Talk:Scalpel

Where
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, so until someone who knows more about Egyptian archaeology than I do cites an example, I'm removing it and replacing it with obsidian.BrianGCrawfordMA 00:14, 27 January 2006 (UTC)

I've heard mention of papyrus being used as well--for eye surgery, I believe. And, you know, the thought of someone poking at my eyeball with a piece of sharpened grass gives me new respect for Ancient Egyptians...

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. Of course, in both cases I've said "I've heard" rather than giving sources, but that is more because I'm a lazy, lazy man...--Raulpascal 18:03, 28 June 2006 (UTC)


 * There seem to be glass knives made for cutting specimens for microscopy, tough daimond knives have replaced them for the more precise cuts. The article I've linked to, Glass knives have no sources though... Johan G 12:03, 25 July 2007 (UTC)

Etymology
Etymology of the words scalpel and lancet should also be included in the article. — Preceding unsigned comment added by 2001:2003:F462:1C00:B427:9EDE:1A69:1D1B (talk) 17:57, 8 December 2015 (UTC)

Need photos
Ideally there would be a picture of each blade and handle listed in the article. Cburnett 05:25, 1 November 2007 (UTC)

Photos would also be useful for the grips 109.207.29.2 (talk) 16:01, 14 March 2013 (UTC)

Disposal
I would like to see some information on disposal of blades. I know in medical institutions blades are probably disposed of with other medical waste, but I am always confused about how best to dispose of the blades I use for arts and crafts.217.43.98.52 (talk) 16:12, 27 December 2007 (UTC)

More about Scalpels on Wikisurgery
I have been in discussion with the Editors of WikiProject Medicine about a possible linkage between Wikipedia and Wikisurgery.

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

The information is aimed primarily at the surgical trainee and other hospital staff, but is of great interest to the general Wipedian, judging by the hit rate when some of this information found its way, unofficially, onto Wikipedia for a short while. The practical information greatly exceeds that in most surgical articles in Wikipedia. The scripts are detailed enough to include, not only the basic surgical information, but also the tips, hints, pearls and what ifs that make surgery an art as much as a science.

In the special field of surgery, the loose, flexible structure of Wikisurgery should form a valuable complementary information source to the disciplined, neutral approach of Wikipedia.

At the suggestion of a WikiProject Medicine Editor, I propose here an article called More about Scalpels in a Wikipedia format. The article is part of a basic surgical training program to be found on-line on Wikisurgery.

I should welcome your comments.

NB All the images on this article come from Wikisurgery.

I have the copyright on all the images.

I wish to retain the copyright.

I understand that the images may be removed from Wikipedia in 7 days.

I will reload them as required.

—Preceding unsigned comment added by Michael Harpur Edwards (talk • contribs) 14:26, 18 June 2008 (UTC)

Article

This subsection has text and images from an interactive multimedia training program on [[Wikisurgery] for basic surgical skills, called PrimeSkills in Surgery. You can use this subsection on its own or follow the whole program (further details at the end of this subsection).

How to use a scalpel

Introduction
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.

This should be suppressed completely.

If it persists, the trainee should not continue with the program.

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.

(This is the polite way of 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.)

How to cut with a scalpel
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.



Rock the handle to enhance this effect.







For a right handed surgeon, incisions are most easily made from left to right, cutting towards the surgeon.

Cutting from right to left is more difficult. Curved incisions are made by rotating the scalpel. Curves up to 4cm. radius or so are best made by rotating the scalpel between finger and thumb.



Curves larger than 4cm. need rotation of the scalpel using the wrist, elbow, and finally the shoulder.







For a right handed surgeon, clockwise curves are easier to do than anticlockwise ones.

Be prepared for a greater tendency to miss the planned track and more slips when cutting an anticlockwise curve.

Incisions need to be made with the blade perpendicular to the tissues to avoid slicing.

Slicing will devascularise the thinner side of the incision.

(NB. Slicing with the blade held at an angle to the tissues is done deliberately when dissecting with a scalpel.)

Planning
As well learning HOW to cut with a scalpel, learning WHERE to cut is vitally important. Each incision has a start point, a path, a depth and a finish point. e.g. The positions of the start and finish points of an ellipse incision will determine the final line of the scar.



The path and the depth of the incision determine whether there is enough clearance around a tumour. With real tissues, once an incision is made, there is no going back.

Mistakes are not acceptable.

On simulated tissue, learn to plan your incisions with this degree of precision.

Next subsection, click on Scalpel 08 Exercises Last subsection, click on Scalpel 06 How scalpels work Surgical Education and Training page, click on Surgical Education and Training Whole program on WikiSurgery.com, click on PrimeSkills in Surgery Whole program on CD-ROM, click on Michael Edwards

Michael Harpur Edwards (talk) 13:33, 18 June 2008 (UTC)]] 14.40, 18 June 2008 (UTC)

Editor comments

 * As per Wikipedia_talk:WikiProject_Medicine/Archive 8, an example where a useful external link. However directly hosting this is a problem as Wikipedia is not a how-to guide - an external link to your site describing this is clearly fine (by me). Otherwise change in approach is needed to move away from a guide to a more encyclopaedic coverage, eg last sentance of "On simulated tissue, learn to plan your incisions with this degree of precision." would perhaps come under "Surgeons now practice their technique on artificial simulated tissue"


 * There is really good material here, just question of how best to use/incorporate it :-) David Ruben Talk 22:09, 18 June 2008 (UTC)


 * I also think that an external link to this page on Wikisurgery is a much preferable approach. Wikipedia is NOT a how-to guide; it is also not written for the convenience of medical students or the edification of surgeons (or other professionals).  Please consider WP:MEDMOS as well, when you're trying to decide whether material is appropriate for this general encyclopedia.  WhatamIdoing (talk) 22:37, 18 June 2008 (UTC)

Lancet?
Should the section on the lancet be it's own section. I think it's looks totally out of place just floating there... Is a lancet even used for medical surgery? If it is, it should be absorbed by the surgery section. —Preceding unsigned comment added by Intothewoods29 (talk • contribs) 18:45, 18 July 2008 (UTC)

Anatomical Snuffbox
It seems to me that the anatomical snuffbox term is being misused by the article.

Under "Pencil Grip":

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 "anatomical snuff box," at the fleshy base of the index finger and thumb.

It sounds like the article is referring to the gap between the thumb and first finger, while the "anatomical snuffbox" is a depression that forms near the wrist.

I've removed the mention because it is not vital to the article and if incorrect it may cause confusion.

If the article's use is correct, then please put the mention back in.

V8Cougar (talk) 22:19, 16 November 2008 (UTC)


 * Probably happened because the image depicting the anatomical snuffbox is slightly ambiguous and people can mistaken the area for the place between the thumb and index finger. I updated the image with an arrow head (changed to yellow circle) to specify it more clearly. - M0rphzone (talk) 02:21, 13 May 2012 (UTC)

History
For such a basic medical device, which has existed for so long, I'd be very curious to know the history of the scalpel. It is a subject I am currently researching, but am not at all qualified to write about. — Preceding unsigned comment added by 71.231.4.175 (talk) 06:26, 13 October 2012 (UTC)

Why does Lancet redirect here?
I came looking for information on the historical lancet, that was used for blood-letting. The only article titled Lancet, was for the publication. It had a link for lancet, which directed here. There's more information here on craft/hobby use, tyan on proper historical lancets. Historical lancets should hage their own proper article, even if it's embarrassing to doctors. As it stands, this isn't very encyclopedic. — Preceding unsigned comment added by 173.206.176.39 (talk) 16:26, 31 December 2014 (UTC)

Scalpel Injuries section: When? and Where? tags
The Scalpel injuries section has long had one When? tag and one Where? tag. The section was contributed in 2007 by someone who was not logged in as a user and is unlikely now to provide the necessary clarifications. I am amending the text and removing the tags based on the date and the cited source of the "offending" contribution. --Frans Fowler (talk) 21:06, 3 June 2020 (UTC)