Surgical Needles • To use a Surgical Suture for approximation, a Needle is a must. • A needle with a hole,(called the eye) at the opposite end of the sharp point may be used for the surgery. • This is called the “Eyed needle”
Surgical Needles . Why these are called traumatic sutures?
Surgical Needles . • Surgical Sutures with needles attached to it are referred to as “eyeless needled sutures” or more commonly “a-traumatic” sutures. Needle Suture
Surgical Needles . • Features & benefits of an eyeless needled suture: • Sharp Sterile New Needle each time for the surgery. • Ready for immediate use. • Saves invaluable time. • No unthreading during surgery. • Less tissue damage as single suture strand passes through the tissue. • The gap made by the needle is “fully plugged” by the diameter of the suture strand. • Chances of “leakage” from the ‘suture line’ remote.
Surgical Needles . . Needle Area of “Step Down” (from the needle) “Step Up” (from the suture) Suture
Needle Structure Point • Portion from the tip to the maximum cross section of the body Body • It forms the majority of the needle length. • Important interaction with needle holder and ability to transmit penetrating force Swage
Surgical Needles . • Swaging • The objective of this procedure is the attach the • needle to the suture in such a manner that : • The needle becomes an integrated part of the stitching system • The step up / step down at the point of attachment is minimum • The gap generated in the tissue by passage of the needle end should totally be filled up by the suture diameter. • The point of transition between the metal and fiber is smooth • The tissue drag is reduced to a minimum • The attachment should be strong enough to withstand the tension of suture pull
Surgical Needles . Before the start of the swaging process, the strands are visually inspected for defects.
Surgical Needles . Swaging
Surgical Needles . Swaging under the microscope
Surgical Needles . . Swaged Eyeless Needled Sutures
Surgical Needles . • Two types of needles are commonly available in • the industry : A) Drilled needles (more common) • Eyeless needles with a hole drilled at the suture attachment end. • They may be mechanically drilled or Laser drilled. • Glue treated Suture material placed inside the hole and crimped. • B) Channel needles • The attachment point of the needle is left flat and open. • Glue treated Suture material is placed inside & then enclosed & crimped by closing the ‘flaps’.
Surgical Needles Shapes (Curvature)
Surgical Needles • Preferred when tissue is easily accessible • Designed to be finger held on or near the surface • Useful for skin closure, Micro surgery- Nerve and vessel repair Straight
Surgical Needles • The curvature of the needle determines the depth of its bite. • Curved needles are used due to quick needle turnout from tissue.
Surgical Needles - Shape . 1/4th Circle
Surgical Needles – ShapeI/4 Circle • Has shallow curvature • Typically used on easily accessible convex surfaces • Ophthalmic and Microsurgical procedures
Surgical Needles - Shape 3/8th Circle
Surgical Needles – Shape3/8 Circle • Most commonly used curved needle • Can easily be manipulated in large and superficial wounds • But are awkward or impossible to use in deep cavities due to large arc of manipulation needed- eg. pelvis
Surgical Needles - Shape . 1/2 Circle
Surgical Needles – Shape1/2 Circle • For use in confined locations • Requires more pronation and supination of wrists
Surgical Needles - Shape . 5/8th Circle
Surgical Needles – Shape5/8 Circle • Ideal for deep, confined holes • Can be used by rotating the wrist with little or no lateral movement.
Surgical Needles - Types Round Body Needle Sharp Point Blunt Point
Surgical Needles – TypesRound Bodied & Blunt • Pierces and spreads the tissue without cutting • Used in easily penetrated tissues like Peritoneum, abdominal viscera etc • Used in internal anstomosis to prevent leakage • Blunt needles are used to dissect through friable tissue – liver & kidney
Surgical Needles - Types Cutting Needles Cutting Edges Reverse Conventional
Surgical Needles – TypesConventional Cutting • Has three cutting edges • For use to cut through tough difficult to penetrate tissue • Ideal for skin sutures
Surgical Needles – TypesReverse Cutting • Ideal for tough tissue like skin, tendon sheath or oral mucosa • Has more strength than conventional cutting needles. • Has reduced risk of cutting out tissue • Used in ophthalmic and cosmetic surgery- minimal trauma