Counting Basics #7-oops, I forgot to finish the sharps: blades

Oops, I forgot to finish the sharps.

The most important sharp of all.

The entire reason there can be surgery at the basic level.

The blade.

AKA the scalpel. AKA the knife blade. AKA the sharp thingy.

The thing that makes the incision.

There are many types of blades. The most common are the numbered blades. Each number corresponds to the shape of the blade. The most common in the surgeries that I do are the #10 and the #15. The #10 is a fatter blade that is used to make big incisions, such as over a joint, or into the abdomen. The #15 is a skinnier blade that is used to make incisions that don’t need to go as deep, such as for laparoscopic surgeries, or lipoma removal.

There are many other blade #s. A #11 blade is used for arthroscopic surgery. It is sharply pointed. A #22 blade is a bigger blade but shaped like a 10. I’ve seen them used for autopsies, useful because it can cut through thicker tissues I’ve never used a #12 but it has been in every operating room I’ve worked at, it is shaped a bit like a scythe with a curved tip. A quick search reveals that it is used for some nasal surgeries or also to open an artery.

And then there are the specialty blades. Besides the ones that are used to cut bone and there are also lots of those, there are beaver blades. These have rounded tips. These do not fit on the usual knife handles that are used for the numbered blades. These are good for delicate tissue surgery where precision is paramount. I’ve used these most often on hand surgeries, and some foot and ankle surgeries.

Blades come separately from the handle. This is for a variety of reasons but the most important reason is to not harm the sterile processing tech who will be reassembling the tray. And, if you ask surgeons, it is so that they can always have a fresh, sharp blade. Depending on the surgeon and the tissue that they are cutting through and the preciseness of the surgery, the number of blades open on the field can be upwards of 20.

There are disposable blades/handle combos. These are used when the regular blades are on backorder, or are used in the ER, or in the field. In the field is outside of the hospital.

In my experience, there are four kinds of knife handles. These are countable on an open case. And is shaped to accept the blade of surgeon’s choice. Handles can also be different. Some only are used for a certain numbered blade, and some can be used with more than 1 blade number.

This is one of the things that makes the OR so challenging. Not only do you have to know what each instrument is called and what surgeries it is used for, but you also have to know about the blade numbers and the surgical needles. And some surgeons expect you to remember all of their minutiae as well.

Of course they do.

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