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All Medical Blades: Images, Identification & Specific Uses

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PART 1 - SCALPEL BLADES

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Blade No. 9

• Shape: Small curved blade with a rounded tip, similar to No. 10 but smaller
• Identification: Short, small curved profile
• Use: Fine incisions in restricted areas, ophthalmic and ENT surgery

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Blade No. 10

• Shape: Large, broad curved blade with a prominent belly; the classic general-purpose blade
• Identification: Wide curved edge, largest of the small-handle curved blades
• Handle: No. 3
• Use: Large skin incisions, subcutaneous tissue dissection, general surgery opening cuts

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Blade No. 10A

• Shape: Similar to No. 10 but with a slightly modified curve; narrower body
• Identification: Looks like No. 10 with a less pronounced belly
• Use: Incisions in slightly tighter spaces than No. 10 allows

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Blade No. 11

• Shape: Triangular, straight-edged with a sharply pointed tip ("stabbing blade")
• Identification: Straight top edge + angled lower edge meeting at a fine sharp point
• Handle: No. 3
• Use: Stab incisions, inserting chest tubes/drains, incising abscesses, vascular catheter entry, laparoscopic port incisions, Bartholin's cyst drainage

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Blade No. 11K

• Shape: Similar to No. 11 but the cutting edge is on the back (concave side)
• Identification: Reverse-edge pointed blade
• Use: Used where a normal No. 11 would cut unintended structures; vascular and ophthalmic procedures

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Blade No. 12

• Shape: Crescent/sickle-shaped, hook-curved blade with the cutting edge on the inside (concave side)
• Identification: Distinctive crescent moon shape; unique among scalpel blades
• Handle: No. 3
• Use: Suture removal, posterior pharyngeal incisions, parotid/cleft palate surgery, cutting in tight curved areas, transantral orbital decompression (as noted in Cummings Otolaryngology)

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Blade No. 13

• Shape: Small, narrow-pointed blade similar to a scaled-down No. 11
• Identification: Pointed tip, smaller than No. 11, narrow body
• Use: Fine stab incisions, ophthalmic surgery, microsurgery

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Blade No. 14

• Shape: Small curved blade with a narrow body and shallow belly
• Identification: Small curved profile, sits between No. 12 and No. 15 in size
• Use: ENT surgery, fine dissection in confined areas

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Blade No. 15

• Shape: Small curved blade, the smallest of the "belly" blades; closely resembles No. 10 in shape but much smaller
• Identification: Short, small curved profile; most commonly used fine blade
• Handle: No. 3
• Use: Short, precise incisions; dermatological excisions; skin lesion removal; organ biopsies; neurological and plastic surgery; scraping burrows in scabies diagnosis; histological sectioning - the workhorse of dermatology (Andrews' Diseases of the Skin)

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Blade No. 15B / 15C

• Shape: Variants of the No. 15 with slightly modified geometry (wider or differently proportioned belly)
• Identification: Resemble No. 15 but with subtle shape differences at the back of the blade
• Use: Fine dermatologic and plastic surgical procedures

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Blade No. 16

• Shape: Narrow, elongated curved blade with a pointed tip
• Identification: Long narrow profile with a pointed end
• Use: Fine dissection in deep or narrow surgical fields

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Blade No. 17

• Shape: Narrow with a curved tip
• Identification: Slender blade, moderate curve
• Use: Specialized ophthalmic and microsurgical procedures

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Blade No. 18

• Shape: Wide, reverse-angled cutting edge; curved back
• Identification: Large blade with an unusual reverse curvature
• Use: Cartilage cutting, rhinoplasty, ENT surgery

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Blade No. 19

• Shape: Larger variant similar to No. 22 family
• Identification: Medium-large curved belly
• Use: General dissection, gross anatomy

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Blade No. 20

• Shape: Large curved belly blade, roughly a bigger version of No. 10
• Identification: Larger, broader version of No. 10
• Handle: No. 4
• Use: Larger incisions through thick tissues, large animal surgery, deeper soft tissue dissection

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Blade No. 21

• Shape: Large curved blade, longer than No. 20
• Identification: Very large curved belly, longer body than No. 20
• Handle: No. 4
• Use: Deep tissue dissection, large incisions in dense tissue, thoracotomy, laparotomy

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Blade No. 22

• Shape: Large broad curved belly blade; "big brother" of No. 10
• Identification: Very wide, rounded belly - the largest of the general curved blades
• Handle: No. 4
• Use: Large skin incisions, gross anatomy dissection, thoracotomy, laparotomy, veterinary surgery

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Blade No. 22A

• Shape: Modified No. 22 with a slightly altered tip angle
• Identification: Looks like No. 22 with a shallower tip
• Use: Similar to No. 22; large incisions

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Blade No. 23

• Shape: Curved blade with a pronounced belly, similar to No. 22 but with a more pointed tip
• Identification: Large curved blade, pointed at the tip unlike No. 22's rounder end
• Handle: No. 4
• Use: Large incisions, abdominal surgery, general surgical procedures

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Blade No. 24

• Shape: Large curved blade, rounded belly
• Identification: Similar to No. 22/23 family; broad cutting surface
• Handle: No. 4
• Use: Large tissue dissection, orthopedic soft tissue work

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Blade No. 25

• Shape: Narrow, pointed straight blade
• Identification: Small, pointed and relatively straight - resembles a miniature No. 11
• Handle: No. 4
• Use: Precise stab incisions when a larger handle is preferred; used in some ENT and thoracic procedures

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Blade No. 36

• Shape: Large spear-point/lance-point shaped blade
• Identification: Very wide base, tapers to a spear point
• Use: Amputations, large orthopedic soft tissue cuts

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Handles: No. 3 handle takes blades 9-17; No. 4 handle takes blades 18-36. The No. 7 handle (long and thin) also accepts No. 10-15 blades for use in deep or confined spaces.

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PART 2 - LARYNGOSCOPE BLADES

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1. Macintosh Blade (Curved)

• Shape: Broad, curved (C-shaped) blade with a wide flange; rounded tip
• Identification: Larger cross-section at the base, obvious curve that sweeps from handle to tip; the cross-section is roughly trapezoidal
• Sizes: 0 (neonate) through 5 (large adult); sizes 3 and 4 are most commonly used in adults
• Technique: Tip is placed in the vallecula (the space between the base of tongue and epiglottis), indirectly lifting the epiglottis via the hyoepiglottic ligament
• Use: Standard adult intubation; uncomplicated airways; keeps tongue retracted; provides more room for tube passage through oropharynx; preferred when prominent upper teeth are present; less risk of laryngospasm than straight blades
• Source: Roberts and Hedges' Clinical Procedures in Emergency Medicine; Morgan and Mikhail's Clinical Anesthesiology

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2. Miller Blade (Straight)

• Shape: Straight, narrow blade with a slight upward curve at the tip; narrow cross-section
• Identification: Flat, long straight profile; narrower at the tip; cross-section is a narrow C-shape
• Sizes: 00 (preterm infant) through 4 (large adult); size 2 most common in adults
• Technique: Tip placed directly under the epiglottis, which is then directly lifted upward
• Use: Pediatric patients (preferred in infants and neonates); patients with anterior larynx; patients with a long floppy epiglottis; airways fixed by scar tissue; anterior-positioned glottis
• Cautions: Less effective with prominent upper teeth; higher risk of laryngospasm (stimulates superior laryngeal nerve on underside of epiglottis); may inadvertently enter esophagus; lightbulb at tip may slightly obstruct view
• Source: Roberts and Hedges' Clinical Procedures in Emergency Medicine; Barash Clinical Anesthesia

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3. Wisconsin Blade (Straight - Pediatric)

• Shape: Straight, flat blade with a slight curve at the tip; cross-section is a nearly flat C
• Identification: The flattest/most rectangular cross-section of the three classic blades; very flat profile compared to Miller
• Sizes: Mainly pediatric sizes (0-2)
• Technique: Direct epiglottis lift (like Miller)
• Use: Pediatric patients; patients with limited mouth opening; neonates and infants when the Miller is unavailable; preferred in some centers for very small airways

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4. Wis-Hipple Blade (Straight - Pediatric variant)

• Shape: Straight, with a short wide body and flat cross-section; combines features of Wisconsin and straight blades
• Identification: Broader, chunkier than Miller for same length; used primarily in infant sizes
• Use: Young children (especially 2-10 years); provides precise visualization of pediatric airway

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5. D-Blade / Hyperangulated Blade (Video Laryngoscopy)

• Shape: Acutely angled blade (up to 60-90 degrees); used with video laryngoscopes (GlideScope, McGrath, etc.)
• Identification: Sharply bent geometry; requires a pre-shaped stylet; cannot be used for direct laryngoscopy
• Use: Difficult and failed airways; cervical spine immobility; morbid obesity; cannot-intubate scenarios; provides improved glottic visualization via video chip at the blade tip

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Laryngoscope Blade Size Guide

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PART 3 - SURGICAL SAW BLADES (Orthopedic/Bone Cutting)

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1. Sagittal Saw Blade

• Shape: Flat rectangular blade with serrated teeth on one end; oscillates in the sagittal (back-and-forth) plane through a small arc (3-5 degrees)
• Identification: Broad rectangular body; teeth only on the cutting end; mounts perpendicular to the saw body
• Use: Precise bone cuts in total joint arthroplasty (hip, knee replacement); wedge osteotomies; tibial and femoral cuts in arthroplasty; minimizes bone damage due to small oscillation arc

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2. Oscillating Saw Blade

• Shape: Flat blade that moves side-to-side (oscillating in the frontal plane); teeth on the cutting edge
• Identification: Blade oscillates perpendicular to its long axis; comes in various widths and tooth configurations; the most versatile shape
• Use: Curved and straight osteotomies; orthopedic, oral/maxillofacial, and podiatric surgery; bone contouring; cast removal; removing bone fixation hardware

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3. Reciprocating Saw Blade

• Shape: Long, narrow blade that moves in a straight in-and-out (reciprocating) motion along its long axis; teeth along one edge
• Identification: Longer, narrower blade compared to oscillating; moves like a jigsaw; serrated edge on one side
• Use: Transverse osteotomies; amputations; bone cuts in deep or narrow spaces where oscillating blades cannot reach; orthopedic, oral/maxillofacial, and podiatric surgery

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4. Gigli Saw (Wire Saw)

• Shape: Flexible stainless steel wire with twisted strands creating serrated cutting surfaces; comes as a loop of wire
• Identification: Looks like a braided wire, not a flat blade; used with handles at each end
• Use: Craniotomy (cutting the skull); amputations; cutting bones in tight spaces where power saws cannot go; obstetric destructive operations

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5. Amputation Saw

• Shape: Large flat straight blade with coarse teeth; similar to a carpenter's handsaw
• Identification: Large size, coarse serrations, straight profile
• Use: Limb amputations; large bone cutting in emergency or resource-limited settings

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Key Differences Summary - Bone Saw Blades

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• Roberts and Hedges' Clinical Procedures in Emergency Medicine, 6th ed. - laryngoscope blades section
• Morgan and Mikhail's Clinical Anesthesiology, 7th ed. - laryngoscope blade comparison
• Barash, Cullen & Stoelting's Clinical Anesthesia, 9th ed. - airway management
• Andrews' Diseases of the Skin - scalpel blade No. 15 for cutaneous surgery
• Cummings Otolaryngology Head and Neck Surgery - blade No. 12 application
• WPI Scalpel Blade Guide - blade geometry and uses