Tissue Scissors Basics and Techniques Quiz

Tissue Scissors: Understanding the Basics and Techniques

Tissue scissors are an essential tool in surgical procedures, designed specifically for cutting tissues during various operations. They come in various shapes, sizes, and designs, each with its unique features and intended use. In this article, we will explore the basics of tissue scissors, their classification, and the techniques used to manipulate them for efficient and controlled cutting.

Classification of Tissue Scissors

1. Tips: Tissue scissors can have sharp-sharp, blunt-blunt, or sharp-blunt tips, depending on the tissue they are intended to cut.

2. Blade Shape: The blade shape can be straight or curved, providing different advantages for cutting thick or tough tissue and allowing greater maneuverability and visibility.

3. Cutting Edge: The cutting edge can be normal or serrated, which affects the tissue's response to cutting and the edge's sharpness.

4. Blunt-blunt tips with a normal cutting edge are typically used for cutting tissues: These scissors provide a balance of control and efficiency for various surgical procedures.

5. Straight scissors provide more mechanical advantage for cutting thick or tough tissue: They are suitable for larger incisions and sturdier materials.

6. Curved scissors allow greater maneuverability and visibility: These scissors are more adaptable for intricate procedures and smaller incisions.

Techniques for Using Tissue Scissors

Scissor Cutting

Scissor cutting is used for cutting loose tissues, and the blades stabilize the tissue during cutting, providing good control of depth and direction. However, scissor cutting is more traumatic than scalpel cutting, as it tends to crush the tissue during the process, leading to jagged edges.

Technique

1. Blades partially closed over tissue and elevated slightly to stabilize.
2. Tips closed to cut the tissue.
3. Only use the tips to cut, avoiding the entire blade, which can cause more crushing trauma and jagged edges.

Push Cutting

Push cutting is an efficient cutting method for longer incisions in light fascia. It is less traumatic than scissor cutting but still provides good control.

Technique

1. Begin with a partially closed blade (tip still open).
2. Continue by pushing the nearly closed blade forward through the tissue in a single continuous motion.
3. The tissue is cut without further opening or closing of the blades.
4. The scissors should advance easily without tearing the tissue or abandoning the technique.

Blunt Dissection

Blunt dissection is used to separate fine tissue attachments between anatomic tissue planes and isolate delicate structures. It is more traumatic than sharp dissection (scalpel or scissor) but can be effective for separating muscles, fat, and fine fascial planes.

Technique

1. Close tips of the scissors are inserted into the tissue.
2. Blades are opened to separate (tear) loose tissue connections.
3. Scissors tips are removed without closing the blades to prevent uncontrolled cutting.
4. The process is repeated as needed.

Skills to Practice

1. Wide-based tripod grip for efficient control.
2. Accurate scissor cutting.
3. Controlled push cutting.
4. Accurate, efficient blunt dissection.

Holds and Grips

1. Wide-based tripod grip: Most efficient hold, with thumb and ring finger through the rings, middle finger on top of the finger ring, and index finger along the handle towards the fulcrum.

2. Backhand grip: Typically used for cutting from left to right, with thumb and middle finger through the rings and the handle resting on the third and fourth fingers.

In conclusion, tissue scissors are an essential tool in surgical procedures, offering a range of techniques for cutting and dissecting tissues. Understanding their classification and proper use can significantly improve surgical efficiency and precision.