Lab: Threading a Suture Needle From Reeled Suture

What do we mean by Suture Integrity

• Avoid crushing monofilament sutures with forceps—use gentle pressure only.

• Keep suture ends organized to prevent tangling or accidental drag across non-sterile areas.

What do we mean by Needle Safety

• Never reposition the needle with fingers—use forceps or needle holders.

• Keep the needle curve oriented away from your palm to reduce puncture risk.

• Dispose of damaged needles; do not attempt to reshape them.

What do we mean by Maintaining Sterility with suture needles

• Always handle suture and needle with instruments, not bare fingers. Use care if handling with gloved hands to avoid breaks in sterility.

• Keep the reeled suture dispenser closed between pulls.

• If the suture touches a non-sterile surface, discard immediately.

• Replace gloves if contamination is suspected at any point.

Perform a last sterility and security check before handing off or beginning suturing, Final Check

• Inspect the needle–suture assembly for contamination or slippage.

• Ensure the free suture end is coiled neatly within the sterile field.

• If contamination is suspected, discard and repeat the process.

Secure the Needle in the Needle Holder: Lock the needle into the needle holder to prevent accidental drops or punctures then do what

• Position the needle at the proximal third of the needle curve.

• Do not grasp the needle over the eye, this can be damaging to the eye and threaded suture.

• Close the needle holder ratchet to the first click only.

• Confirm the needle is aligned perpendicular to the jaws.

• Tug gently on the suture to ensure it remains threaded.

How do we Thread the Needle

Pass the suture end through the needle eye while minimizing contact and maintaining sterility.

• Grasp the suture end with a sterile gloved fingers.

• Guide the suture tip directly into the needle eye using a single smooth motion.

• The suture should be fed into the needle eye from the convex side of the needle to the concave side of the needle (or toward the point of the needle).

• Pull 3-5 cm of suture through the eye and bring the suture back around and feed it through the eye from the convex side of the needle to the concave side of the needle again, repeating the previous pass through the eye a second time.

• Pull both the suture ends tight away from the needle to tighten within the eye.

How do we Align the Needle for Threading

Position the needle to allow smooth passage of the suture through the eye.

• Use sterile forceps or needle driver to hold the needle at its midpoint.

• If holding the needle by hand, orient the point up and away from your fingers and grasp the needle at the midpoint of the curve, carefully.

• Orient the needle eye toward your dominant hand.

• Stabilize your hand against the table or drape to reduce tremor, avoid breaking sterility. You can brace your wrists together as shown in the class video.

• Ensure the eye opening is fully visible.

Why should we Inspect the Needle and Suture

Verify that both components are intact and appropriate for the planned tissue type.

• Check the needle for bending, burrs, or defects.

• Confirm the needle eye is open and unobstructed.

• Inspect the reeled suture signs of fraying, discoloration, or contamination.

• Confirm suture size and

How do we Prepare the Sterile Field

Reminder that reeled suture is sterile in the reel package.

Establish a controlled, contamination-free workspace before handling any suture or needle intended for use in a surgical patient.

• Perform a full surgical scrub and don sterile gloves.

• Confirm that the instrument table, drapes, and all materials are sterile.

• Ensure reeled suture is in a sterile dispenser or has been properly sterilized.

• Position needle holders, forceps, and scissors within easy reach.