Changing knives a wasteful and unnecessary ritual

Area of Science:

• Surgical Practices
• Infection Control
• Bacteriology

Background:

• The practice of using two knives for surgical incisions is prevalent in British surgery.
• A survey indicated that nearly all surgeons in the South-West Thames Region employ this two-knife technique.

Purpose of the Study:

• To investigate the bacteriological contamination of surgical knife blades.
• To determine if using a single knife for incisions increases the incidence of wound infection.

Main Methods:

• A bacteriological study of knife blades used in a general surgical unit.
• A survey of world literature on surgical incision techniques and wound infection rates.

Main Results:

• Pathogenic organisms were not found to contaminate single knife blades under normal surgical conditions.
• Using only one knife for surgical incisions does not lead to a higher incidence of wound infection.
• Existing literature supports the findings that a single knife is sufficient.

Conclusions:

• The ritualistic use of two knives for surgical skin incisions lacks scientific and clinical justification.
• Discontinuing the two-knife practice is recommended as it is wasteful and unnecessary.