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Surgical Needles

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Surgical Needles - Anatomy of A Surgical NeedleIdeal Characteristics Of A NeedleShapes/Angle of CurvaturePointsGuidelines For Selection.Suturing Technique

Text of Surgical Needles

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Surgical NeedlesContentsAnatomy of A Surgical NeedleIdeal Characteristics Of A NeedleShapes/Angle of CurvaturePointsGuidelines For Selection.Suturing TechniqueAnatomy of a Surgical Needle

The swage is the point where the material joins with the needles. It creates a single, continuous unit of suture and needle.There are three parts to a suture needles: swage (connection point for the suture) 2. the body 3. point The swage is the point of attachment of the suture to the needle. The swaging process provides a smooth junction between the needle and suture as opposed to the rough junction of a thread being attached to the needle by insertion through an eye. A swage requiring lower uniform forces to detach its suture, sometimes called pop-off or control release, is also available.

All needles are made of stainless steel A suture needle has 5 geometries: 1. length - distance of the circumference from the swage to the point 2. chord length - distance of the straight line from the swage to the point (which determines the width of the bite) 3. radius- length of the line from the center of the circle 4. needle diameter - measured in mils (1/1000 of an inch) and 1 mil is about 25 um a smaller diameter needle required less force and cause less trauma during passage through the tissue 5. bicurve - two radii on a needle, the radius near the point is usually shorter than the radius of the body near the swage

3IDEAL CHARACTERISTICS OF A NEEDLE Made of high quality stainless steel as thin as possible without compromising strength.Stable in the grasp of a needle holder.Able to carry suture material through tissue minimal trauma.Sharp enough to penetrate tissue with minimal resistance.Rigid to resist bendingDuctile to resist breaking during surgery.Sterile and corrosion resistant no micro organism, no foreign materials.

Needle Shapes

Needle PointsCutting points : the cutting edge is on the concave surface. It is used when tissue is difficult to penetrate such as skin and tendon

Reverse cutting: the cutting edge is on the convex surface and is ideal for skin, tendon sheath, or oral mucosa. Reverse cutting needles have more strength than conventional, and a reduced risk of cutting through tissue.

Taper point : used in soft tissue such as intestine and peritoneum, the sharp point is at the tip of needle

Blunt point : used for suturing friable tissue such as liver and kidneyConventional vs Reverse Cutting

Cutting edge on inside of circleSkinTraumaticCutting edge on outside of circleSkinLess traumatic than cuttingConventional CuttingReverse CuttingBlunt vs Lancet

Taper point vs Trocar point

General Guidelines for Selection of Needle

Suturing TechniqueA needle holder is used to grasp the needle at the distal portion of the body, one half to three quarters of the distance from the tip of the needle.

The needle holder should not be tightened excessively because damage to both the needle and the needle holder may result.

Incorrect placement of the needle in the needle holder may result in a bent needle, injury to the tissue, and/or an undesirable angle of entry into the tissue.

Suturing TechniqueA needle holder is held with the first and fourth fingers in the appropriate finger holes. The second and third fingers are used for stabilization and fine control of the instrument.

When suturing, always sew towards yourself.

Suturing TechniqueThe needle should always penetrate the tissue at a 90 angle. This minimizes the size of the entry wound and promotes a proper path through the tissue. Not doing so results in excessive tissue damage and sub-optimal or incorrect positioning of the suture.

The distance traveled, depth, and angle of the suture depends on the surgeon goal. In general, the 2 sides of the stitch being placed should be mirror images, with the needle also exiting the tissue in a perpendicular plane.

ReferencesBailey & Loves Short Practice of Surgery