Scissors

The tips of a pair of surgical dissecting scissors are usually rounded; scissors in which both tips are pointed are only used for very fine dissection. Look after your scissors carefully. Use straight scissors near the surface and curved ones deeper inside. Hold them with your index finger resting on the blades. Use the tips for cutting.

You can also use scissors for blunt dissection by pushing their blades into tissues and then opening them. This will open the tissues along their natural planes, and push important structures, such as nerves and blood vessels, out of the way. This is the ''push and spread' technique shown in B, Fig. 4-8. If there is something nearby which it would be dangerous to cut, blunt dissection is always safer. But remember that even blunt dissection can injure veins, and that venous bleeding can be very difficult to control.

Remember: (1) Don't use sharp-tipped scissors in dangerous places, or cut what you cannot see. (2) Don't use scissors which are longer than the haemostats you have, or you may find yourself cutting a vessel which you cannot reach to clamp. (3) Mayo's, McIndoe's, and Metzenbaum's scissors are intended for cutting tissues, so don't use them for anything else. Use other scissors for cutting sutures and dressings.

Buy good quality scissors, and don't autoclave them with the other instruments. Instead, keep them in a covered tray of antiseptic (2.5). The very best ones have tungsten carbide inserts, which make their cutting edges last much longer. These are four times more expensive, but justify their extra cost.

SCISSORS, operating, Mayo, straight, bevelled, 200 mm, one pair only. Use these for cutting sutures.

SCISSORS, operating, Mayo, curved, bevelled blades, 170 mm, one only. These tissue scissors are curved in the plane of the blades.

SCISSORS, operating, McIndoe's, curved, with rounded tapering blades, 180 mm, one only. These elegant tapering tissue scissors are curved perpendicular to the plane of the blades.

SCISSORS, operating, Metzenbaum, curved 275 mm, one pair only. These have long handles and quite narrow blades. Use them for dissecting at the bottom of a deep wound.

SCISSORS, Aufrecht's, light, curved, 140 mm, one pair only. This pair of scissors is for the set of instruments for hand surgery.

SCISSORS, straight with fine sharp points, Glasgow pattern, 100 mm, stainless steel, two pairs only. Use these very fine scissors for cutting down on veins.

SCISSORS, suture cutting, ''assistant's scissors', rounded ends, four pairs only. Keep these in spirit with the other scissors. Your assistant needs a pair; so does the scrub nurse.

SCISSORS, suture wire cutting, 130 mm, one pair only. If you cut suture wire with ordinary scissors, it will ruin them.

SCISSORS, bandage, angular, Lister, 180 mm, one only. These have a blunt knob at the end of one blade which goes under the bandage to protect the patient. Insert them away from the wound; if they become soiled or wet, clean and sterilize them before you use them on someone else.

IN DANGEROUS PLACES BLUNT DISSECTION IS SAFER THAN SCISSORS Fig. 4-2 SCISSORS. Mayo's, McIndoe's, and Metzenbaum's, scissors are intended for cutting tissues, so don't use them for anything else. Use other scissors for cutting sutures and dressings.