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A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and also for various arts and crafts (called a hobby knife). Scalpels may be single-use disposable or re-usable, and recently Safety Scalpels are the norm in the Operating Rooms. Re-usable scalpels can have permanently attached blades that can be sharpened or, more commonly, removable single-use blades. Disposable scalpels usually have a plastic handle with an extensible blade (like a utility knife) and are used once, then the entire instrument is discarded. Scalpel blades are usually individually packed in sterile pouches but are also offered non-sterile. Double-edged scalpels are referred to as “lancets”.

surgical scissor

 

Scalpel blades are usually made of hardened and tempered steel, stainless steel, or high carbon steel; in addition, titanium, ceramic, diamond and even obsidian knives are not uncommon. For example, when performing surgery under MRI guidance, steel blades are unusable (the blades would be drawn to the magnets, or may cause image artifacts). Historically, the preferred material for surgical scalpels was silver, on account of its antimicrobial properties (although the mechanics were not understood at the time). Scalpel blades are also offered by select manufacturers with a zirconium nitride-coated edge to improve sharpness and edge retention. Others manufacture blades that are polymer-coated to enhance lubricity during a cut. Alternatives to scalpels in surgical applications include electrocautery and lasers.

Reusable handle (top) and disposable scalpels (bottom):

Surgical scalpels consist of two parts, a blade and a handle. The handles are often reusable, with the blades being replaceable. In medical applications, each blade is only used once (even if just for a single, small cut).

Surgical Staple after an Operation

disposable scalpel and blade

 

Where can I locate the history of the surgical scalpel?

Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.

Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.

There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.

Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.

A scalpel may appear alarming at first.

This is a useful safety reaction and should mean that you will learn carefully and steadily.

A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.

For fine work with a No 15 blade, hold the scalpel like a pen.

This is the correct way of holding a pen, using a tripod grip.

The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.

Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.

This grip enables the surgeon to:

Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.


The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.

The handle rests in the palm of the hand.

The digits and hand are largely on top of the scalpel unlike with the pen grip.

This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the

way as in the pencil grip.

The grip is quite gentle.


For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than

on the side.

This will let you increase the downward pressure of the blade on the tissue.


For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.

The handle does not touch the hand.


Holding the scalpel in the fist or like a dagger is far too clumsy.


DO NOT dissect with the handle of the scalpel.

You will be concentrating on the site of dissection and may accidentally cut your assistant.

DO NOT hold the scalpel in your hand while using another instrument.

You may accidentally cut the patient as you concentrate on the dissection area.


ALWAYS pass the scalpel to someone else handle first.


Preferrably, place the scalpel in a dish for the scrub nurse to pick out.


DO NOT throw the scalpel down onto the bench (or onto the patient.)

The part of the blade that does the cutting is the curve and not the tip.

This means that you need to drag the curve of the blade across the tissue.

Scratching with the tip of the blade is a beginner's error.

A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.

You will feel the curved blade cutting into the tissue.

Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.


Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.


Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.