Table of Contents 

Welcome
Introductory Letter 
History of Surgical Industry in Pakistan 
Company Profile
Organizational Hierarchy
Quality Policy
Process Flow Chart
Process Model
Manufacturing Steps
Cleaning, Sterilization & Maintenance Process

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WELCOME 

We feel immense pleasure to present our latest catalogues in which we have featured a most comprehensive range of all quality Surgical Instruments required for day-to-day use for SURGEONS, OPERATING ROOM, NURSES CENTRAL SUPPLY, CLINICS, FLOOR USE, EMERGENCY ROOMS, PROFESSIONAL AND OTHER MEMBERS OF THE SURGICAL-CARE TEAM. Without their loyalty, support and steady flow of innovative ideas, we would not be marking this momentous occasion.
Further, we are proud to dedicate this landmark edition to you being our valued customer. With this dedication, we would also like to recognize and honour team past and present, especially one gentleman whose name is synonymous with the creation of fine Surgeon instruments, our associate for more than one decade, Mr. Qadeer Ahmad Khan.
Together, we have followed in the footsteps of our founder, Mr. Abdul Ghani (Late) in a culture dedicated to quality, service and responsiveness to our customer's needs. Today, all of us at QZA INTERNATIONAL is proud to serve as your single-source supplier for the specialty of all kinds of Surgical Care Products.
We have ISO 9001:2000, ISO: 13485:2003, cGMP Approved and CE Marked. We wear this badge with pride. We have implemented not to our product, but rather to a Company's documented quality policies, processes and procedures.
All instruments are manufactured according to the recognized standard patterns currently in use in Hospitals throughout the world and are being produced under the strict control of experts to avoid any flaw and to refrain any complaint at any stage. If there is any way we can be of service to you, please contact us without any hesitation.
We express our thanks to our entire customer for the confidence they have placed in us in the past. We further assure them, that we will continue our best efforts to gain their confidence in the future.

Quality is never an accident; it’s always the results of an intelligent effort.
 

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INTRODUCTORY LETTER

Subject: Supply of Surgical Instruments 

Dear Sir/Madam, 

We introduce ourselves as pioneer Manufacturers – cum – Exporters of Surgical Instruments in super quality here in Pakistan beg to our most excellent service to cater against your valuable requirements. 

Our organization, backed by the history of over four decades fully equipped with the most modern machinery, hardening, tempering, plating plants having adequate testing facilities by the highly skilled and most experienced craftsmen / technicians, is producing unrevealed quality carrying an unconditional GUARANTEE for: -  

1        Use of best steel of proper specification in the production, flawless workmanship and superb finish. 

2        Electrolytically passivated and ultrasonically cleaned with the best-imported chemicals to provide maximum resistance to corrosion. 

3        Exact match of samples approved by the buyers, as well as, uniform standard of fabrication and finish for any quantities. 

4        Immediate settlement of any item found to be of substandard quality replaced including the applicable charges if any.

CATALOGUES: 

Illustrated Surgical Catalogue is being provided for your future reference. 

DELIVERY:

All orders are being supplied within the stipulated period of time.
However, the orders of special and non-existing items can also be executed upon receipt of sketch, drawings or specifications from the customer.  

SAMPLES: 

In order to just take an idea about our quality, please ask for necessary samples of your interest against which we shall be very glad to submit without any further delay. 

PRICE: 

Now-a-day, due to great competition, this business is being conducted on quotation basis, therefore, you are requested to kindly provide us a list of your desire items against which we shall appreciate to quote / offer our most competitive prices for favour of your kind approval. 

Looking forward to your early kind encouraging reply.

With Cordial Greetings,

OUR EXPORT MARKET:
1    Germany 
2    Malaysia 
3    Brazil 
4    United Kingdom
5    U.S.A 
6    Ukraine  
7    Colombia
8    Malta
9    Hungary
10  Australia

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History of the Surgical Industry

In Pakistan

            At the end of the nineteenth century an American Mission Hospital was established in Sialkot, India to service the poor population for whom access to health care was limited.  The Dean of this Hospital became aware of the skill of local artisans who for centuries made swords and daggers for the Royal Armies.  He concluded that if these artisans were given prototypes that they cold also make surgical instruments.  In the beginning he commissioned a few of these artisans to make scalpels, which they did to this complete satisfaction. 

            As a result of this demonstrated ability the Dean asked these artisans to make spatulas and knives of different types.  Slowly but steadily more items were requested.  Within a short time word spread of these artisans to other missionary hospitals throughout India who began sending for instruments.  This type of domestic sales activity continued up until World War II. 

            During the Second World War the British had difficulty getting surgical instrument supplies to their field hospitals.  As part of an alternate source strategy they conducted a survey of potential sources for surgical instruments and found that the Sialkot artisans, with the right guidance, could make the necessary instruments. 

            To facilitate this guidance the British established a Surgical Development Center in Sialkot bringing British instrument making technology to the industry and training some workers in the necessary skills.  These skilled workers began working in small factories where many types of haemostatic forceps, dissecting forceps, knives, scalpels and other instruments were initially made with the help of this Surgical Center and sold to the British Army. 

            By the end of the war the surgical instrument industry was firmly established in small factories in Sialkot.  These factories sent their agents to various cities in India and began receiving orders for their instruments.  These domestic sales continued until August of 1947 when India was partitioned and Pakistan formed.           

            Sialkot was in Pakistan now and the industry immediately faced a serious crisis because most of the factory owners were Indian Hindus who abandoned their businesses and migrated to back to India. Event the electric Supply Co. was run by Hindus who migrated and suddenly Sialkot was without any qualified personnel to run their electric plant. Sialkot went without electric service for several years, which set back the industry’s development.
With the return of electrical power the industry began to rebuild in the early 1950’s and by 1954 exports of surgical instruments began. 

            The first export market became England seeking manicure items and Nurses Scissors. By the early 1960,s instruments were exported throughout the United Kingdom and in Germany. Later the United States was added to the list of importing countries. Pakistan, in its early years, regulated its import activity by requiring Companies to possess an import license, but with surgical instrument exports growing the Government relaxed their import regulations to help a few factories import raw materials, chiefly stainless steel. In 1968 the Government also allowed six factories to import manufacturing equipment such as Hammers, Milling Machines, Eccentric Presses, Electrolytical polishing plants and Ultrasonic cleaners to increase production and upgrade the industry’s manufacturing from manual to semi-mechanical processes. 

            Through time more machinery was allowed entry into Pakistan. Production capability grew and as the supply and market expanded the competition began to mount with pricing the major weapon. Competitors began to under cut each other’s prices forcing the Government to set minimum export prices in 1962. This control was successful in stabilizing the industry and remained in effect until 1982. However, when price controls were lifted the price wars resumed and as prices dropped the need for inexpensive raw material grew. Substituting medical grade stainless steel with lesser steel became a cost containment strategy especially when disposable instruments were introduced and accepted into the market place. This was also the time when many Pakistani Firms began establishing offices in the United States to increase sales

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COMPANY PROFILE

 Briefly Corporate History:  

1       Introduction & Start up year: 

To introduce the firm briefly, M/s. QZA INTERNATIONAL was established in 1940 by (Late) Mr. Muhammad Abdul Ghani, who was well known as a specialized skilled worker and maker of Surgical Instruments.  

1       The QZA International Story: 

He used to supply his hand made products with in the entire territory of sub-continent prior to August 1947 when the India and the Pakistan were combined. After the Freedom, the founder of the firm (Late) Mr. Muhammad Abdul Ghani started the export to the Middle East.  

2       Dynamic Expansion: 

Then Mr. Qadeer Ahmad Khan, the son of the founder, entered into the business under the supervision of his great father. He sorted out the markets through concrete and rest less efforts and he succeeded. He also started export to Europe and gradually developed and expanded his business around the Globe. This company is totally involved in Surgical field, covering operation room, Floor Grade use and Disposable Line etc.

3       Business Review: 

Since then the QZA International are exporting the major lots of quality products to USA, UK, Germany and Brazil etc., and their export performance is raising up yearly and now looking ahead. By the grace of God Almighty, This firm is recognized as a leading Manufacturing / Exporting Unit of Sialkot, Pakistan.

We are quite aware of the present situation in the USA, UK, Germany and Brazil etc.,  regarding the competition in Surgical instruments and also know about the execution of Contracts keeping in view main three factors i.e. “ Flawless Quality “, “ Most Competitive prices ” and “Delivery in Time” is most essential for achieving this goal.

QZA INTERNATIONAL is a unique leader in producing the best quality standard instruments and is well familiar with quality controlling process by using most modern technology of International quality control systems/programme. Our all instruments are carefully passivated, electrolytically polished and ultrasonically cleaned with best chemicals available. Therefore, we GUARANTEE of our instruments against any eventual manufacturing defects and material, to either replaced or credit. 

Customer satisfaction is our priority, business, recognition & basic aim

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QUALITY POLICY

 Our Strategy 

1        Fair dealing, Straight Forwardness, Honesty, Sincerity, Truth 

2        The Material used in the production against order is exactly as per approved samples. 

3        Normally, in Cutting instrument, we use (420 Type) Japanese stainless Steel. 

4        For Non-Cutting instruments like Forceps, Tweezers etc; we use (410 Type) Japanese Stainless Steel. 

5        Moreover, we can also the material as per our customer requirements. 

6        We always cordially welcome our valued customer’s opinions, suggestion and recommendation.  

7        We give replacement against defective goods, if the malfunction occurred at our end. 

The best you advise us, the better we will serve you

Our Goals & Objectives:

All of our goals and objectives are reviewed on a periodic basis to ensure that they are used as a means of continuous improvement for the organization.  

This is our family Business, so we know it better 

 The quality policy is the main guiding principles that provide the focus of Quality to the whole organization and improve the effectiveness of the quality management system.

Long life customers through quality while consistency in quality

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PROCESS FLOW CHART

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PROCESS MODEL

        QUALITY MANAGEMENT SYSTEM

A TRADITIONAL OF EXCELLENCE

Instruments Care:

To Our Customers:

Concerning your question on why staining, pitting or rusting can develop on stainless steel instruments; there are some basic points for the care and handling of Surgical instruments which will extend the life of the instrument, eliminate staining or corrosion and lower the cost in use.

These are as follow:

1.    Instruments should be rinsed as soon as possible after use to remove blood, serum and saline. Do not use a sponge basin as any reside from normal saline solution can cause corrosion to develop over a period of time.

2.    Instruments should be thoroughly dried after cleaning and before wrapping or storing, as moisture left in the box lock or serrations can cause rust or corrosion to develop.

3.    Do not leave instruments in a cold sterilization soak solution for extended periods as these solutions tend to be corrosive (after cold sterilization, rinse the instruments in distilled or demineralized water and dry thoroughly).

4.    If using cold sterilization technique, change the solution according to directions, as prolonged use will cause the solution become corrosive.

5.    Do not use caustic cleaners or any other cleaner except those specified for cleaning Surgical instruments

6.    Do not clean instruments with steel wool or scouring powder, or use high PH detergents. If cleaning by hand, use a specific instrument cleaner or a neutral detergent soap and a soft brush (rinse with demineralized or distilled water).

7.    Check your autoclave. Iron, sodium, calcium, magnesium or copper in your water can cause spotting, staining or corrosion to occur. In hard water areas, clean the lime deposits from steam lines periodically or use distilled or demineralized water for your autoclave. Install a steam filter if possible. It will remove most of dirt, rust and pipe scale.

8.    Make sure your muslin wraps are rinsed sufficiently (6 to 8 times) by the laundry to remove all chlorine bleach as any residue can cause staining or corrosion during autoclaving.  

9.    Do not leave instruments in the following solutions for extended periods as corrosion can result: -
(a) Aluminum, Barium, Calcium, Ferrous or Stannous Chloride solutions.
(b) Phenol, Lysol or Lodine.
(c) Dakin's Solution or Zephirin.
(d) Any acid, Mercury or Potassium solution.

10. Do not sterilize stainless steel instruments with chrome plated instruments if possible, as any break in the surface of the chrome plate will allow an electrolytic action to develop between the dissimilar metals, causing pitting and/or a rusty appearance to develop.

11. Preheat instruments in autoclave before allowing steam to enter, if possible, to prevent an excessive amount of condensation forming on the surface of the instruments.

12. Don't open the autoclave too quickly after the sterilization cycle as excessive condensation will develop on the surface of the instruments (crack the clave to allow drying before opening fully).
If you follow the above rules and use instrument cleaners and lubricant milk such as our Ami-Clean or Ami-Tec products, your instruments should remain rust, spot and stain free. I hope this will answer any question you might have on this topic.
When proper care is taken these stainless steel instruments can last for many years.

Sterilization Method:

Sterilization in Autoclave:

1.    After having carefully washed dried and oiled instruments place instruments that can be opened in the open position; put these instruments in sterilization packets and place in appropriate trays.

2.    Be careful not to over load autoclave. When an autoclave is too full it's possible that proper sterilization has not taken place.

3.    After the sterilization cycle has taken place, follow manufacture's suggestions for drying cycle.  

Cold Sterilization:

When using a solution for sterilizing instruments careful attention must made that the solution kills specific bacteria and virus, many solutions have no effect on bacteria or virus when in the presence of blood; also many solution are very corrosive on the instruments, most solutions recommend a soak time of 10 hrs. Because of the long soak time the chemical action can damage the instrument. Reduce when possible soak time; where indicated use a corrosion inhibitor.

IMPORTANT INFORMATION 

To our Customer:

1      To provide "Excellent Service and Economically Price" is the motto of our business.

2      All instruments are made of Stainless Steel otherwise specified.

3     All types of "Mirror-Finish" "Satin/Dull-Finish" "Sand Blast-Finish" instruments are available in stock but choice of polishes will be supplied on demand without any extra charges.

4     All Disposable/Floor Grade Instruments are stamped with words "STAINLESS" and "PAKISTAN". Buyer’s own brand may also be engraved on demand. "Die-Sunk" procedure generally used.

5     The etching stamps are only used for "High Quality" Instruments and keep in stock as per our customer's demand. These are also available in both "Mirror-Finish" "Satin/Dull-Finish" "Sand Blast-Finish" and are processed through boil test and passivated, which is a warranty against oxidization.

6     Each and every piece is individually packed in airtight polythene bag in order to avoid by contamination but can be packed as per customer's demand.

7     All general items are stored in big quantities in finishes three "Mirror-Finish" "Satin/Dull-Finish" "Sand Blast-Finish" in order to fulfill the urgent requirements of our valuable customer's immediately and price would be same for both finishes.

8    We offer Freight prepaid and collect prices as per Customer's requirements.

9    Compromise on running inquiry is our one of the greatest characteristics of our dealing.

10  While ordering, specify quantity, catalogue number and description completely.
State if order is to be dispatched by UPS, FedEx or other means of transportation.

11  Easy replacement in case of any damage.

12  Advise carrier promptly of any damage or shortage.

13  Merchandise will not be accepted for exchange or credit unless or until prior permission for its return has been granted.

14  Samples are provided at free of cost.

15  Special items can also be supplied if sketch, drawing or samples are provided to us or refer any reference from any reputed catalogue for our guidance.

1       Specification of material used production:

 All Instruments are being produced under the supervision of highly experienced and skilled craftsmen carrying an "UNCONTDITIONAL GUARANTEE" for: -

1       Use of best steel of proper specification in the production.

2       Adequate testing in hardening/tempering.

3       Accurate adjustment of ratchets/serrations of forceps, etc.

4       Electrolytically polished, passivated and ultrasonically cleaned with best suitable chemicals.

5       Flawless workmanship and superb finish.

6       Minute inspection at every quality controlling process as per International Standard Organization specifications.

7       Immediate settlement of claim against substandard quality.

This "GUARANTEE" is always maintained as all instruments are fabricated in uniform standard of samples exactly approved by the buyers.

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MANUFACTURING STEPS

PRODUCTION CAPABILITIES

QZA International is an employee owned company of Craftsmen and has got a good reputation for quality and reliability. Our significant manufacturing steps are being described here-under briefly: 

1.         MATERIAL USED:  Always a best quality stainless steel material is purchased from steel manufacturers. Two kinds of series i.e. 300, 410 and 420 of stainless steel is used for production of Surgical Instruments.

2.         MATERIAL TESTING:  The purchased raw material is thoroughly tested under PQA. authority. A rigid quality control policy is being adopted before releasing to production. This test is taken to check the standard of steel as per desired specifications and is considered the most important factor of our business.

3.         FORGING & HAMMERING:  After testing, the stainless steel strips/bars are divided into different sizes as per our requirements and our highly experienced craftsmen are specialized in forging (Hot/Cold Drop) to perform all standard press operations in forming and deep drawing of all type of instruments. We anneal the forging and prepare for the milling process.

4.         MACHINE & TOOL WORK:  Our highly skilled technicians have a great knowledge about machine milling process. We form accurately male/female portion of box-joint forceps, as well as, serrations/ratches in uniformity. We are equipped to mill, drill, bore turn and grind all type of metals. We have in house facility of custom tool and die production, maintenance and repair.

5.         FILLING: We are specialized in hand–made fabrication. First, we assemble male/female portion after setting/adjusting of Extracting Forceps and Scissors, tips, serrations, ratches in uniformity and file precisely to make it semi-finish under strictly quality control specifications. We are now moving from basic hand manufacturing techniques to mechanization to production run.

6.         HEAT TREATMENT:  All instruments are being tempered maintaining “Rock-Well Hardness” for Hemostat/Forceps 40° to 45° degree, Extracting Forceps & Retractor 45º to 50º degree, Scalar, Gauges and Scalpel 50° to 55 º degrees, Scissors 45° to 55° degree. A test is taken to check the hardness after tempering of each lot to maintain the uniformity and, before proceeding further, we clean all instruments by various chemicals. In addition, we will buy specialized Q/C equipment in near future to meet special customer Q/C. specifications. 

7.         RIVETING & WELDING:  We perform a wide variety of assembly operations from prototype quantities to production run. We rivet precisely each instrument such as, Hemostat/Forceps and Scissors, Extracting Forceps & Retractor, etc. But, for some kind of instruments, we use spot welding.

8.         GRINDING & POLISHING:  For precise grinding and excellent finish, we specialize in applying polishing wheels to belts to improve the overall finish in high uniformity utilizing best of polishing luster. We use electro-plating plants to polish serrations/ratches and joints of stainless steel instruments. For satin/matt finish instruments, we use glass heads to achieve uniformity. All instruments are being polished under rigid quality control specifications.

9.         PASSIVATION:  This method actually provides the instruments with its corrosion resistance properties. Passivation, which follows the final polishing step, is a chemical bath, which creates an oxidized layer on the surface of instruments. We are now equipped with most modern process.

10.       ULTRASONIC CLEANING:  We are full equipped with most modern ultrasonic cleaning plants imported from “Branson Cleaning Equipment Co. USA”, and all instruments are being cleaned properly utilizing various chemicals such as, Tri-Chloroethlyine etc.

11.       INSPECTION & STAMPING:  We inspect all instruments under rigid Q/C. specifications and give the assurance to our relative clients that all instruments shall be free from all defects such as, burrs, sharp edges, cracks, pitting, scratches, grease / excessive oil and foreign matters etc. We also guarantee for its workmanship. For stamping, we use both process i.e. die sunk and electrolytic marking and are being marked under customer’s specifications.

12.       PACKING & LABELING: We pack all instruments under strictly Q/C. specifications as per customer’s demand. Normally, we pack individually in polybag and further 12 pieces in one box mentioning outside with Part Number, Description and Lot Number. All instruments are packed in polybags with adequate desiccant in each polybag to absorb moisture. Mostly, we are packaging and labeling as per customer demand.

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CLEANING, STERILIZATION & MAINTENANCE PROCESS

RECOMMENDED STEPS IN CLEANING, STERILIZATION AND

MAINTENANCE OF SURGICAL INSTRUMENTS.

         V.  After scrubbing, rinse instruments thoroughly under running water. While rinsing, open and close       scissors, Needle holders and other hinged instruments to make sure the hinge areas are rinsed out, as well as the outside of the instruments. 

  3.          AFTER CLEANING:
               If instruments are to be stored, let them air dry and store them in a clean and dry environment. 

  4.          AUTOCLAVING:
               If instruments are to be reused or autoclaved: 

              A.  Lubricate all instruments, which have any “metal to metal” action such as scissors, Needle holders, self-retaining retractors, etc. Recommended Surgical lubricants such as instrument milk are best. Do not use WD-40 oil or other industrial lubricants.

               B.  Put instruments up for autoclaving either individually or in sets. 

Individual instruments

               Disposable paper or plastic pouches are ideal. Make sure you use a wide enough pouch (4” or wider) for instruments with ratchet locks such as needle holders and other instruments can be sterilized in an open (unlocked) position.

             Instrument Sets

Unlock all instruments and sterilize them in an open position. Place heavy instruments on bottom of    set (when two layers are required). Never lock an instrument during autoclaving. It will not be sterile, as steam cannot reach the metal-to-metal surfaces. The instrument will develop cracks in hinge areas because of heat expansion during autoclave cycle. Do not overload autoclave chamber, as pockets may form that do not permit steam penetration.
Place towel on bottom of pan to absorb excess moisture during autoclaving. This will reduce the chances of getting “Wet Packs”. Make sure the towels used in sterilization of instruments have no detergent residue and are neutral PH (7) if immersed in water. This can be a real problem as laundries frequently use inexpensive but high PH (9-13) detergents and do not properly rinse out or neutralize those detergents in the final wash/rinse cycle. Also sometimes bleaches such as Clorox are added and are not neutralized.

     CAUTION- At the end of the autoclave cycle- before the drying cycle-unlock autoclave door and open it no more than a crack (about ¾”). Then run dry cycle for the period recommended by the autoclave manufacturer. If the autoclave door is opened fully before the drying cycle, cold room air will rush into the chamber, causing condensation on the instruments. This will result in water stains on the instruments and also cause wet packs.
If you have any unusual staining on your instruments during sterilization contact your local instrument representative. 

 5.       COLD STERILIZATION

     Most cold sterilization solutions render instruments sterile only after a 10-hour immersion. This prolonged chemical action can be more detrimental to Surgical instruments than the usual 20 minutes autoclave cycle. If the instruments need to be “disinfected” only, cold sterilization is okay, as disinfections will take place in only 10 minutes. But keep in kind the difference between:

      STERILE – an absolute term (no living organism survives)
 and
      DISINFECTED – basically clean. 

Always use the proper sterilization/cleaning technique to render the instrument in the required condition for use.