Needles and Suture information

The ideal needle

• sharp enough to penetrate tissue with minimal resistance

• Carry suture through tissue with minimal trauma

• Rigid enough to not break

• sterile

• stable enough to grasp with needle holder

Parts of a needle

• needle point

• needle body

• needle eye (where suture connects to needle)

Taper point needles

• sharp point to piece skin and spreads tissue without leaving small cuts

• used for soft tissues

Taper cut needles

• round, tapered body with cutting points on side

• used on tough fibrous tissue and cardiovascular procedures

Blunt point needles

• Taper body with a rounded blunt point

• used to dissect friable tissue without cutting

• recommended for liver and kidney suturing

Spatula needle

• flat on top and bottom to reduce tissue injury

• used in eye procedures

cutting edge needle

• three cutting edges on the point and body

• third edge on inside curvature (medial aspect)

• can be traumatic as the curve cuts toward the wound

• used for tough tissue like skin

• creates weakness allowing suture to tear out

Reverse cutting edge needle

• three cutting edges but third edge is on outside curvature (lateral aspect)

• stronger than cutting needle and designed to resist tissue cutout

Needle body types

• straight

• ½ curved (half a circle)

• circular needle

most common needle sizes

sizes 3/8 and 1/2

needle eye types

• closed

• French

• swaged

Closed eye needle

French eye needle

contain a slit to ease threading

swaged needle

• minimal tissue damage

• preloaded with suture

Suture material types

• absorbable or non-absorbable

• braided and monofilament

Types of absorbable braided suture

• Vicryl

• vicryle rapide

Types of absorbable monofilament suture

• chromic gut (natural)

• monocryl (synthetic)

• cat-gut (natural)

Types of non-absorbable braided suture

• Ethibond (synthetic)

• silk (natural)

Types of non-absorbable monofilament suture

• ehtilon

• nylon

• prolene

• stainless steel

non-absorbable suture characteristics

is not broken down by body and can remain in body for at least 2 years

absorbable suture characteristics

broken down by the body, this starts as early as 7 days

Tensile strength

amount of force in PSI the suture can withstand before it breaks

suture memory

ability or tendency of the suture to return to its original package form

• lower memory is easier to handle

suture flexibility

ease with which suture is manipulated by surgeon or tissue

suture capillarity

• ability of suture to allow microbes to wick in the interior of the suture strand

• Multifilament treated with wax

Suture structure

• monofilament: single sloid strand of suture material, causes less tissue drag and friction

• multifilament: braided suture

knot security

• ability of suture to hold knot

• braided has less knot slippage

suture color

used as a means of identification. DO NOT use black suture on a black lab

suture packaging

• single use package (long shelf life

• Reel or cassette (exposed but unused, do not resterilize, catgut or chromicgut)

  • The type we used in shelter

Staples

• external

  • Stainless steel

• internal

  • specific soft tissue may benefit (thoracic cases)

Suture/staple removal

• generally removed in 10-14 days

Suture/staple removal supplies

• suture scissors

• staple remover

• adson brown thumb tissue forceps

• gauze and aseptic cleaner (peroxide)