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Scalpels

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Brandon Buckner, CST, CRCST
Lamar State College Port Arthur (TX)

Main Text

Surgical instruments have a long history, but their modern versions have only been around for a relatively short period of time. The macairion, a surgical knife introduced by Hippocrates, served as the precursor to the modern scalpel, which nevertheless carries a notable similarity to its ancient predecessor.1 

Available in different shapes and sizes for diverse surgeries, contemporary scalpel blades and handles are typically crafted from hardened and tempered steel, stainless steel, and high carbon steel, with blade shapes designed according to their intended use. Recognized as indispensable surgical tools, scalpel blades contribute to precise incisions and minimal scarring, which is particularly crucial in minimally invasive, ophthalmic, cardiovascular, and endoscopic surgeries. Cutting in a firm and controlled way, usually at angles of 30–90 degrees from the tissues, necessitates holding the instrument in various ways, often placing a steadying forefinger along the back of the instrument. The tissue through which the scalpel is incising should also be steadied and put under a slight degree of tension.2

The demonstration of surgical scalpels in this video provides valuable insights into their usage. The handles are available in different designs, serving two functions: fitting the appropriate size of surgical blades and ensuring a firm hold to reduce the chance of slipping.

Surgical blades come in sterile packaging, and the number on a surgical blade communicates both its size and shape. This video demonstration aids in understanding how each blade is tailored to meet certain demands in surgery. Some common types include: 

  • No. 10 blade: used for making large incisions in muscle and skin.
  • No. 11 blade: carries an elongated triangular shape with a sharp edge and a pointed tip, making it well-suited for stab incisions.
  • No. 12 blade: features a crescent-shaped blade sharpened along the inside edge of the curve. It is sometimes utilized as a suture cutter but also for arteriotomies or pelviolithotomies.
  • No. 15 blade: features a small, curved cutting edge and is commonly employed for making concise and accurate cuts.

This video further explores the proper technique for mounting a scalpel blade onto a handle and safely removing it, highlighting the importance of selecting an appropriate handle based on size, weight, and length to ensure optimal precision during surgical procedures. The necessity of careful handling of scalpels to prevent accidental injuries is emphasized.

In summary, the persistent evolution of surgical scalpels from ancient prototypes to modern design underscores their critical role in achieving successful surgical outcomes. The careful choice of blades and handles, based on both historical practices and modern requirements, enhances the accuracy and safety of contemporary surgery.

Check out the rest of the series below:

  1. Scalpels
  2. Surgical Sutures
  3. Surgical Staplers
  4. Opening Sterile Surgical Packs
  5. Opening Sterile Surgical Instrument Containers
  6. Laparoscopic Instruments

Citations

  1. Ochsner J. The surgical knife. Bull Am Coll Surg. 1999;84(2).
  2. Crumplin MKH. Surgical knives: the scalpel. Brit J Surg. 2023;110(1). doi:10.1093/bjs/znac344.

Cite this article

Buckner B. Scalpels. J Med Insight. 2023;2023(300.1). doi:10.24296/jomi/300.1.