Surgical scissors are specialized instruments designed with specific shapes, blade compositions, and tip configurations tailored to distinct tasks within the operating field. Unlike general-purpose shears, surgical instruments are named to reflect their intended function, the tissue they are designed to cut, or the surgeon who first developed the design. This systematic naming convention allows medical professionals to identify the exact tool needed for precise and safe manipulation of tissue and materials.
Classification by Function and Design
Surgical scissors are broadly categorized based on their primary function: dissecting or operating. Dissecting scissors are engineered for separating biological tissues, requiring precision and minimal trauma to surrounding structures. Operating scissors are typically more robust and used for cutting non-body materials like sutures, drapes, and sponges.
Blade tips are classified using a combination of sharp (S) and blunt (B) designations. A sharp-sharp (S/S) tip provides maximum cutting precision for delicate work but carries a higher risk of accidental puncture. The sharp-blunt (S/B) combination offers a compromise, where the blunt tip minimizes tissue damage while the sharp tip maintains cutting efficiency. Blunt-blunt (B/B) tips are the safest option, frequently used for cutting materials or for blunt dissection.
Specific Scissors for Tissue Dissection
Metzenbaum scissors are identified by their long handle relative to their short, delicate blades, providing surgeons with enhanced reach and fine control. These slender instruments are used for delicate soft tissue dissection, such as separating fat or thin membranes. They are designed to minimize tissue trauma and are not intended for cutting tough or fibrous structures.
In contrast, Mayo scissors are heavy-duty instruments designed for cutting thick, tough tissue like fascia, muscle, or dense connective tissue. The straight version is frequently used for cutting sutures or materials near the surface of the wound. The curved version is preferred for deep tissue cutting, as the curvature allows the surgeon to follow natural contours and cut in deeper planes.
Iris scissors are extremely small and feature exceptionally fine, sharp blades and points. Originally developed for ophthalmic (eye) surgery, they are now used in any micro-surgical procedure requiring precision. Their small size makes them suitable for cutting minute structures and performing intricate dissections in plastic and reconstructive surgery.
Specialized Utility and Suture Instruments
Lister Bandage Scissors are distinct due to their lower blade, which ends in a flattened, rounded tip often called a “shoe” or guard. This design allows the lower blade to slide safely under tight bandages or dressings, lifting the material away from the patient’s skin before the cut is made. The blunt tip prevents accidental injury or skin punctures during the removal process.
Operating scissors serve as a general-purpose cutting tool for non-body items like gauze, tubing, and surgical drapes. Their names often include the tip designation, such as “straight operating scissors S/B,” indicating their use in utility tasks. For suture removal, specialized instruments like Littauer or Spencer Stitch Scissors are used. These instruments have a small hook or notch incorporated into one blade near the tip, designed to safely lift the suture material before cutting it close to the skin surface.