Should a sharp, fit for purpose instrument really be a luxury item?

Surgeons use tools to perform all kinds of Surgery, from Brain to Bowel to Feet. The tools they use differ, but in essence do the same thing. These tools, or instruments as they are called in the trade, essentially cut human tissue so it can be divided, removed or replaced with a prosthetic. All surgeons will use a scalpel to penetrate the skin to access whichever organ or part of the body they need to gain access to. The Scalpel is a single use instrument, sharp and disposed of almost immediately after the initial skin incision, the reasons for this are thus, a thin blade to create a clean incision will blunt very quickly, a blade used in the skin may carry Skin Flora (bacteria) which if used again within the body may transfer this bacteria inside. Most eye surgery instruments follow the same premise and are disposed after 1 use, imagine using a blunt instrument in the Eye! Laparoscopy (key hole Surgery in the Abdomen) instruments have long shafts with moving parts, which are very difficult to clean properly and guarantee all contamination has been removed. Orthopaedic instruments generally cut bone, saw blades for Knee and Hip Replacement have been around for decades but only became single use in the last ten years. A saw blade, attached to a power tool, needs to be sharp to ensure accurate cuts for fitting of a prosthesis. A blunt saw blade will have to work harder, vibrate more and ultimately transfer this vibration into the surgeons hands. Prolonged use could lead to Hand-Arm Vibration syndrome. Arthroscopy shaver blades, again Single-use, cut soft tissue and remove bone. Osteotomes and Curettes sculpt and remove bone by a more controlled fashion, they are manually held and controlled by the hands rather than attached to a mechanical device. Most of these manual instruments seem to have flown under the radar for decades, blunt, old, maltreated and rarely, if ever, sharpened are handed to Orthopaedic Surgeons on a daily basis. Some even resemble Museum pieces. Have Surgeons just accepted that this is how it is? Should it really be a luxury to use something fit for purpose?


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