ABSTRACT Scalpel injuries can expose surgeons, nurses, and other OR personnel to bloodborne pathogens. Direct and indirect costs of managing exposure include time spent reporting, treating, and following up on the injuries; salaries and benefits for injured staff members; laboratory testing of exposure sources and exposed personnel; and postexposure prophylaxis. Standard precautions, training and awareness for those at risk, the use of neutral passing zones, and safety-engineered devices have helped decrease the incidence of injury for specific categories of sharps. One new safety device is a hand piece that uses electrosurgical plasma induced with pulsed radio-frequency energy to cut tissue. AORN J 90 (December 2009) 867–872. © AORN, Inc, 2009.