Scalpel
Encyclopedia
A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery
, anatomical dissection
, and various arts and crafts
(called a hobby knife). Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable blades. Disposable scalpels usually have a plastic handle with an extensible blade (like a utility knife
) and are used once, then the entire instrument discarded. Scalpel blades are usually individually packed in sterile pouches but are also offered non-sterile. Double-edged scalpels are referred to as "lancets".
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. 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 laser
s.
Graphical
and model-making scalpels tend to have round handles, with textured grips (either knurled
metal or soft plastic). These are often called by the name of the most well-known manufacturer of graphic arts blades, X-Acto knives
. The blade is usually flat and straight, allowing it to be run easily against a straightedge
to produce straight cuts.
There are many kinds of graphic arts blades, the most common around the graphic design studio is the #11 blade which is very similar to a #11 surgical blade (q.v.). Other blade shapes are used for wood carving
, cutting leather and heavy fabric, etc.
, as many as 1,000 people each day are subject to accidental needle sticks and lacerations while providing medical care. Scalpel blade injuries are among the most frequent sharps injuries, second only to needlesticks. Scalpel injuries make up 7 percent to 8 percent of all sharps injuries.
"Scalpel Safety" is a term coined to inform users that there are choices available to them to ensure their protection from this common sharps injury.
There are essentially two kinds of disposable safety scalpels offered by various manufacturers. They can be either classified as retractable blade or retractable sheath type. The retractable blade version made by companies such as OX Med Tech, DeRoyal
, Jai Surgicals, Swann Morton
are more intuitive to use due to their similarities to a standard box-cutter. Retractable sheath versions have much stronger ergonomic feel for the doctors and are made by companies such as Aditya Dispomed, Aspen Surgical and Southmedic.
Few companies have also started to offer a safety scalpel with a reusable metal handle. In such models, the blade is usually protected in a cartridge. Such systems usually require a custom handle and the price of blades and cartridges is considerably more than for conventional surgical blades.
However, CDC studies shows that up to 87% of active medical devices are not activated. Safety scalpels are active devices and therefore the risk of not activating is still significant. There is a study that indicated there were actually four times more injuries with safety scalpels than reusable scalpels.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, anatomical dissection
Dissection
Dissection is usually the process of disassembling and observing something to determine its internal structure and as an aid to discerning the functions and relationships of its components....
, and various arts and crafts
Arts and crafts
Arts and crafts comprise a whole host of activities and hobbies that are related to making things with one's hands and skill. These can be sub-divided into handicrafts or "traditional crafts" and "the rest"...
(called a hobby knife). Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable blades. Disposable scalpels usually have a plastic handle with an extensible blade (like a utility knife
Utility knife
A utility knife is a knife used for general or utility purposes. The utility knife was originally a fixed blade knife with a cutting edge suitable for general work such as cutting hides and cordage, scraping hides, butchering animals, cleaning fish, and other tasks.Today, the term "utility knife"...
) and are used once, then the entire instrument discarded. Scalpel blades are usually individually packed in sterile pouches but are also offered non-sterile. Double-edged scalpels are referred to as "lancets".
Scalpel blades are usually made of hardened and tempered steel, stainless steel
Stainless steel
In metallurgy, stainless steel, also known as inox steel or inox from French "inoxydable", is defined as a steel alloy with a minimum of 10.5 or 11% chromium content by mass....
, or high carbon steel; in addition, titanium
Titanium
Titanium is a chemical element with the symbol Ti and atomic number 22. It has a low density and is a strong, lustrous, corrosion-resistant transition metal with a silver color....
, ceramic
Ceramic
A ceramic is an inorganic, nonmetallic solid prepared by the action of heat and subsequent cooling. Ceramic materials may have a crystalline or partly crystalline structure, or may be amorphous...
, diamond
Diamond
In mineralogy, diamond is an allotrope of carbon, where the carbon atoms are arranged in a variation of the face-centered cubic crystal structure called a diamond lattice. Diamond is less stable than graphite, but the conversion rate from diamond to graphite is negligible at ambient conditions...
and even obsidian
Obsidian
Obsidian is a naturally occurring volcanic glass formed as an extrusive igneous rock.It is produced when felsic lava extruded from a volcano cools rapidly with minimum crystal growth...
knives are not uncommon. For example, when performing surgery under MRI
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
guidance, steel blades are unusable (the blades would be drawn to the magnets) or may cause image artifacts. 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 laser
Laser
A laser is a device that emits light through a process of optical amplification based on the stimulated emission of photons. The term "laser" originated as an acronym for Light Amplification by Stimulated Emission of Radiation...
s.
Surgical scalpels
Surgical scalpels consist of two parts, a blade and a handle. The handles are reusable, with the blades being replaceable. In medical applications, each blade is only used once (even if just for a single, small cut). Medical scalpel handles come in two basic types. The first is a flat handle used in the #3 and #4 handles. The #7 handle is more like a long writing pen, rounded at the front and flat at the back. A #4 handle is larger than a #3. Blades are manufactured with a corresponding fitment size so that they fit on only one size handle. The following table of blades is incomplete and some blades listed may work with handles not specified here. The handle is also known as b.p handle .| Blade No. | Compatible Handles | Blade Description | Uses |
|---|---|---|---|
| #10 | 1, 3, 7 | Curved cutting edge with flat back | For cutting skin and muscle in surgery, and for general carving and stencil Stencil A stencil is a thin sheet of material, such as paper, plastic, or metal, with letters or a design cut from it, used to produce the letters or design on an underlying surface by applying pigment through the cut-out holes in the material. The key advantage of a stencil is that it can be reused to... making; also can be used for removal of 'edge beads' from photolithography resists. |
| #10a | 3, 3L, 3 Graduated, 5B, 7, 9, B3, B3L | This blade is a small and straight | |
| #11 | 1, 3, 7 | Triangular blade with sharp point, flat cutting edge parallel to the handle and flat back | For precision cutting, stripping, sharp angle cuts and also stencil Stencil A stencil is a thin sheet of material, such as paper, plastic, or metal, with letters or a design cut from it, used to produce the letters or design on an underlying surface by applying pigment through the cut-out holes in the material. The key advantage of a stencil is that it can be reused to... cutting due to its similarity to the X-Acto artknife blade |
| #12a | 3, 7 | A small, pointed, crescent-shaped blade sharpened on the inside edge of the curve | |
| #12b | 3, 7 | A small, pointed, crescent-shaped blade sharpened on both sides of the curve | |
| #15 | 3, 7 | A smaller version of the #10 | For the same general uses as the #10 blade |
| #15a | 3,7 | A front-facing straight blade with flat back | |
| #15c | 3, 7 | The #15 with a downward angle, flatter and thinner than the #15 | |
| #16 | 1, 3 | A narrow chisel-like blade with flat, angled cutting edge, positioned higher than the axis of the handle | For cutting stencils, scoring and etching |
| #17 | 1, 3 | A flat face 1.6 mm chisel blade | For narrow cuts |
| #18 | 2, 5, 6 | A 12.7 mm chisel blade | For deep cuts and scraping |
| #19 | 4 | A similar blade to the #15 | |
| #22 | 2, 4, 5, 6 | A larger version of the #10 | For general use, shaping, whittling and trimming |
| #23 | 4, 4L, 4-Grad, 6B | Similar to #22, leaf-shaped | For long incisions. |
| #24 | 2, 4, 5, 6 | A wide, flat, angled cutting edge | For corner cuts, trimming, stripping, and cutting mats and gaskets |
| #25 | 4 | A front-facing straight blade with flat back (similar to #15a) | |
| #25a | 4 | A triangular straight blade with flat back edge taking a downwards angle (similar to #10a, shorter than #26) | |
| #26 | 4 | A triangular straight blade with flat back edge taking a downwards angle (similar to the #15a, longer than #25a) | |
| #34 | 4 | A triangular blade similar to the #11 | |
| #36 | 4 | A larger blade | Used in general surgery but also within a Laboratory setting for Histology and Histopathology |
| #60 | 4 | A long blade resembling the #10 with a long cutting edge, rounded tip and flat back. |
Palmar grip
Also called the "dinner knife" grip. The handle is held with the second through fourth fingers and secured along the base of the thumb, with the index finger extended along the top rear of the blade and the thumb along the side of the handle. This grip is best for initial incisions and larger cuts.Pencil grip
Best used for more precise cuts with smaller blades (e.g. #15) and the #7 handle. The scalpel is held with the tips of the first and second fingers and the tip of the thumb with the handle resting on the fleshy base of the index finger and thumb. Care should be taken not to allow the handle to rest too far along the index finger as this promotes an unstable grip and cramped fingers.Graphic design and arts and crafts blades
Graphic design
Graphic design is a creative process – most often involving a client and a designer and usually completed in conjunction with producers of form – undertaken in order to convey a specific message to a targeted audience...
and model-making scalpels tend to have round handles, with textured grips (either knurled
Knurling
Knurling is a manufacturing process, typically conducted on a lathe, whereby a visually attractive diamond-shaped pattern is cut or rolled into metal.- Uses :...
metal or soft plastic). These are often called by the name of the most well-known manufacturer of graphic arts blades, X-Acto knives
X-acto
X-Acto is a brand name for a variety of cutting tools and office products owned by Elmer's Products, Inc. Cutting tools include hobby and utility knives, saws, carving tools and many small-scale precision knives used for crafts and other applications....
. The blade is usually flat and straight, allowing it to be run easily against a straightedge
Straightedge
A straightedge is a tool with an edge free from curves, or straight, used for transcribing straight lines, or checking the straightness of lines...
to produce straight cuts.
There are many kinds of graphic arts blades, the most common around the graphic design studio is the #11 blade which is very similar to a #11 surgical blade (q.v.). Other blade shapes are used for wood carving
Wood carving
Wood carving is a form of working wood by means of a cutting tool in one hand or a chisel by two hands or with one hand on a chisel and one hand on a mallet, resulting in a wooden figure or figurine, or in the sculptural ornamentation of a wooden object...
, cutting leather and heavy fabric, etc.
Ancient scalpels
- Ancient EgyptAncient EgyptAncient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...
ians made incisions for embalming with scalpels of sharpened obsidianObsidianObsidian is a naturally occurring volcanic glass formed as an extrusive igneous rock.It is produced when felsic lava extruded from a volcano cools rapidly with minimum crystal growth...
, a material that is still in use. - Ancient Romans used more than 150 different surgical instruments, including scalpels.
- Indian AyurvedicAyurvedaAyurveda or ayurvedic medicine is a system of traditional medicine native to India and a form of alternative medicine. In Sanskrit, words , meaning "longevity", and , meaning "knowledge" or "science". The earliest literature on Indian medical practice appeared during the Vedic period in India,...
medicine mentions the use of sharp bambooBambooBamboo is a group of perennial evergreens in the true grass family Poaceae, subfamily Bambusoideae, tribe Bambuseae. Giant bamboos are the largest members of the grass family....
splinters.
Scalpel injuries
In the last decade, a rising awareness of the dangers of sharps in a medical environment has led to the development of various methods of protecting healthcare workers from accidental cuts and puncture wounds. According to the Centers for Disease Control and PreventionCenters for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
, as many as 1,000 people each day are subject to accidental needle sticks and lacerations while providing medical care. Scalpel blade injuries are among the most frequent sharps injuries, second only to needlesticks. Scalpel injuries make up 7 percent to 8 percent of all sharps injuries.
"Scalpel Safety" is a term coined to inform users that there are choices available to them to ensure their protection from this common sharps injury.
Safety scalpels
Safety scalpels are becoming increasingly popular as their prices come down and also on account of legislation such as the Needle Stick Prevention Act.There are essentially two kinds of disposable safety scalpels offered by various manufacturers. They can be either classified as retractable blade or retractable sheath type. The retractable blade version made by companies such as OX Med Tech, DeRoyal
DeRoyal
DeRoyal Industries is a vertically integrated manufacturer and marketer of health care products. It is a privately held company with headquarters in Powell, Tennessee and manufacturing facilities in the U.S. states of Tennessee, Florida, Georgia, South Carolina, and Virginia, as well as in Costa...
, Jai Surgicals, Swann Morton
Swann Morton
Swann Morton Ltd. is a British manufacturer of scalpel handles, blades and other surgical equipment. It was founded in 1932 by W. R. Swann, J. A. Morton and D. Fairweather to make and sell razor blades.Mr Swann's founding principles:...
are more intuitive to use due to their similarities to a standard box-cutter. Retractable sheath versions have much stronger ergonomic feel for the doctors and are made by companies such as Aditya Dispomed, Aspen Surgical and Southmedic.
Few companies have also started to offer a safety scalpel with a reusable metal handle. In such models, the blade is usually protected in a cartridge. Such systems usually require a custom handle and the price of blades and cartridges is considerably more than for conventional surgical blades.
However, CDC studies shows that up to 87% of active medical devices are not activated. Safety scalpels are active devices and therefore the risk of not activating is still significant. There is a study that indicated there were actually four times more injuries with safety scalpels than reusable scalpels.