Muppet Surgery Guide to Surgery Scissors

Scissors may have long or short handles, and the blades are straight or curved and serrated or smooth. The tips may be sharp or blunt. Scissors used in cutaneous surgery can be either completely stainless steel (most popular, least expensive) or have tungsten carbide inserts to strengthen the blades.

Gradle scissors are small, delicate, sharp-tipped, and tapered to a very fine point with a gentle curve. Due to their sharpness and precision. Gradle scissors must be used with care, and they should never be used to cut sutures. With improper use, they are quickly dulled, the cutting surfaces are nicked, and the tips are easily malpositioned.

Tissue scissors have relatively short handles and sharp tips. They are available in straight or curved models, with or without the serrations that prevent tissue motion during cutting. These scissors have a fine bevel angle at the cutting edge, and they are available with smooth edges or one serrated edge. The ‘razor-like’ edge of these scissors enables the surgeon to cut tissue in a smooth, easy motion.

Westcott and Castroviejo scissors are delicate, spring-loaded tissue scissors with very sharp tips . The configuration of their handle and spring-loaded action make them ideal for manipulation in small delicate sites. For this reason, they are popular with oculoplastic surgeons. They should only be used for cutting thin tissue, such as that encountered in eyelid surgery, or they will dull quickly.

Large, less expensive scissors are sufficient for cutting sutures. Tissue scissors should never be used to cut sutures. Specially designed suture-removal scissors with a half-moon hook on the lower blade are available and the small hooked tip easily grasps the loop and prevents accidental sticks.

Undermining scissors are usually blunt-tipped (for safety) and have longer handles (for comfort). They are available in different sizes to accommodate the various anatomic regions in which skin surgery is performed. Baby Metzenbaum scissors have a high handle-to-blade length ratio, and, with the resultant small blade arc, they have become the most widely used scissor for sharp or blunt undermining . Larger Metzenbaum scissors are appropriate for extensive undermining in fascial planes on the scalp, trunk and extremities. The tips of these scissors allow for sharp, less traumatic undermining.