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Surgical scissors are excellent surgical instruments for disection & for blunt cutting. Most scissors are designed for use with the right-handed grip that enables direction control & precision of cuts. Having a thumb-ring grip gives the greatest control and movability that gives max closing, torque & shear power using your natural grip movement of your right hand.

Pronation to normal hand positions gives the greatest maneuverability of surgical scissors in different directions. The supinated hand can move only toward the prone position and therefore has limited maneuverability.

Surgical scissors can dissect flaccid tissue successfully because the tissue is stabilized between the scissor blades. Surgical scissors cutting employs closing force, torque & shear to give an exact cut. When you push cut you allow a more smooth cut along the surface. "chewing it" happens when you jagged & crusehd wound stuck between the blades of surgical scissors lacking in slicing force.

While cutting sutures with the scissor tips, look for the knot between the slightly spread blades, instead than under the surgical scissors. Use the left hand, the patient's body, or some other structure thats stable as a fulcrum to steady the scissors when making delicate cuts or when cutting sutures held by another person. When your cutting a row of sutures, hold the sutures in your left hand so that each one becomes taut as you cut it and so that the cut sutures are put out of the way.

By spreading the scissors while inside the tissue planes, blunt dissection can be done or by doing a probe or rake by using surgical scissors. Blind dissection is sometimes useful between tissue planes away from vital structures.

Curved surgical scissors offer greater maneuverability and visibility, Straight surgical scissors give the best possible mechanical advantadge when cutting through thick, tough skin.

Surgical scissors can be used to give the most control and accuracy for the maneuver performed. Surgical scissors may be used for sharp cutting & for blunt dissection.

Surgical scissors are made so that three force vectors can be used in cutting: shearing, torque and closing. These forces are transferred from the hand to the shanks, and then get a fulcrum to the cutting edges. The closing force is that what causes the blades to come together. Shearing is when you blade the two blades flat up against each other. Mainly a cutting movement. Torque is the force that rolls the leading edge of each blade inward to touch the other. Alot of surgical scissor designers create these devices so when you move your hands in the right motion the cut automatically slices through perfectly.

When you cut, for accurate control & direction, its important to make sure the tissue is correctly put between the 2 blades & the security of the individual using the surgical scissors rest The wider the surgical scissors are opened and the closer the tissue is to the fulcrum, the more upon this. The blades tend to push the tissue away, making a buncking effort of the cutting action. The more obtuse the angle between the blades when cutting. The less the surgical scissors steady the tissue, then the less accurate the cut will be.

To get a crisp, clean cut, try using the the grip that is designed to the three force vectors. Surgical scissors are most commonly held with the tips of the thumb and ring finger through the finger rings & with the index finger sitting on the shanks near the fulcrum. This grip gives the largest "tripod" and therefore gives the best stability for direction control. The, closing & torque forces; and is therefore the grip that gives maximum control. The middle finger and thumb grip which allows the index finger to be used to hold the sides of the shanks. This 3-point grasp tip will give you a more tiny tripod as opposed to the previous method, therefore, slightly less stable.

Hold the surgical scissors in a cutting motion leaning forward, use your thumb-index grip. This grip uses only two-point direction control, this may casue a person to wonder off course. Though closing force is strong, this grip applies the least shearing and torque forces of all grips possible for forward cutting. With less shear and torque the blades will tend to "chew" as opposed to cut thick tissue cleanly.

The thumb-index finger grip used for cutting in a reverse motion. This type of grip provides good three point directional control with a well lateral stability, but the shear and torque forces are virtually nonexistent, this reverse direction grip's main advantage lies in push slicing toward the operator.

The backhand grip is kind of a slight variation in the thumb-ring finger grip & is useful in cutting en route for the right.

All the grips we've covered thus far have a strong retracting force. The thumb-ring finger grip provides the best direction, shear and torque forces. For reverse cutting, when your in direction control the grip is more stable. The prevouse 2 grips, when used in reverse cutting, you could lose control .

Surgical scissors isn't just a good medical tool for sharp cutting, for blunt dissection you may want to get the proper tips on the surgical scissors by probing, spreading or ranking. Surgical scissors have an added advantage over a clamp for blunt cutting, because alternating sharp and blunt dissection can be done without switching back and forth your surgical instruments. Blunt cutting spreads apart the layers of tissue. The cementing substance can be either scar tissue from a prior surgery or normal areolar tissue as in between fascial layers.

In the blunt cutting of layers bound by scar tissue you will come across hazard where the scar tissue traverses the cut in one of the layers. It's considered risky when the cutting between layers when the adhesions have more tensile strength than the bound layers. Some scars could bring together bowel & fascia or parietal pericardium to the heart with more tensile strength than is present in the bowel or in the interior the myocardium. You may not want to use blunt dissection with your surgical scissors in this case & result in an unintended enterostomy or entrance into the myocardium. This is why its risky for blunt cutting where you see some old scares come together with natural planes or where dense scar tissue is stronger than the structures it blinds.

Most blunt dissection and cutting with surgical scissors is under direct view. Blind scissors cutting & blunt dissection can sometimes be of enormous advantage & may be accurate & secure. Such blind dissection is done between well-established tissue planes in anatomic regions far away from important structures like nerves & big blood vessels. Blind surgical scissor dissection is an excellent way for opening a tunnel just underneath the dermis to put in a heterograft when you make an arterial venous fistula.

Blind surgical scissor dissection can also be put to advantage while doing a breast biopsy through a small circumareolar incision. It's difficult to notice a deep side of a breats lump; but, by palpation, when you use a left pointer-giner as a guide, surgical scissors can be used to circumscribe & remove the lump.

When you expose major blood vessels by cutting, be sure to express caution when doing this, because you could tear branches and small tributaries. If surgical scissors are used to spread parallel to a major vessel, concentrate on preventing any tearing of small side branches; if you spread perpendicular to the great blood vessel; focus your full attention plaques. Both methods, through having drawbacks, can be used if the inherent problems are understood.