There's little doubt among most health care workers that using safety sharps dramatically reduces the risk of accidental injuries and the transmission of bloodborne pathogens. Despite this conviction, compliance with the 2000 Needlestick Safety and Prevention Act is lagging-according to a recent report, OSHA has already cited 34 facilities with violations. One of the key arguments surgeons and staff pose against using safety sharps is that they require a change in technique or an extra step to deploy the safety mechanism. Fortunately, however, manufacturers are stepping up to the challenge of making sharps safer and easier to use.

One device that has undergone numerous revisions is the ubiquitous surgical scalpel. Today's safety scalpels offer features that reduce the risk of accidental cuts during use, passing, and disposal, as well as provide a similar feel, comfort and "weightiness" of conventional devices. To help you determine which safety scalpels may be right for your facility, we asked five safety scalpel manufacturers to explain the features of some of their most popular devices.

Sheathed Scalpels
Many safety scalpels incorporate a sheathing safety mechanism. The sheath encapsulates the blade between and after use, protecting its integrity and reducing the risk of exposure. Following are three companies that offer variations on this theme.

The BD Bard-Parker Protected Disposable Scalpel, from Becton, Dickinson and Company features a transparent retractable shield that locks into place to enclose the stainless steel blade after use. To expose the blade, simply depress the button on the shield and pull it back toward the handle. The shield can be manipulated multiple times. There are three ways to confirm whether the shield is locked during or after use-an audible click, a tactile sensation and a lock indicator line. According to the company, the locking feature minimizes the risk of accidental movement or retraction of the shield, which could expose the blade. Because the shield is transparent, it allows the surgeon to easily identify the size and check the integrity of the blade. The scalpel is very close in size and weight to a conventional disposable scalpel; it also boasts a durable plastic handle. This product was designed with the help of a panel of surgeons from 10 different specialties, to ensure that it could be used for a variety of procedures.

The BD Bard-Parker Protected Disposable Scalpel is autoclave compatible and can be sterilized on site. It comes in three blade sizes - 10, 11 and 15. Next year the company will be introducing five additional sizes. The suggested retail price is $2.49. For more information, call (888) 237-2762 or visit www.bd.com/scalpel.

Personna Medical also offers a scalpel with a sheathing mechanism; according to the company, it is the only disposable scalpel with a sheath that locks permanently after use, for safe disposal. The sheath has three positions. When received in the sterile package it is in the closed or guard position. You can retract it to the open position for use and move it forward to the guard position so it can be used again. When ready for disposal, move it all the way forward to the locked position. The sheath is attached to the handle and moves backward and forward on a channel. Suitable for one-hand (left or right) activation, a slight pressure of the thumb slides the sheath back to expose the blade or forward to cover it. Two small icons on either side of the handle indicate the locked and unlocked positions.

The Personna Safety Scalpel comes in biohazard orange to contrast with the surgical drapes in the OR. Available in sizes 10, 11 and 15. Suggested retail price is approximately $2.00. For more information call 800-457-2222 or visit www.asrco.com/medical/.

Diamatrix offers a sheathed safety scalpel, the Williamson Trapezoid Knife, which is particularly appropriate for ophthalmic procedures. The surgeon activates the cylindrical sheath with a screwing motion (this can be done with one hand); the sheath rests on the handle during use and screws back on after the procedure. On average, the Williamson Trapezoid Knife can be used 10 to 15 times and can be sterilized for reuse, according to the company. It is available in three different blade sizes: 2.5/2.9mm; 2.7/3.2mm; and 3.0/3.75mm.

The Williamson Trapezoid Knife sells at $195 for a set of six. For more information, call (800) 867-8081 or visit www.diamatrix.com.

Retractable Scalpels
If your surgeons find sheathed scalpels too bulky or difficult to activate, you may want to offer them retractable devices. These scalpels feature mechanisms that retract the blade into the handle. The blades can be advanced and retracted multiple times. Following are two retractable devices of note:

The DeRoyal Retractable Safety Scalpel is the only patented safety scalpel on the market with manually controlled retraction of the entire blade into the handle, according to the company. Designed by a cardiovascular surgeon and a safety engineer, this scalpel has a sliding mechanism located in the center of the scalpel. This makes it easy to withdraw and retract with a single gloved hand. Audible and tactile clicks help the user identify the blade's open and locked positions. Its ribbed finger grips make it slip-resistant, while its high visibility red color makes it easy to detect on the sterile field and easy to dispose of afterward. Its comfortable styling allows for a variety of hand positions and its full blade visibility reduces the potential for injury. This product is disposable and was initially accepted for use in the ER where high-risk patients and a high-stress environment increase the risk of percutaneous injuries and disease transmission. In an ambulatory facility, you can use it anywhere surgeons use traditional surgical scalpels.

Available in nine different stainless steel blade sizes, the sliders are color-coded for each size for easy identification. Available sizes include: 6, 10, 10A, 11, E11, 14, 15, 15A, 15C and 16. The DeRoyal Retractable Safety Scalpel is competitively priced at $1.00 to $1.50 per unit with blade.

For a free sample, training video or more information, call (800) 251-9864 or visit www.deroyal.com/acutecare/safetyscalpel.htm.