Surgical scissors are an indispensable tool within the medical field because they are required for the purpose of precision in cutting tissues, sutures, and other materials during medical procedures. Design and functionality have evolved over the years in this field, with evolution processes focused on the improvement of surgical techniques and materials. This blog discusses the types, uses, and best practices associated with surgical scissors.
Surgical scissors are tools designed to cut and dissect tissues during any surgical procedure. They are typically made from high-quality stainless steel to offer strength, corrosion resistance, and ease of sterilisation. The precise design and build of surgical scissors are significantly crucial for causing the least amount of trauma to tissues and promoting the best surgical recovery.
Types of Surgical Scissors
They come in various shapes and sizes to perform a specific function. Their main classifications are:
- Operating Scissors
Operating scissors are general-purpose instruments used to cut tissues, sutures, and materials like gauze and drapes. They come in different forms as follows :
Sharp/Sharp: Both blades have sharp tips. Useful in cutting tissues precisely.
Sharp/Blunt: One blade has a sharp tip. The other one is blunt. It is useful in cutting sutures and materials near delicate tissues.
Blunt/Blunt: Both blades have blunt tips. They are used in cutting dressings and materials.
- Dissecting Scissors
Dissecting scissors are utilised to separate or cut the tissues during the process of dissection. They are more delicate than operating scissors and include:
Mayo Scissors: These heavyweight scissors have a sturdy design, and they are used to cut tough tissues like fascia, muscles, and tendons. Available in straight and curved forms.
Metzenbaum Scissors: These are long and slender with a fine curve at the tips. They are used in cutting fine and delicate tissues. They are generally used in procedures on soft tissues and organs because of the ease of separating and getting through tissues.
- Suture Scissors
Suture scissors are specifically designed for cutting sutures during and after surgical procedures. The most common types are:
Littauer Suture Scissors: They are a hooked blade that lifts the suture and cut without damaging tissues around it.
Spencer Stitch Scissors: This is much like Littauer scissors, but a lot smaller and hence much finer for minor fine sutures.
- Specialised Scissors
There are various specialised scissors to cater for specific surgical requirements.
Bandage Scissors: Blunt tip, Children-Thorpe Style, with an angled blade that permits bandages and dressing materials to be cut safely, making sure that there is no injury to the patient.
Cast Scissors: Heavy-handled scissors are meant for cutting plaster or fibreglass casts.
Tenotomy Scissors: Small, sharp-pointed scissors have a fine point at the end. Delicate scissors are used in delicate procedures like tendon surgeries.
Plastic Surgery Scissors: Fine and accurate scissors used in plastic and reconstructive surgeries.
Used In Different Fields
Surgical scissors find use in all fields of medicine, and the different speciality fields of surgery utilise them in a specific manner.
- General Surgery
In general, surgery, operating, and dissecting scissors find much use. The Mayo scissors are particularly liked for their strength and durability to cut through tough tissues. Metzenbaum scissors are mainly preferred in delicate dissections where extra precision is required.
- Orthopaedic Surgery
Orthopaedic surgeons quite often use heavy-duty scissors like Mayo and cast scissors when dealing with the dense tissues and materials encountered during procedures concerned with bones, muscles, and joints.
- Plastic and Reconstructive Surgery
Precision is essential in plastic and reconstructive surgery. Plastic surgery scissors and Metzenbaum scissors are demanded for fine incisions and to manipulate delicate tissue for optimal aesthetics in plastics.
- Ophthalmic Surgery
Ophthalmic surgeons need small, fine scissors, like Iris scissors, for cutting with minimal trauma in delicate structures of the eye while maintaining accurate incisions.
- Cardiovascular and Thoracic Surgery
Cardiovascular and thoracic surgeons need specialised scissors like tenotomy and Metzenbaum scissors to move around and cut through the intricate, delicate tissues of the heart and chest cavity.
Best Practices in Surgical Scissors
Among the most important is how one handles, maintains, and sterilises these implements. The best practices are observed by following key guidelines for proper handling, maintenance, and sterilisation. Here are some of the most effective guidelines:
- Proper Handling
Grip and Control: The grip on the scissors should be firm but light to ensure full control. Usually, the thumb and ring finger will support the rings, while the index and middle fingers guide the blades.
Blade Alignment: The blades should be aligned to avoid unequal cuts and tissue damage. If they are misaligned, they crush rather than cut.
Cutting Technique: A smooth, continuous motion in cutting will help minimise trauma to tissues. Do not apply too much pressure, which causes jagged cuts, thus inflicting more tissue trauma.
- Maintenance
Inspection: Before and after each use, inspect scissors for wear, damage, or corrosion. It is necessary in terms of a tool’s performance; damaged scissors should be replaced or repaired accordingly.
Sharpening: Sharpening should be performed to ensure optimal performance from the blades by a qualified sharpener. Dull blades can significantly increase tissue trauma and act to reduce cutting efficiency.
Lubrication: Medical-grade lubricants should be applied to the pivot joint to ensure smooth operation and prevent rusting.
- Sterilisation
Cleaning: Clean scissors after each use, removing blood and tissue. Clean blades and joints gently with soft brushes and medical-grade detergents.
Disinfection: Every pair of scissors needs to be disinfected according to the instructions given by its manufacturer. Most often used are autoclaving, chemical sterilisation, and ultrasonic cleaning.
Storage: Sterilised scissors should be kept in a clean and dry place. Use protective cases or trays to protect from damage and contamination.
- Training and Education
Continual Education: Mandatory education and training on the proper usage, handling, and care should be given to all surgical staff using surgical scissors. Periodic training allows the refreshing of skills with the latest techniques and information about best practices.
Simulation and Practice: Engage surgeons and staff in practising different types of scissors in various mock scenarios to increase familiarity and expertise. The more practice done on such procedures in mock situations, the lesser the chances of mistakes when it comes to actual practice.
Advances in Surgical Scissors
The surgical field never stops improving, and new innovations in surgical scissors bring along higher precision, safety, and efficiency for surgical procedures. Some outstanding developments include:
- Ergonomic Designs
The greater part of modern surgical scissors features ergonomic designs targeted to minimise hand fatigue and increase comfort during long procedures. This often includes contoured handles and tension adjustment.
- Advanced Materials
Material science innovations have resulted in surgical scissors being made from high-strength alloys and composites. These materials ensure better durability, corrosion resistance, and edge retention.
- Disposable Scissors
One of the trends seen in some applications is disposable surgical scissors. They eliminate sterilisation and reduce cross-contamination. However, they have to be used judiciously so as to strike a balance between cost and impact on the environment.
- Precision Cutting Technologies
Inventions in areas of precision cutting technologies are laser and ultrasonic cutting, fitted into surgical scissors. With such technologies, unparalleled causal accuracy and minimal tissue damage derive, especially during delicate procedures.
Conclusion
Surgical scissors are basic instruments of the medical profession and perhaps are used in every imaginable procedure, from cutting bandages to cutting tissues. The paper tries to briefly introduce the types, uses, and handling/maintenance practices for surgical scissors to realise the optimum surgical outcome. Improving technology shall result in even more advanced variations of surgical scissors to provide better service and still finer precision and efficiency in the times to come.
Correct use of surgical scissors will help a medical professional ensure effectiveness and safety while using them on patients, thus enhancing care and surgical success, provided that good practice is pursued and updated with the latest developments.