Core Surgical Skills: Basic Instrument Use

Independent Activity 2

Printer-friendly versionObjective:

In this activity, you will practice two scalpel grips, the pencil grip and the fingertip grip, and slide cut and press cut techniques.

What you will need:

  • #3 scalpel handle
  • #15 blade
  • #10 blade
  • Needle holders
  • Unripe banana
  • Tape
  • Marker

Preparation:

Before attempting this activity, thoroughly review the following topics in the Scalpel Module: Scalpel Grips and Incision Methods. You might find it helpful to watch the training videos while you practice these skills.

  1. Pencil Grip and Slide Cut Technique Practice
  • Using the tape, secure the unripe banana onto a table surface. Using the marker, draw a small dime-sized circle on the skin to serve as a practice "lesion."
  • Safely arm a scalpel handle with a #15 blade.
  • Grasp the armed scalpel in the pencil grip. The scalpel should be gripped close to the blade between the tips of the thumb and index finger, with the remaining handle resting on the web of the thumb, much like grasping a pencil.
  • Practice accurately removing the small circle "lesion" with the scalpel using a pencil grip and a slide cut technique. Use the fine motion of your thumb and index finger to cut the banana skin accurately. To increase accuracy of your cutting, steady your hand by resting the ring and little fingers on the table as you cut.
  • Use the pencil grip to "backhand" part of the incision by reversing the direction of the blade without changing the upper arm position.
  • Draw different "lesions" of various shapes on the banana skin.
  • Practice removing these "lesions" with the forehand and backhand pencil grip.
  1. Pencil Grip and Press Cut Technique Practice
  • Now practice a press cut technique with your scalpel. Begin your press cut exercise by grasping the scalpel in a pencil grip. With the inverted blade positioned over the tissue at a 45-degree angle to the surface of the banana skin, slowly push the blade (parallel to the long axis of the scalpel) through the banana skin. When the bursting strength threshold of the banana skin is exceeded, the blade will suddenly "slide" through the skin into the "meat" underneath.
  • Practice 5 press cut incisions in the banana skin. Recall that this is the same technique surgeons use to initially enter the bladder or stomach.
  • Safely disarm the #15 blade from the handle. Deposit the blade in a "sharps container." If you do not have access to a "sharps container" you can temporarily store the used blades in an empty container like a jar until they can be disposed of properly.
  1. Fingertip Grip and Slide Cut Technique Practice
  • Flip the banana to the opposite (unused) side, and orient the banana perpendicular to your line of view. Tape the banana down to the table surface.
  • Safely arm the scalpel handle with a #10 blade.
  • Grasp the scalpel in the fingertip grip, with the scalpel positioned between the thumb and middle finger and the index finger on the spine of the scalpel blade. In the fingertip grip, pressure is applied downward, much like grasping a butter knife.
  • Practice making several long straight incisions on your banana using a fingertip grip and a slide cut technique. Make certain to maintain a consistent depth, incising just through the banana's skin. Recall that this is the same grip and cutting method surgeons use when incising skin.
  • Safely disarm the #10 blade from the handle. Deposit the blade in a "sharps container" or as previously instructed.