In the ER, Sugical scissors are most commonly used for 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 best control and movability that gives maximal closing, shear and torque forces with a natural grip-ping movement of the right hand.
For the biggest movabilty, have a neutral hand postion of the surgical scissors in all directions. The supinated hand can move only toward the prone position & therefore has limited maneuverability.
If the flaccid tissue us successfully placed correctly in between the surgical scissors then it can be slice just fine. Surgical scissors cutting employs closing force, torque and shear to give an exact cut. Push-cutting allows straight cuts along the grain of a piece of tissue. "chewing" results in a jagged, crushed wound from tissue trapped between the blades of the surgical scissors lacking in shear & torque forces.
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, someone else, or some other structure thats stable as a fulcrum to steady the scissors when making fragile cuts or when held by antoher person cutting sutures. When cutting a row of sutures, place the structure in your left hand do this so the invidual one can "taut" as you cut it & they do this so that the cut sutures are held out of the way.
Blunt cutting can be done by spreading scissor blades between tissue planes or by using the surgical scissors as a rake or probe. Blind dissection is occasionally useful between tissue planes away from vital structures.
for better visibility and maneuverability use curved scissors, Straight surgical scissors give the best possible mechanical advantadge when cutting through thick, tough skin.
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