How to Maintain Your Diamond Scalpel

Over the decades, I have been asked many times how many cases one should expect to get off of a single diamond scalpel. My answer has been modified to where I now simply quip “anywhere between zero and infinity.” As corny as it sounds, it is actually true. Below, I will discuss the six steps to keeping your diamond scalpel performing like new for years to come.

Before Use:

Step 1.  Limit diamond scalpel handling to experienced staff only. 

We have had numerous experiences where a distraught surgeon or nurse has called us during or immediately after a procedure to tell us the blade was broken off or dull. This is almost always the result of mistakes in staff handling. As simple as this sounds, the diamond journey begins with who might open and handle your packages with instruments in receiving to who then moves them along to your surgical team. Careful thought should be given here to an area one would not normally have a concern about. Less people handling diamonds in any organization is always better. 

Step 2. Inspect and sterilize diamond scalpel upon receipt.

Upon receipt, and after the diamond scalpel has been critically inspected under the surgical microscope by the surgeon or experienced staff member, the diamond scalpel can be sterilized as denoted in our verified sterilization documentation, Packaging and Sterilizing Mastel Precision Diamond Knives (visit mastel.com/faq). 

Step 3. Keep the diamond scalpel retracted and isolated when not in use.

If the diamond scalpel is simply touched to anything other than soft tissue, it will be damaged. The most common mistakes causing diamond scalpel breakage that I have witnessed are the following:

  • Touching another instrument or the speculum
  • Setting the diamond scalpel on the mayo stand with the blade extended where it can roll around and run into something
  • Setting the diamond scalpel where another instrument could poke up into the barrel (even if retracted!)
  • Sending an instrument in the mail without its case or properly protecting it 

Note: If this happens to you, it is important to never use a blade that is dull by “forcing it,” as this can lead to complications. Ask for another scalpel if it does not feel right.

During Use:

Step 4. Cautiously decide who extends and retracts during surgery.

The surgeon in a new setting (or with new assistants or ancillary personnel) should be the only person to extend and retract the blade during the procedure. With experienced staff, however, it can be far more efficient for the assistant to extend and retract the diamond for the surgeon.

After Use:

Step 5. Clean debris off of the diamond scalpel immediately after usage. 

After usage, we strongly recommend using the Mastel Diamond Blade Cleaning System in the OR. We then recommend placing your retracted diamond scalpel in the sterilization case that precludes the round instrument from rolling around and also ensures staff outside the OR do not touch these these ultra-delicate devices apart from sterilization.

Note: It can be extremely difficult to clean the diamond as compared to other micro instruments. Due to the nature of single crystal diamond being oil wettable and not water wettable {as are most materials such as metals}, it has an extreme affinity to have tissue, blood or viscoelastics dry on and not be removed with normal cleaning approaches. It requires soap or other surfactants that lift the material from where it desires to stick. If you were to bake on these biological materials just one time, it becomes a significant challenge to get them clean again.  It does not look good and can degrade the performance at the same time. 

Step 6. Send in your diamonds for annual inspection.

Any diamond scalpel has the inherent weakness of the epoxy bonding the diamond to the metal dop (or holder). With Mastel diamonds, we recommend that the mountings be checked on an annual basis depending upon volume because the diamonds can loosen or fall out, neither of which is pleasant. On controlled-depth handles, this is a critical error. It is the autoclaving cycle that destroys the integrity of the epoxy resins used by all companies in the industry. Good maintenance protocols should involve your vendor’s expertise and insight.

By Doug Mastel