Just before the new year, we have published the third chapter of ‘the Cutting Edge.’ This chapter describes the various and most common instruments you need as a surgeon. Please go to the menu and click the ‘Cutting Edge’ tab.
What kind of grip do you use when you hold your instruments? The ‘pencil grip‘ is used for short or sharply curved incisions. In this grip, the hand’s muscles and the upper arm are used to direct the scalpel, allowing small and accurate movements. As the scalpel is held almost vertical and mainly uses the blade’s tip, it is only in partial contact with the wound edges. This facilitates the making of curves and improves the accuracy of the incision.
The ‘fingertip grip’ or ‘palm grip‘ is used for long, slightly curved, or straight incisions. The scalpel is held more horizontally so that the blade is in contact with the tissue over a longer distance (using the blade’s belly). This grip stabilizes the scalpel and reduces the effect of the variable blade pressure on the incision’s depth.
In this grip, the scalpel is predominantly guided by the arm muscles. There is less radial deviation, which makes the grip less tense. The incision should be made with a fluid movement without removing the blade from the wound. This avoids the ragged edge of several subsequent incisions. When cutting through the skin, the free hand may pull the skin tight to control better the scalpel pressure and, hence, the incision’s depth.