrates may be used. Thus, the box could contain multiple tiers of pivotally mounted substrates to even further increase the implement holding capacity of the device.
Referring to Figure 4, the device 10 is shown in its closed position mechanically latched by the elements 42 in a known manner. Advantageously, the top and bottom 11, 13 are made of a transparent material. This permits the visual inspection of surgical implements, such as the blade 30, retained on the substrate 22 when the device 10 is closea. Also advantageously, the top and bottom 11, 13 are made of a rigid material, such as a hard plastic which prevents the sharp implements retained on the substrate 22 from piercing or projecting through the exterior of the device 10. As shown in Figure 4, when the device 10 is closed, the -top and bottom sidewalls 1~, 16 mutually ~2~ 6~

interface to provide a completely enclosed container.
Thus, the needles 28 and the blades 30 are encapsulated within the device 10 and cannot fall out Referring to Fi~ure 5, the device 10 is shown in its closed position with the substrate 22 lying parallel to the top and bot-tom surfaces 12, 16. The substrate 22 is spaced from the top and bot-tom surfaces 12, 16 an - approximately equal distance providing ample room to -~ 10 encase ins-truments on ei-ther side of the subs-trate 22~
Referring to Figure 6, an alternate embodiment of the device 10 is shown. The top surface 12 has a magnetizable member 48 affixed thereto and located ; adjacent to the top sidewall 14. Similarly 7 the bottom -~ - 15 surface 16 has afEixed thereto a magnetizable member - 50 which is located adjacent to a corresponding bottom sidewall 18. The magnetizable members 48, 50 are of a sufficient height and are positioned so that they will be in mutual contact when the device 10 is closed.
20 At least one of the magnetizable members 48, 50 is magnetized so that when the members 48 and 50 are placed in mutual contact, they will magnetically lock the top and bottom surfaces 12, 16 together. The members 48, 50 therefore are an alternative to the mechanical latching 25 elements 42.
A planar substrate 52 has a slot 54 cut into one edge. The slot 54 is of sufficient size to permit full exposure of the magnetizable member 50 when the substrate 52 is parallel to the bottom surface 16. Similarly, the 30 slot 54 will permit full exposure of the magnetizable member 48 when the substrate 52 is pivoted to be parallel to the top surface 12. Thus, the slot 54 permits the magnetizable members 48, 50 to contact each other when the device 10 is closed - 35 The substrate 52 has a pair of tabs 56 which protrude 9~;6C~

outward exterior of the bottom sidewall 18. The tabs 56 therefore rest against an upper edge 58 ~f the bottom sidewall 18 tv support and maintain the substrate 52 in a parallel position with respect to the bottom surface 16. The tabs 56 are very thin so that the top and bottom sidewalls 14; 18 substantially engage when the device 10 is closed. ~hus, the tabs 56 do not - prevent the device 10 from completely encasing the 10 portion o~ the substrate 52 which receives the surgical instruments. Were it not for the tabs 56, the magnet in substrate 52 would tend to flex against the bottom surface 16 which could result in implements being dislodged from the s~bstrate. In addition, the tabs 56 provide a 15 convenient handle for the operator's finger to aid in pivoting the substrate 52.
An optional strip of foam 59 is shown affixed to the upper surface 12 extending between opposing top sidewalls 14. The height of the foam is 20 approxLmately that of the height ~ the top sidewalls 14. The foam 59 can be used to hold sharp surgical instruments which are placed through the foam. In addition, the foam 59 maintains the substrate 52 spaced from the top surface 1~. Thus, if a similar piece of 25 foam were placed on the bottom surface 16, the need for the tabs 56 would be eliminated.
Referring to Figures 7 and 8 a second alternate embodiment 60 for the implement receiving substrate 2 is shown. The substrate 60 is quite similar to the 3Q receiver for surgica~ instruments disclosed in U.S.
~atent 3,727,658, issued to the instant inventor, John D~ Eldridge, Jr.
The substrate 60 has an upper surface 62 and a lowe~ surface 63 formed by a thin elastomeric 35 material 65. The material 65 envelops two bar magnets 64 thereby preventing magnetic dust from entering the surgical area. Each of the bar magnets 64 has numbered ~ ' ~L95~iO

needle instrument receiving zones 66 which provide an accurate system for counting the surgical ~mplement.s.which ha~Je been used during a surgical procedure. ~he substrate 60 has a pair o slots 68 sized to fit over the hinges 20 of the device 10. The material 65 also envelops an additional magnet 70 which is positioned along one edge of the substrate 60. The magnet 70 contacts the magnetizable members 34, 36, thereby holding the substrate 60 in a position parallel to, but spaced from the top surface 14 or the bottom surface 16. ~hus, the su~strate 60 provides two identical implement receivins surfaces 62, 63 which are made accessible by pivotally mountiny the substrate 60 over the hinges 20 between the top and bottom surfaces 12, 16.
lS Referring to Figures 9 and 10, a third alternate embodiment 74 of the substrate 22 is shown.
.. ., , _ The substrate 74 is c~mposed of a porous foam which has an upper surface 76 and a lower sur~ace 77. Extending outward from the upper and lower surfaces 76, 77 are a pair of elongate embossments 78. The substrate 74 also has a pair of slots B0. Positioned along one edge of the substrate 74 is a magnet 82 serving the same function as the magnet 68 in Figur~ 6. In Figure 10 a needle 84 is shown extending through the foamed embossment 78 above the upper surface 76.
It will be understood that the upper and lower surfaces 76, 77 are virtually identical. Thus, the substrate 74 also has two surgical receiving surfaces. It should be undersbx~
that the oamed substrate could be made of various types of foam having different degrees of rigidity. Less rigid --foams may require a rigidizing supporting member between the upper and lower surfaces 76, 77 to prevent deformation.

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956~) The ~agnet 82 holds the substrate 74 against the magnetizable strips 34, 36. The slots 80 fit over the hinges 20 to pivotally mount the substrate 74 ~etween the top and bottom surfaces 12, 16.
- Referring to Figuxe 11, a fourth alternate embodiment 88 of the substrate 22 is shown.

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The substrate 88 has an - upper surface 90 formed of a thin elastomeric material which has two columns of crescent-like depressions 92.
15 Extending s~mewhat above and through the middle of each column of depressions 92 is a bar maynet 94 which lies beneath the elastomeric material of the surface 90. The substrate 88 also has a pair of slots 96.
Located along one edge of the substrate 88 is a bar

2~ magnet 98. In combination with the device 10, the slots 96 pivotally mount the ~ubstrate 88 over the hinges 2Q. The magnet 98 holds the substrate 88 against the magnetizable strips 34, 360 Referring to Figure 12, the precise configuration of 25 the column of crescent-shaped depressions 92 is shown.
The bar magnet ~4 extends somewhat ab~ve the depth of the depressions and holds surgical instruments, such as a needle 100 within each crescent-shaped depression. It should be understood that the substrate 88 has a lower 30 surface 101 which is substantially identical to the upper surface 9~. Thus, the substrate 88 has two surfaces for receiving surgical instruments.
Referring to Figure 13, a fifth alternate embodiment 102 of the substrate 22 is shown.

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~he substrate 102 is composed of a porous foam having an upper surface 104. The surface 104 has two columns of crescent shaped depressions 106.
The substrate 102 has a pair of slots 108. Along one edge of the substrate 102 is located a bar magnet 110~ When 10 employed with the device 10, the substrate 1~2 is pivotally mounted over the hinges 20 by means of the slots 108. The magnet 110 holds the substrate 102 against the magnetizable members 34, 36.
- Referring to Figure 14, a portion of the column of 15 crescent-shaped depressions 106 is shown. Each depression has a centrally located tapered embossment 112 which receives a surgical implement such as a needle 114. The depressions are formed to partially envelop an implement. This reduces the chance that a needle 20 will hecome detached ~rom the substrate. The embossments 112 are tapered to receive different sized ~ - needIes. Thus, the wide area of the embossment 112 ;~ holds a large needle whereas ~he narrow area holds a small neeidle~ This aspect is important in making sure 25 the needle will lie flat against the substrate as shown in Figure 14 rather than protruding upward. Finally, it should be understood that the lower sur~ace c~f the substrate 102 (not shown) is virtually identical to the surfac~ 104 so that the substrate 102 has two ~mplement ~; 30 receiving sides. As discussed above with respe~t to the substrate 74, it may be necessary, when utilizlng softer oarns ~ to employ a xigid support member between the upper and lower surfaces 102, 104.
It should be understood that, in addition, 35 substrates like any of 22, 52, 60; 74, 88 or 102 could ~e af f ixed to either the top sur~ace 12 or bottom surface 16. Thus, the top and bottom surfaces 12, 16 ~ ' ~LZ~9560 l 14 can also be adap-ted to receive surgical implements.
The device 10, therefore, has a poten-tial of four surgical implement receiving surfaces: One provided by the top surface 12, a second provided by the bottom surface 16 .and a-third and fourth surface provided by the pivotally mounted substrate. The invention, therefore, offers a large instrument receiving capacity contained in a relatively small volume. In addition, the device 10:is uncomplicated and can be easily manufactured at low . .-~
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Claims

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A surgical instrument holder, comprising:
a pair of open containers, either of which can form the top or bottom of a box, each of said containers comprising a planar surface surrounded by sidewalls;
means for connecting one side of one of said containers to one side of the other of said containers, with said containers in side-by-side relationship, and said planar surfaces essentially coplanar;
a substrate comprising means for retaining surgical instruments; and substrate hinge means, on a hinged side of said containers, for pivotally mounting said substrate to alternatively lie against either of said containers to selectively expose surgical instruments on either side of said substrate and permit access thereto.

2. A surgical instrument holder as defined in Claim 1, wherein said connecting means comprises a hinge for opening and closing said box, and said substrate hinge and said box hinge are hinged along a common hinge line.

3. A surgical instrument holder as defined in Claim 2, wherein said box hinge extends beyond one marginal edge of said box further than any other part thereof.

4. A surgical instrument holder as defined in Claim 1, wherein said substrate hinge means comprises a slot in said substrate, said hinge means of said containers passing through said slot to mount said substrate.

5. A surgical instrument holder as defined in Claim 2, additionally comprising:
means for supporting said substrate to maintain said substrate in a substantially parallel position relative to one of said planar surfaces of said containers, and thereby preventing said substrate from contacting said planar surfaces of said containers.

6. A surgical instrument holder, comprising:
a box comprising a pair of open containers, either of which can form the top or bottom of said box, each of said open containers comprising a planar surface with surrounding sidewalls, the marginal edges of one of said containers conforming to the marginal edges of the other;
a hinge for opening and closing said box, said hinge connecting respective adjacent marginal edges of said containers, along a hinge line on one side of said box, so that said pair of containers can pivot relative to each other about said hinge line, said hinge extending beyond said one side of said box further than any other part thereof to permit said box to be fully opened with said planar surfaces of said containers essentially coplanar;
a substrate, comprising:
means for retaining surgical instruments, such as scalpels and needles, on both sides of said substrate;
hinge means for pivotally mounting said substrate along said one side of said box, between said containers forming said box, so that said surgical instruments are encased by said box when said box is closed, said substrate selectively pivotable, when said box is open, between a first position adjacent one of said open containers, to a second position adjacent the other of said open containers, to selectively expose the surgical instruments on either side of said substrate and permit access thereto.

7. A surgical instrument holder, as defined by Claim 6, wherein said box hinge and said substrate hinge are mounted to pivot about a common hinge line.

8. A surgical instrument holder as defined by Claim 6, wherein said substrate hinge means comprises a slot formed in said substrate, said box hinge passing through said slot to mount said substrate.

9. A surgical instrument holder as defined by Claim 6, wherein said substrate hinge means comprises:
a portion of said substrate which extends outside of said box; and means for attaching said extending portion of said substrate along said hinge line of said containers.

10. A surgical instrument holder as defined by Claim 9, wherein said attaching means comprises a slot through which said box hinge passes.

11. A surgical instrument holder as defined by Claim 6, wherein both of said containers are transparent to permit viewing of surgical instruments on said substrate surfaces.

12. A surgical instrument holder as defined by Claim 6, additionally comprising:
means for supporting said substrate to maintain said substrate in a substantially parallel position relative to one of said planar surfaces of said containers, and thereby preventing said substrate from contacting said planar surfaces of said containers.

13. A surgical instrument holder as defined by Claim 12, wherein said supporting means comprises a pair of spacing blocks fixedly mounted within said pair of containers, respectively, said spacing blocks having a height approximately equal to the height of the sidewalls of said containers.

14. A surgical instrument holder as defined by Claim 13, wherein said spacing blocks are formed of a foam-like material suitable for retaining sharp surgical instruments placed therethrough, so that said spacing blocks may serve the additional function of holding said surgical instruments.

15. A surgical instrument holder as defined by Claim 12, wherein said substrate supporting means comprises a tab portion projecting from said substrate, outside of said containers, said tab portion bearing against at least one of the container sidewalls to support said substrate thereon.

16. A surgical instrument container comprising:
a top surface bordered by sidewalls;
a bottom surface bordered by sidewalls, said top and bottom surfaces being articulately connected to form a box having open and closed positions;
a substrate having upper and lower surfaces adapted to retain surgical instruments, said substrate being pivotally mounted to said box between said top and bottom surfaces to encapsulate instruments held by said substrate within the box when said box is in the closed position, said substrate being articulately connected to said box to permit said substrate to freely pivot essentially 180° between first and second instrument receiving positions when the box is open to provide easy access to both upper and lower surfaces, said substrate upper surface positioned to receive instruments in the first position and said substrate lower surface positioned to receive instruments in the second position;

said top and bottom surfaces being formed of essentially transparent material to permit visual inspection of said upper and lower substrate surfaces when the box is in a closed position.