A blade shows in below image, which is commonly used for creation of large skin incision such as in laparotomy surgery. Identify the number of blade?

1. A

   22

2. B

   21

3. C

   12

4. D

   32

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

• The image shows a No. 22 surgical blade, identifiable by its large, leaf-like shape and prominent curved cutting edge.
• This blade is specifically designed for making long, continuous incisions through skin and subcutaneous tissue.
• It is the standard and preferred choice for major procedures requiring large access, such as laparotomy (abdominal surgery) and thoracotomy (chest surgery).
• The No. 22 blade is used with a larger No. 4 scalpel handle, which provides the necessary leverage and control for making deep and long cuts.

Why Other Options Were Wrong

• Option B: While the No. 21 blade is also a large blade used for major incisions, it is slightly smaller and more pointed than the No. 22. The blade in the image, with its broad, curved belly, is a classic representation of a No. 22 blade.
• Option C: The No. 12 blade is a small, crescent-shaped (hooked) blade. Its shape and size are completely different from the one shown and it is used for entirely different purposes.
• Option D: No. 32 is not a standard or commonly used surgical blade number in the context of scalpels for general surgery.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and application of surgical blades as background academic context rather than a clinical decision trigger.
• A key nursing responsibility in the operating room is anticipating the surgeon's needs. Knowing which blade is used for which type of incision ensures the correct instrument is ready, promoting efficiency and safety.
• Nurses are integral to sharps safety. This includes correctly loading the blade onto the handle (using a needle holder, never fingers), passing the scalpel safely, and ensuring proper disposal in a sharps container immediately after use to prevent injuries.
• The surgical count of all instruments, sponges, and sharps (including blades) is a critical safety protocol managed by nurses to prevent retained surgical items.

How to Approach the Question

• First, carefully examine the image of the surgical blade. Note its key features: it is large, and it has a long, curved cutting edge.
• Next, read the question stem, which specifies the blade's use: 'creation of large skin incision such as in laparotomy surgery'.
• Connect the visual information with the functional description. The blade's large size and shape are consistent with making long, sweeping cuts.
• Recall or deduce the system of surgical blade numbering. Generally, blades in the 10-series (10-15) are smaller and fit a No. 3 handle, while blades in the 20-series (20-24) are larger and fit a No. 4 handle.
• Evaluate the options based on this knowledge. A No. 12 blade is small and hooked, which is incorrect. No. 21 and No. 22 are both large blades. No. 32 is not a standard number.
• Between 21 and 22, the classic 'leaf shape' with a prominent belly shown in the image is characteristic of the No. 22 blade, making it the best answer for a large laparotomy incision.

Concept Tested & Keywords

• Concept Tested: Identification and application of surgical blades.
• Stem keywords: blade, large skin incision, laparotomy surgery
• Lead-in keywords: Identify the number
• Clinical cues: Image of a surgical blade with a large, curved cutting edge.

Question ID

Qk0LAgTODFu5qnHsrfRlyj

Copy ID

Reference Book

E6 Gynecology Williams pp. 428-434, 429-435