Can't get your surgeons to use safety scalpels? Don't feel so bad. Renea Goode, RN, can't even get her surgeons to trial them.

"If you find a surgeon that will, send him my way," says Ms. Goode, the director of nursing at The Surgery Center in Oxford, Ala.

Safety scalpel conversion? Try aversion. Two years of trying to get her 42 credentialed surgeons to use safety scalpels and all Ms. Goode has to show for it is one surgeon who's been willing to try. He is Clinton Ray, MD, an orthopedic surgeon who just doesn't see the sense of the devices. The rest tell Ms. Goode in no uncertain terms not to even bother bringing the safety devices into the room. "At least try it and then yell at me," she pleads.

Dr. Ray has twice tried to use a safety scalpel during knee arthroscopy. Both times he aborted the trial seconds into the procedure because the safety sheath prevented him from cutting deeply enough. He formed two other opinions: the scalpel didn't fit in his hand like he's used to and he was worried that he'd cut himself trying to activate the device.

"I don't see any benefit to safety scalpels," says Dr. Ray. "If it was to my or to my patient's advantage to use a safety scalpel, I would do it without hesitation. But having something bulky between you and the end of the blade that can hang on tissue and doesn't let you control the knife the way you want to interferes with the operation."

It's not uncommon for surgeons to dismiss safety scalpels as being too light, too cumbersome to activate and more slippery than textured metal. But as you'll see when you open the next page, many of today's safety scalpels have been engineered to have the same weight and balance of conventional scalpels. The wide selection is reason enough for Ms. Goode to keep trying — that and the fact that OSHA requires continuous evaluation of safety blades.

Try it, you'll like it?
"I'm going to go through every blade on the market. There's a ton out there," says Ms. Goode.

Up next: She's going to ask her surgeons to evaluate a model that has a reusable metal handle, a disposable blade and a sheath. Strike that. She's not going to ask, she's just going to have the safety scalpels suddenly show up in the ORs. "When I say, ????-??Will you please try?' a lot of them say, ????-??Oh, I hate those things. You're just wasting my time. Have we had any injuries? Why are we doing this?'

"Unless you can make [a safety scalpel] feel exactly like a non-disposable blade, we're going to get resistance, just like we did with marking the surgical site. Like anything else, we're creatures of habit. Our doctors don't want to change."

Amber Hogan, MPH, a former compliance inspector for OSHA and a safety and health affairs officer for a safety scalpel manufacturer, thinks the key to getting more safety scalpels in more ORs is for surgeons and nurses to think about sharps safety as an element of quality patient care.

"Part of better patient outcomes is reducing sharps injuries in the OR," says Ms. Hogan. "When we move into the patient quality forum rather than focusing on sharps injuries to surgeons and nurses, maybe it will elicit that culture change."

Advanced Medical Innovations
Retractable Safety Scalpel
www.amiwelisten.com
Foolproof design retracts blade during passing; there is no partially exposed blade when the user guard is off.

American Surgical
Safe-Lok Surgical Scalpel
Retractable tip is moved forward into a locking position for disposal. Available only in lightweight models.

Angiotech
SharpGuard Guarded Knives
www.sharpoint.com
A textured, moveable sheath retracts to expose the blade and extends back to cover it when the knife is not in use.

BD Medical
Bard-Parker Protected Surgical Blade and Reusable Handle
www.bd.com/surgical
Clear protective shield is activated with one hand and locks when the blade is both covered and uncovered.

Cardinal Health
Allegiance Retractable Safety Scalpels
www.cardinal.com/mps
Visual proof that the blade is safely locked for disposal and bubble sensory grip for maximum control.

DeRoyal
Canica Safety Handles
www.deroyal.com
Reusable handle, similar to length, weight and feel of a metal slab handle, accepts most conventional blades.

DeRoyal
Disposable Safety Scalpels
www.deroyal.com
Blade retracts easily into handle for safe passing and temporary forward lock prevents accidental retractions.

Diamatrix
ProTekt Sharps Safety Knives with Snap-Safe handle
www.diamatrix.com
Movable sheath, which has a textured, ergonomic grip, retracts to expose the blade and extends to cover the blade.

Feather Safety Razor
Safeshield Scalpel
www.feather.co.jp
Blade size identified by a corresponding colored button on the slide mechanism; locking retractable shield.

Jai Surgicals
Surgeon Safety Scalpel with Steadfast Disposable Lock
www.jaisurgicals.com
"Use" or "Pass" position notched onto button with a corresponding indicator line on the handle.

Medline
The BladeGlove Safety Scalpel System
www.medline.com
One-handed activation and cartridge removal; similar in length, shape and center of gravity to reusable scalpels.

Merit Medical
Futura Safety Scalpels
www.merit.com
Locking inset provides tactile and audible feedback for this scalpel, which features one-handed activation.

Miltex
Disposable Safety Scalpel
www.miltex.com
Metric ruler on handle assists in determining incision length. Blade sizes (10, 11, 12, 15, 15C, 22) clearly marked.

Myco Medical
TecnhoCut Retractable Scalpel
www.mycomedical.com
Audible clicks indicate the blade's position, whether it's retracted, extended or locked for disposal.

Personna Medical
Personna Plus Safety Scalpel
www.asrco.com/medical_landing.aspx
Tab at blade's end offers extra safety; side-mounted mechanism allows for easy opening and closing.

PL Medical
Retractable Safety Scalpels
www.plmedical.com
The blade's shield has an anti-slip grip surface and an easy-to-operate,push-button lock.

Sandel Medical Industries
Weighted Safety Scalpel
www.sandelmedical.com
Same weight as a reusable scalpel (27 grams) and comes with a "TimeOut" removable sleeve as a safety reminder.