I probably should have been more clear, I'm referring to only modern medical instruments. It is my mistake if you are refering to historical examples. However we should be clear in our distinctions. My straight razor has a polished edge, my disposables not so much. Surgical steel is all stainless, mostly 440 but some 410 depending on the instrument. I've never seen a high carbon steel scalpel in modern use. Undoubtedly scalpels used historically were carbon steel. Previous surgeons also did not have the benefit of electrocauteries, and used a scalpel for all cutting maneuvers and therefore sharpened their own instruments and probably stropped them. I've never been in a situation where a "toothed" edge similiar to a kitchen knife would have been helpful. The cleanest cut and the most control possible are paramount. Medical sterilization is undertaken with high pressure, heat and steam and would ruin what most of us consider a well honed edge. Scalpel blades used in modern medicine are all disposable, due to the possibility of various rare infections that can survive the autoclave (a different topic entirely). In fact, most of them are made from the scrap from decomissioned Navy submarines because of their high quality and consistent steel. Amputations are usually done with an oscillating bone saw, another item that does not have a polished edge, merely a machined one. Bone chisels have a high angle of about 45 degrees and are sharpend the same way as disposable scalpel blades, ground on a high grit wheel. In this case is boils down to economics, polishing an edge on a medical tool that has to be disposed of anyway is not economically sensible, especially when the tool gets dull, it can be replaced in a few seconds.