NAME: ALEX KATE C.

DELA YEAR AND SECTION: BSN 3-A

1. TYPE OF SCALPEL BLADE, DESCRIPTION, SIZE OF SCALPEL

HANDLE THAT IT COULD FIT

NO.10 BLADE

It has large, curved cutting edge and it is one of the more traditional
blade shapes used in veterinary surgery. It is generally used for
making large incisions in the skin and subcutaneous tissue, as well as
cutting other soft tissues.

NO.11 BLADE

It is an elongated, triangular blade sharpened along the hypotenuse

edge. It has a strong, pointed tip, making it ideal for stab incisions and
precise, shortcuts in shallow, recessed areas. It is used in various
procedures, such as the creation of incisions for chest tubes and drains,
opening major blood vessels for catheter insertion, removing the mop
ends of torn cruciate ligaments, and for meniscectomy.

NO.12 BLADE

It is a small, pointed, crescent-shaped blade sharpened along the

inside edge of the curve. It is used for cat declaws and disarticulating
small joints, such as those between the metacarpals, metatarsals, and
phalanges during digit amputation. It is sometimes utilized as a
suture cutter.

NO.15 BLADE

It has a small, curved cutting edge. It is one of the most popular blades in
small-animal surgery because its shape is ideal for making short and
precise incisions. It is utilized in a variety of surgical procedures,
including then excision of small skin lesions, organ biopsy, and fine
neurological applications.
 NO. 20 BLADE

A large curved blade commonly used for cutting tissue and other procedures that
require a puncture or cut.

NO. 21 BLADE

Similar to the #20, it features a large curved blade commonly used

for cutting tissue and other procedures that require a puncture or
cut.

NO. 22 BLADE

It is a larger version of the No.10 blade with a curved cutting edge

and a flat, unsharpened back edge. It is often used for creating large
incisions through thick skin, and for soft tissue dissection in large-
animal surgery.

NO. 23 BLADE

A large blade that is slightly narrower than the #21 and

#21.
 SINGLE-USE OR REUSABLE BLADES

Reusable blades are permanently attached to the handle and must be sharpened consistently. Single-use blades
are designed to lock onto a scalpel handle and are easily removable. Surgical scalpels are available in either
single-use or reusable versions. There are also disposable surgical scalpels which typically have plastic handles
and an extensible blade. These can be used only once before the entire instrument is discarded.

The use of safety scalpels has been shown to help prevent accidental injuries caused by inadvertent contact
with the blade.
#3 SCALPEL HANDLE

No. 3 handle is graduated from 0 to 6 cm in 1 mm intervals and

measures 127 mm in length; takes blade numbers 10 to 15.

The 3 Bard Parker style scalpel handle with metric ruler is used for
cutting gingival tissue and making surgical incisions. Handle is 4.9″
long and 13mm wide at base. Compatible with standard scalpel
blade sizes. The popular size #10 and size #15 scalpel blades will fit
on a size #3 handle, however scalpel blade sizes such as No.6, 9, 11,
11P, 12, 12D, 13, 14, 16, 40 will also fit on a size #3 scalpel handle.

#4 SCALPEL HANDLE

It offers a wide array of surgical advantages. Its principal

use is to provide reliable support for multiple blades to
perform precise incisions. For this purpose, the
instrument features a slotted tip designed to insert and
statically hold the blade. In addition, the slot size is ideal
to mount blades of a variety of sizes according to the
surgical procedure.

This features a slim, flattened handle that ensures an

optimal grip. Furthermore, the surfaces of the device
have transverse ridges that not only ensure a
comfortable grip but also reduce the risk of slippage.

#5 STRAIGHT AND #5 ANGLED ROUND SCALPEL HANDLE

These are used for cutting gingival tissue and making surgical
incisions. The 5 Round Scalpel Handle provides greater rotational
movement with fingertip control and enhances dexterity. The 5
Offset Angle Scalpel handle design is ideal for posterior and palatal
areas and provides greater rotational movement with fingertip
control while enhancing dexterity. Handle is 5.8″ long with a 30°
angle. Compatible with standard scalpel blades including 6, 9, 10,
10a, 11, 11P, E11, E/11, 12, 12D, 13, 14, 15, 15A, 15C, 15T, D/15, 16, 17,
22 and 40 blades.
COLLIN SCALPEL HANDLE NO. 8

The Collin Scalpel Handle No. 8 has a grooved tip which securely locks
the scalpel blade into place. This gives the user maximum control
during surgeries. On top of that, this scalpel handle’s focus on an
ergonomic design ensures a comfortable and secure grip.

Collin Scalpel Handle No. 8 is manufactured in stainless steel. It can be

sterilized and reused. For Cardiovascular, ENT, General Surgery,
Gynecology & Obstetrics, Neurosurgery / Spine, Oral &
Maxillofacial, Orthopedic, Stomach, Intestine & Rectum, Urology

BEAVER SCALPEL HANDLE

It is a surgical device that ophthalmic and microsurgery

specialists commonly use to hold, carry and guide micro
scalpel blades during surgeries that involve minute parts of
the body. This offers a wide assortment of surgical benefits.
Its principal use is to provide a safe way to perform
incisions on the surface of delicate tissues.

For this purpose, the instrument features a micro-slotted tip

for holding the smallest scalpel blades with precision. In
addition, the device is available in a variety of sizes, which
range from 10.0 to 15.0cm, that help to reach deep spaces.
Moreover, the Beaver Scalpel Handle features an
ergonomically designed pen-shaped handle that enhances
gripping. Also, the device has a knurled style cover that
minimizes the risk of slippage and reduces fatigue.
 CASPAR SCALPEL HANDLE

The Casper Scalpel Handle is used to hold and maneuver micro-

blades for small-scale incisions. It is used for holding and
maneuvering micro-scalpel blades. These blades are primarily
used for small incisions. The product has a grooved tip for
tightly securing the blades. Its round handle facilitates
movement.

COLLIN SCALPEL HANDLE NO. 9

The Collin Scalpel Handle No. 9 has a grooved tip which securely locks
the scalpel blade into place. This gives the user maximum control
during surgeries. On top of that, this scalpel handle’s focus on an
ergonomic design ensures a comfortable and secure grip.
2. TYPES AND SHAPES OF NEEDLES
NEEDLE SHAPE (CURVATURE)

Needle may be straight or curved and curvature according to circle angle, divided to (1/4 circle, 1/2 circle,
3/8 circle and 5/8 circle). The choice of needle shape always dependent to the accessibility of tissue which
will undergo surgical procedure, the more confined surgery site requires more curvature.

The most common shapes of needles

QUARTER CIRCLE

It has a little curvature, use on convex surface and delicate surgery, typically use on ophthalmic
procedures, facial aesthetic, eyelids, fascia, and microsurgery.

ONE-HALF CIRCLE

It has a large arc to use in confined sites, the application area is skin, muscle, peritoneum, eye, abdominal
surgery and gastrointestinal tract.
THREE- EIGHTHS CIRCLE

The most common needles use in large and superficial wound and it’s impossible to use in deep cavities.
This needle applied in skin, hand surgery, fascia, muscle, subcuticular.

FIVE-EIGHTHS CIRCLE:

These needles perfect with deep and confined cavities due to the needle design make a maneuvering in
small location easier. Application area Intraoral, urogenital, and anorectal procedures.

ONE-HALF CURVED (SKI NEEDLE)

The curved portion for this needle passes through tissue easily, used in laparoscopic technique and skin
closure.

J SHAPE NEEDLE

Used on deep incision so it used in laparoscopic surgery without any injury to visceral and applied in
vagina and rectum.

COMPOUND CURVED NEEDLE

Used on oral, eye and anterior segment ophthalmic surgery.

STRAIGHT NEEDLE

Can be used without needle holder as is the case of curvature needle and there is a high risk of accidently
sticking yourself. It uses in easily accessible tissue, typically in abdominal surgery, rhinoplasty.

Needles type according to body and point of needle

TAPER-POINT NEEDLE:

these needles designed to provide good penetration to soft tissue, after

needle passes through the tissue the tissue closes tightly around suture
material which forming leak-proof suture line. Needle holder position is
between needle point and attachment area this position confers more
stability to needle held. Its available with wide range of diameter the
finer diameters good for softer tissue like gastrointestinal and vascular,
High diameters is good for tougher tissue such as muscle.

TAPER-CUT NEEDLE:

This needle like two needles in one with round body to reduce the trauma to wound and with
cutting tip to improve the penetration and the cutting tip is limited to the point of needle, they
are not recommended for suturing skin.
 BLUNT TAPER POINT:

This type is not as sharp as standard needle whereas the blunt needle
has been designed to reduce the risk of needle stick injury, used in all
surgery which contain vary friable tissue such as the liver and any
specialty that includes surgery of the muscle or fascia.

REVERSE CUTTING NEED LE:

This needle has a triangle shape body, the triangle apex in outer side of the curve concave, with sharp edge on
the outside curvature help to cut the wound with three edge on sides, utilize specifically for tough and default
penetration tissue such as skin, tendon sheath, or oral mucosa and ligament.

CONVENTIONAL CUTTING NEEDLE:

This needle has a triangle shape like reverse cutting but the triangle apex in inner side of the curve concave, its
suitable for most purposes atypically applied on skin, ligament, nasal cavity, tendon and oral.

SPATULA NEEDLE:

These fine needles are designed with sharp cutting edge, square, flat body from the top to bottom to reduce
tissue injury whereas has easy penetration and high control passage through and between soft tissue layer and
they are designed specific to ophthalmitis and oculoplastic surgical procedure.
 3. TYPES, DESCRIPTION, PURPOSE, SIZES, COLOR AND EXAMPLES
OF SUTURES

Types of sutures
TYPES OF ABSORBABLE SUTURES

Polyglycolic Acid sutures, Polyglactin 910 , Catgut, Poliglecaprone 25 and Polydioxanone sutures.

This natural monofilament suture is used for repairing internal soft tissue wounds or lacerations. Gut
shouldn’t be used for cardiovascular or neurological procedures. The body has the strongest reaction to this
suture and will often scar over. It’s not commonly used outside of gynecological surgery.

 Polydioxanone (PDS). This synthetic monofilament suture can be used for many types of soft tissue
wound repair (such as abdominal closures) as well as for pediatric cardiac procedures.
 Poliglecaprone (MONOCRYL). This synthetic monofilament suture is used for general use in soft
tissue repair. This material shouldn’t be used for cardiovascular or neurological procedures. This
suture is most commonly used to close skin in an invisible manner.
 Polyglactin (Vicryl). This synthetic braided suture is good for repairing hand or facial lacerations. It
shouldn’t be used for cardiovascular or neurological procedures.

TYPES OF NONABSORBABLE SUTURES

Polypropylene sutures, Nylon (poylamide), Polyester, PVDF, silk and stainless steel sutures.

Some examples of nonabsorbable sutures can be found below. These types of sutures can all be used
generally for soft tissue repair, including for both cardiovascular and neurological procedures.

 Nylon. A natural monofilament suture.

 Polypropylene (Prolene). A synthetic monofilament suture.
 Silk. A braided natural suture.
 Polyester (Ethibond). A braided synthetic suture.

MONOFILAMENT, MULTIFILAMENT SUTURES AND BARB SUTURES TYPES

Monofilament sutures include:

Polypropylene sutures, Catgut, Nylon, PVDF, Stainless steel, Poliglecaprone and Polydioxanone sutures.

Multifilament or braided sutures include:

PGA sutures, Polyglactin 910, silk and polyester sutures.

Barb sutures are usually available in:

Polydioxanone, Poliglecaprone and polypropylene suture materials.

SUTURE SIZE CHART
 4. TYPES OF SUTURING WOUND

CONTINUOUS SUTURES

This technique involves a series of stitches that use a single strand of suture material. This type of suture
can be placed rapidly and is also strong, since tension is distributed evenly throughout the continuous
suture strand.
INTERRUPTED SUTURES

This suture technique uses several strands of suture material to close the wound. After a stitch is made, the
material is cut and tied off. This technique leads to a securely closed wound. If one of the stitches breaks,
the remainder of the stitches will still hold the wound together.

DEEP SUTURES

This type of suture is placed under the layers of tissue below (deep) to the skin. They may either be
continuous or interrupted. This stitch is often used to close fascial layers.

BURIED SUTURES

This type of suture is applied so that the suture knot is found inside (that is, under or within the area that is
to be closed off). This type of suture is typically not removed and is useful when large sutures are used
deeper in the body.

PURSE-STRING SUTURES

This is a type of continuous suture that is placed around an area and tightened much like the drawstring on
a bag. For example, this type of suture would be used in your intestines in order to secure an intestinal
stapling device.

SUBCUTANEOUS SUTURES

These sutures are placed in your dermis, the layer of tissue that lies below the upper layer of your skin. Short
stitches are placed in a line that is parallel to your wound. The stitches are then anchored at either end of the
wound.
5. LAYERS OF ABDOMINAL INCISION
 6. COMMON TYPES OF INCISION

ABDOMINAL INCISIONS

A. MIDLINE INCISIONS

The midline incision implies a vertical incision through skin, subcutaneous fat, linea alba, and peritoneum. Most of the fibres,
crossing the linea alba in a medio-caudal and medio-proximal direction, are cut transversely.

A midline incision will thus encounter the following layers of tissue:

- Skin
- Subcutaneous fatty layer (Camper’s fascia)
- Membranous fascia (Scarpa’s)
- Linea alba
- Transversalis fascia
- Preperitoneal fat
- Parietal peritoneum

B. PARAMEDIAN INCISI ONS

An alternative for the standard midline incision is the paramedian incision. This technique stays clear of
the relatively avascular linea alba, possibly avoiding impaired wound healing.
Two variants are known: the conventional “medial” paramedian incision, in which the rectus sheath and
rectus muscles are transected close to the linea alba, and the so-called lateral paramedian technique.

C.TRANSVERSE INCISIONS

A supraumbilical transverse incision offers excellent exposure of the upper abdomen. However, in case the
operation area needs to be enlarged, extending the original incision is more difficult than when the midline
incision was used and extensions do not always offer the desired view.
- When a full-length transverse incision is made, the oblique and transverse muscles, as well as the
rectus abdominis muscle and linea alba are cut in a horizontal plane. The fibres of the oblique muscles
are partly split and partly cut, while the transverse muscle is split along the direction of its fibres.
- The rectus muscle fibres are cut perpendicular to their direction. The deep epigastric arcade is divided,
but as it is supplied from above and below this should not pose a problem. Damage to the segmental
arteries and nerves is minor.
- The incision is accompanied by more blood loss than the midline incision and is more time-
consuming (average 13 minutes).
- Smaller transverse incisions can remain unilateral, take less time to perform and leave the deep
epigastric arcade unharmed.
- An infraumbilical transverse incision in the lower abdomen is the Pfannenstiel incision, often used for
gynaecological and obstetric procedures. The skin is incised transversely, often with a convexity
downward to avoid dissection of blood vessels and nerves.
- The abdominal wall muscles are often cut in the same plane as the skin incision, but some surgeons
open the abdominal cavity in a vertical direction, thus combining a transverse with a vertical technique.

1. PFANNENSTIEL’S IN CISIONS:

These are the most common muscle-separating incisions. They are frequently used for women’s reproductive-
and urinary system-related operations. They are commonly used for cesarean delivery because they provide a
cosmetically better appearance. They are also known as bikini incisions. They are made just 5 cm above your
groin area (pubic) and are mostly 12 cm long.

2. CHERNEY’S INCISIONS:

These are made 2-3 cm above the groin area, lower than Pfannenstiel’s incisions. They provide excellent
access to the pelvic organs during urinary bladder or vaginal repair surgeries. Because they are a tendon-
detaching operation, reattachment of the tendons (fibrous collagen tissue band) is tedious.

3. MAYNARD’S INCISIONS:

These are true muscle-cutting incisions. They give excellent exposure to the genital organs. They are made
parallel to the traditional placement of Pfannenstiel’s incisions. They are also as popular as Pfannenstiel’s
incisions for cesarean delivery and are used for cancer surgeries.

4. MODIFIED GIBSON INCISIONS:

These incisions are specifically made during surgeries related to women’s reproductive system
or cancer surgeries. Cuts are made on the side of the midline of the abdomen (belly), most often made only on
the left side.

5. LANZ INCISION:

An incision designed to be more cosmetically subtle than the gridiron, with the benefit that it may be hidden
beneath the bikini line but the disadvantage of commonly severing the ilioinguinal and iliohypogastric nerves.

OBLIQUE INCISIONS

The subcostal or Kocher incision is an oblique incision that follows the profile of the costal margin and is
directed in a medio-proximal direction. It provides good exposure for biliary and bariatric surgery and can be
extended bilaterally if needed.

Many segmental blood vessels and nerves are dissected, as well as the fibres of the external oblique, the
transverse and the rectus abdominis muscles. The direction of the gridiron or McBurney incision is medio-
caudal. It follows the direction of the fibres of the external oblique muscle, segmental blood vessels and nerves,
damaging as little as possible.

Notably, this incision splits all three muscular layers parallel to the direction of their fibres. Time to perform
the incision and blood loss are comparable to those of transverse incisions.

1. McBurney’s Incisions:

These are specifically used for appendectomy (appendix removal operation). They are made at the junction of
the middle third and outer third of the line running from the navel to the upper margin of the pelvic girdle.

2. SUBCOSTAL INCISIONS:

These start at the midline. They are 2-5 cm incisions below the lower part of the sternum (breastbone) that
extends down outward parallel to the lower edge of the chest-rib. They provide easy access to
the gallbladder and spleen. They are often performed in gallstone removal operations.
A. KOCHER INCISION:

A Kocher incision is a subcostal incision used to gain access for the gall bladder the biliary tree. The incision is
made to run parallel to the costal margin, starting below the xiphoid and extending laterally.

The incision will then pass through the all the rectus sheath and rectus muscle, internal oblique and
transversus abdominus, before passing through the transversalis fascia and then peritoneum to enter the
abdominal cavity.

Structures within the transpyloric plane:

- L1 vertebral body
- Tip of the 9th costal cartilage
- Fundus of the gallbladder
- Duodeno-jejunal flexure
- Pylorus of the stomach
- The neck of the pancreas
- Renal hila
- Conus of the spinal cord

Two modifications and extensions of the Kocher incision are possible:

CHEVRON / ROOFTOP INCISION OR MODIFICATION:

The extension of the incision to the other side of the abdomen. This may be used for oesophagectomy,
gastrectomy, bilateral adrenalectomy, hepatic resections, or liver transplantation
MERCEDES BENZ INCISION OR MODIFICATION:

The Chevron incision with a vertical incision and break through the xiphisternum. This may be used for the
same indications as the Chevron incision, however classically seen in liver transplantation

B. GRIDIRON INCISION:

An arcing incision through the skin, subcutaneous fat and fascia, external and internal obliques, transversus
abdominis and transversalis fascia used for open appendicectomies.

The incision is centred over McBurney’s point two-thirds of the distance between the umbilicus and the right
anterior superior iliac spine (ASIS), where the base of the appendix is most likely to be found.

This classically corresponds to the area of maximal tenderness on clinical examination when the appendix has
become sufficiently inflamed to cause localised peritonitis. This incision may be modified to follow the
horizontal Langer’s lines for improved cosmesis.

Disadvantages include the risk of injury to the ilioinguinal and iliohypogastric nerves. The arc may be
extended cephalad and laterally in order to facilitate access to the ascending colon, which is known as
the Rutherford-Morison incision.