Originally published in September 1997 issue Vol. 6, No. 9.

Be Sharp!
Dull Instruments Just Don't Cut It

-- by Rick Schultz

Crushed and shattered bone.  Ripped and tattered flesh.  Do those sound like gory descriptions from the movie Jurassic Park?  Well, yes.   But they're also some very real outcomes when surgical instruments haven't been properly sharpened.

An orthopedic surgeon who tries to cut bone with a dull chisel or osteotome runs the risk that the bone might shatter.  Blunt rongeurs would end up crushing, grabbing, or tearing the bone instead of cutting cleanly.  And dull scissors can pull or tear tissue.

Clearly, sharp instruments are critical to the success of surgical procedures.  But all too often the cart is in front of the horse: The people responsible for maintaining the instruments usually wait for surgeons to complain before they'll have the instruments sharpened.

As with all instrument maintenance and repair, it's far better to take a proactive approach to sharpening and preventative maintenance.  The problem is that many managers think it's a big undertaking to gather up their instruments and sets for preventative maintenance.  Or they may be reluctant to send instruments offsite, fearing that they won't be returned when needed. 

However, it's important to understand how costly it is to wait until an instrument has serious damage or needs replacement-- especially when that expense could have been prevented by routine maintenance.

Here's a real-life example: A facility purchased $400 gynecological biopsy punches (which are used to take a sample of the cervix), but never sharpened or maintained them.  After 14 months of use, the punches were crushing the tissue rather than cutting it.  That put so much stress on the biopsy punch that the metal fatigued, then cracked.  As a result, the $400 biopsy punch was beyond repair and had to be replaced.  The cost of preventing this occurrence: $9.50.

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