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A scalpel, orlancet, is a small and extremely sharp bladed
instrument used forsurgery,
anatomicaldissection, and various arts and crafts (called a
hobby knife). Scalpels may be
single-use disposable or re-usable. Re-usable scalpels can have
attached, resharpenableblades 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 sterilepouches 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, orhigh
carbon steel; in addition, titanium,ceramic,diamond and
evenobsidian knives are not
uncommon. For example, when performing surgery underMRIguidance,
steel blades areunusable (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 coatedto enhance lubricity during a cut.
Alternatives to scalpels in surgical applications include
electrocautery andlasers.
Contents
[hide]
1 Surgical scalpels
o 1.1 Gripping a medical scalpel
1.1.1 Palmar grip 1.1.2 Pencil grip
2 Graphic design and arts and crafts blades
3 Ancient scalpels
4 Scalpel injurieso 4.1 Safety scalpels
o 4.2 Blade removers
o 4.3 Safety
5 See also
6 References
7 External links
[edit] 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.
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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 .
Types of surgical scalpel blades
Blade
No.
Compatible
HandlesBlade Description Uses
#10 1, 3, 7Curved cutting edge with
flat back
For cutting skin and muscle in surgery,
and for general carving and stencilmaking; 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 sharppoint, flat cutting edge
parallel to the handle andflat back
For precision cutting, stripping, sharpangle cuts and
alsostencilcutting due
to its similarity to the X-Acto artknifeblade
#12 3, 7
A small, pointed, crescent-
shaped blade sharpened on
the inside edge of the curve
#12d 3, 7
A small, pointed, crescent-
shaped blade sharpened on
both sides of the curve
#15 3, 7A smaller version of the#10
For the same general uses as the #10blade
#15a 3,7A front-facing straight
blade with flat back
#15c 3, 7The #15 with a downwardangle, flatter and thinner
than the #15
#16 1, 3
A narrow chisel-like bladewith flat, angled cutting
edge, positioned higher
than the axis of the handle
For cutting stencils, scoring and
etching
#17 1, 3A flat face 1.6 mm chiselblade
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 #10For general use,
shaping, whittling and
trimming
#234, 4L, 4-Grad,
6BSimilar to #22, leaf-shaped For long incisions.
#24 2, 4, 5, 6A wide, flat, angled cutting
edge
For corner cuts, trimming, stripping,
and cutting mats and gaskets
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#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 (similarto #10a, shorter than #26)
#26 4
A triangular straight blade
with flat back edge taking adownwards angle (similar
to the #15a, longer than
#25a)
#34 4A triangular blade similarto 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 flatback.
[edit] Gripping a medical scalpel
[edit] 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 initialincisions and larger cuts.
[edit] 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 thehandle 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.
[edit] Graphic design and arts and crafts blades
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X-Acto knife
Graphical and model-making scalpels tend to have round handles,
with textured grips
(eitherknurled 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 andstraight, 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 bladeshapes are used forwood carving, cutting
leather and heavy fabric, etc.
[edit] Ancient scalpels
Ancient Egyptians made incisions for embalming with scalpels of
sharpened
obsidian, a material that is still in use.
Ancient Romans used more than 150 different surgical
instruments, includingscalpels.[1]
Indian Ayurvedic medicine mentions the use of sharpbamboo
splinters.[citation needed]
[edit] 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
Prevention, as many as 1,000 people each day are subject to
accidental needle sticks andlacerations 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.[2][3]
"Scalpel Safety" is a term coined to inform users that there are
choices available to them toensure their protection from this
common sharps injury.[4]
[edit] 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
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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 versionshave 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 usuallyprotected 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.[5] There is a study that indicated
there were actually four times more injuries with safety
scalpels than reusable scalpels.[6]
[edit] Blade removers
There are various scalpel blade removers on the market that
allows users to safely removeblades from the handle, instead of
dangerously using fingers or forceps. In the medicalfield, when
taking into account activation rates, the combination of a
single-handed scalpel
blade remover with a passing tray or a neutral zone was as safe
and up to five times safer
than a safety scalpel.[7] Companies likeQlicksmart offers a
single-handed scalpel bladeremover that complies with regulatory
requirements such as US OSHA Standards.[8]
[edit] Safety
The usage of both safety scalpels and a single-handed blade
remover combined with ahands-free passing technique are potentially
effective in reducing scalpel blade injuries.[7] It
is up to employers and scalpel users to consider and use safer
and more effective scalpelsafety measures when feasible.
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