a. Procedure by Surgeon

With knife #4 and blade #20, the skin incision is made. In making this primary incision, the surgeon may apply tension to the skin in one of three ways:

1. by pulling the skin upward at the upper end of the wound, cutting through the taut skin and shifting tension as he progresses downward;
2. by effecting pressure laterally to make the skin taut and side to side;
3. by exerting pressure in a downward direction, using a gentle outward pull to keep the skin taut.

After making the skin incision, the surgeon returns the “skin knife” to the scrub who covers the blade and places the wound skin knife on the back table.

b. Items Supplied by Scrub

“Skin knife/scalpel (#4 knife handle with #20 blade)

NOTE: When the knife handle and blade are put together as one, it can be called knife or scalpel.