We currently have a paraplegic on our unit with 2 extensive wounds on his left leg which are currently being managed with a wound vac. During one of the vac changes a few days the surgeon was present during the wound vac change and "took over" the wound care. He encountered difficulty in removing the foam dressing that was packed in the tunneling part of the wound. He picked up a scissors from the patients bedside table (which defineately was not sterile. It was used for cutting tape etc. not to mention - it probably had fallen on the floor several times etc.) and proceeded to make 3 large cuts within the wound to allow him access to the tunneling dressings. Granted this patient had decreased sensation in that leg but could feel pain the deeper one probbed. The surgeon didn't tell the patient what he was intending to do, nor did he ask the nurse to get him a sterile scissors. The issue I have is that I was not the nurse present who witnessed this surgeons actions. The nurse who was - refuses to report the surgeon seeing as though she works with him frequently. In my opinion this is ethically wrong, and it appalls me to think that this surgeon would have done this. It defineately makes me wonder what other things he may do that noone witnesses. Do I have an obligation to report this to our nurse manager or do I stay away from the entire situation seeing as though I wasn't directly involved. I already talked with the nurse who was involved and encouraged her to report the incident however, she declines to do anything further.