Improving Surgical Scalpels to Reduce Scarring and More

By Matt Phillion

Hypertrophic scarring impacts 40% of patients after surgery and can lead to physical disfigurement, pain, psychological challenges, and more. The condition impacts roughly 15 million patients in the U.S. alone each year, and the costs of associated treatment exceeding $4 billion. It also impacts patients with darker skin tones at a disproportionate rate.

A new type of surgical blade has the potential to significantly reduce hypertrophic scarring in post-surgical patients, according to a recent study.

Planatome has created nano-polished surgical blades which, the study finds, have resulted in an 86% reduction in hypertrophic scarring from statistically equivalent patient populations relative to ethnicity, age, gender, smoking status, and comorbidities. It found just a 1.8% occurrence rate of hypertrophic scarring in patients when using the new blades, compared to 12.3% in those using conventional blades.

The concept for the nano-polished blades came from an unexpected source: computer chips.

“My background is in making computer chips, and when you make a chip there’s about 15 processes to it, and one of those is a nano-polishing process,” says Tim Tobin, CEO of Planatome. “When we polish the surface of a chip, the result is a near molecularly perfect surface finish—it’s like taking a hair from your head, looking at the end, and then cutting that up to 30,000 times—it’s incredible how smooth that is. We had to do that to make sophisticated transistors and chips, and we were doing this for really big-name companies in the tech world. We wanted to look for where else we could use this technology, to take what we knew from one industry and apply it to another.”

Scalpel blades are everywhere in healthcare: there’s some three-quarters of a billion blades sold every year in the U.S.

“That’s a high level of utilization, and if you look at a standard blade under a microscope the edge is incredibly serrated,” says Tobin. “When we show a microscopic image of a standard blade to surgeons, often even they are surprised, and we’re not even showing them the worst that we’ve found—we zoom in on the number one blade in the world.”

The disposable scalpel blade was invented in 1915, and it’s been a remarkably durable invention—very little has changed or evolved since its first implementation over a hundred years ago.

“We started looking at why that is,” says Tobin.

They went first to talk with plastic surgeons, not just because of the nature of their work but also because they are often early adopters of new technology.

“They immediately understood it conceptually and asked, ‘Does it make a clinical difference or not?’” says Tobin. “We had to work a bunch of things into our design so they could achieve extraordinary clinical benefits from it without any learning curve or adjustments often associated with new tools. Plastic surgeons always ask, ‘What’s new?’ and in this case, what’s new is what’s old.”

There’s a reason why the surgical blade has had such a long and stable career. From the business perspective, stability comes from low cost or high differentiation, and with scalpel blades, they are a low-cost, familiar solution. Blades usually run between 20 and 50 cents and there was not much focus on highly differentiating a tool that was both cheap and got the job done. There was a cost associated with developing new technology to replace it.

“We knew that was the case, and we said let’s apply this technology and see if there are clinical benefits,” says Tobin.

The pace of change

Tobin notes that they would often hear that the blade was less of a differentiator than the technique and early discussions were often dismissive of the concept of these heightened scalpel blades.

“I love my country and the medical community, but in the U.S.  there seems to be far more hesitation to make changes to things, especially in this area,” he says. “And I think folks are dealing with many other issues, and will say: this works, so I’m not putting this on my plate to change.”

The new blades are more expensive, roughly $3 a blade.

“If you go to a patient, show them pictures of both blades, and ask them if they’d rather have a $3 blade or a 50-cent blade used in their surgery with these benefits, there’s no hesitation. That’s not even a rounding error in a single surgery,” says Tobin. “But if you pose the same question to an administrator who buys 100,000 blades a year, that’s a big deal.”

The blades are created using existing, manufactured scalpel blades that are then polished from the jagged edge to a smoother line.

“If you think about it, intuitively you know a blade with a jagged edge is going to saw and tear. It pulls at the tissue,” says Tobin. “It’s stretched, elongated, and can inhibit and worsen the healing process.”

With a nano-polished edge, there’s less trauma, less snagging and tearing, which means less swelling and far faster healing.

“It’s almost like comparing saw cut to a paper cut,” says Tobin.

They have also found that surgeons use fewer blades polished in this manner.

“The jagged features in a conventional blade bend, break, or get gunked up with tissue. These serrations are removed in the polished blades, so they tend to last up to five times as long. Durability wasn’t our intent, but if one blade can replace a number of standard blades, that price difference becomes negligible, and that’s not even thinking of the cost of complications, scarring, or trouble with healing,” says Tobin.

Physiologically, Tobin explains, what’s happening is with less tearing versus slicing, there’s 50% to 60% less collagen deposition, and the wound closes faster. The study found three-day postoperative wound closure at 90% using Planatome versus 10% for conventional blade technology.

“You want as clean wound edges as possible,” says Tobin. “And if you’re able to close the wound with less tension, so much the better.”

For the surgeons who have used the new blades, Tobin notes, some have said they can see a difference with the naked eye, and under a magnifying lens the difference is even clearer.

“With folks who are focused on the clinical benefits, it’s a no-brainer, and for those who are concerned about cost differences, it’s economically a wash,” he says.

Planatome commercially launched in September 2024 and are looking at ways to apply the polishing technique to other surgical or cutting instruments to reduce scarring and improve healing in other areas, like surgical scissors, biopsy punches, rongeurs, surgical staplers, and many more.

“In some ways, I wish we started with scissors,” Tobin says. “It’s really interesting how surgeons look at blades. With scissors, they want them as sharp as they can be, and there’s a big wow factor there with polished scissors. With scalpels, there’s question of how sharp we want them to feel. If they push with the same pressure as a normal blade, they could cut too deep, so we intentionally made the scalpels feel as close as possible to standard blades because they don’t want a big learning curve. But that sharpness is much more durable and long-lasting for the surgeon.”

They also continue to identify ways improving the blades can help with efficiency, healing, and safety in the healthcare setting.

“One of the top challenges for surgical staff are inadvertent sticks. If they’re changing blades a lot, they get stuck, and if you don’t have to exchange blades as often, there’s fewer opportunities for sticks,” says Tobin. “And from the patient perspective, the patient’s journey to healing is such a different experience. You can go from A to Z very quickly with Planatome, or you can be all over the place with conventional blades depending on how you heal and recover. If there’s less inflammation, less pain, less trauma, less need for pain medications, less chance for scarring or infection, you’ve got a faster recovery and you’re back to work or to your family faster.”

In the immediate future, the team is looking at how improved blades can specifically help diabetic patients.

“Twenty-five percent of diabetics develop foot ulcers in their lifetime. It’s the number one cause of hospitalization for them,” says Tobin. “The five-year mortality rate is the same as all-cause cancer. It’s a staggering number and a lot of times those ulcers don’t heal. Then you amputate and the mortality rate jumps again. We’re going after this by reducing inflammation and expediting healing because it has the potential to have such a big impact.”

It’s about improving what works to get better results, Tobin explains.

“These types of benefits can have such an unbelievable societal impact with such a simple, inexpensive change,” he says. “It’s the same tool, but a better version of that.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.