Suture scissors are specialized instruments designed for the safe and precise removal of stitches after a wound has adequately healed. Their unique design allows medical professionals to cut suture material close to the skin without causing trauma to the underlying tissue. Mastering the correct handling of these tools is directly linked to procedural efficiency, minimizing patient discomfort, and preventing potential complications. Proper technique ensures controlled, deliberate movements essential for delicate procedures like stitch removal.
Essential Parts of Suture Scissors
A standard pair of suture scissors consists of several distinct parts that influence its function. At the proximal end are the finger rings, which serve as anchor points for the user’s digits and dictate the overall grip. The long, slender metal body connecting the rings to the working end is called the shank.
The hinge, or joint, is the pivot point where the two shanks and blades meet, allowing the instrument to open and close. At the distal end are the blades, which are configured specifically for suture removal. Suture scissors often feature one blade with a small notch, hook, or blunt tip designed to be gently slipped under the suture material without piercing the skin.
Mastering the Standard Ring Grip
The most effective way to hold suture scissors is by employing the standard ring grip. This grip maximizes precision and leverage while minimizing the risk of hand tremor. To execute this technique, the dominant hand’s thumb is placed into the proximal finger ring, while the ring finger is inserted into the distal ring.
Only the distal phalanx should enter the ring openings to maintain maximum dexterity and maneuverability. The index finger is then positioned on the shank, resting near the hinge or screw head of the scissors. This placement acts as a directional stabilizer, providing a crucial third point of control and guiding the tips of the blades with fine adjustments.
The middle finger rests alongside the shank, supporting the instrument and enhancing stability. This controlled grip allows the user to manipulate the scissors using only the intrinsic muscles of the hand, which reduces fatigue and increases tactile feedback. Alternative grips, such as placing the index or middle finger through the second ring, restrict the fine motor control necessary for precise suture cutting.
Safe and Effective Suture Cutting Technique
Suture cutting begins by positioning the blunt or hooked tip correctly relative to the stitch. The non-dominant hand should use gauze or forceps to gently stabilize the skin or lift the suture knot away from the wound. The specialized blunt tip is then carefully slid beneath the suture strand, moving toward the knot and ensuring the tip remains parallel to the skin surface.
The goal is to cut the segment of the suture that was previously buried beneath the skin, which has remained clean and sterile. This prevents contaminated exterior thread from being pulled through the healing wound. Once the blunt tip is positioned, the scissors are closed to cut only a single strand of material directly under the knot. Cutting the thread closest to the knot and opposite the exit point is common practice.
After the cut is made, the non-dominant hand, still grasping the knot, gently pulls the suture thread sideways in the direction of the cut. This action smoothly draws the entire stitch out of the tissue through the original entry and exit points. This systematic approach ensures the removal process is rapid, minimally invasive, and reduces the risk of introducing surface bacteria into the wound tract.