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Surgical Needles & Knots

By Muhammad Saad Zaheer 4 th year, M.B.B.S A.I.M.C. Surgical Needles & Knots. WOUND. “Injury to tissue of body, especially caused by physical mean that causes interruption of continuity”. CHARACTERISTICS OF A NEEDLE. Slim as possible Stable to grasp

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Surgical Needles & Knots

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  1. By Muhammad SaadZaheer 4th year, M.B.B.S A.I.M.C Surgical Needles & Knots

  2. WOUND • “Injury to tissue of body, especially caused by physical mean that causes interruption of continuity”

  3. CHARACTERISTICS OF A NEEDLE • Slim as possible • Stable to grasp • Able to carry suture material with minimal trauma • Sharp • Rigid • Sterile • Non-corrosive

  4. Few Terms • CHORD LENGTH: • Straight line distance from the point of curved needle to swage • NEEDLE LENGTH • Distance measured along the needle itself from point to end • NEEDLE DIAMETER • It’s the thickness of needle. • Heavy gauge … for sternum , retention sutures in abdomen • Fine gauge … microsurgery • NEEDLE RADIUS • The distance from center of circle to the body of needle if the curvature of the needle were continued to make a full circle

  5. ANATOMY OF NEEDLE • The eye • The body • The point

  6. The eye • Closed eye • Round, oblong, square • French eye [ split or spring eye] • Swaged eye [ no eye]

  7. NEEDLE USED NOWADAYS • SWAGED NEEDLE. • No prep time req. • Convenient to use • Minimum trauma • Cleaning, sharpening, handling, sterilizing problems no more • Easy to locate if needle dropped in body cavity • CONTROL RELEASE NEEDLES.

  8. THE BODY • Place from where we grab the needle during surgical procedure. • Body should be as close to the diameter of suture material as possible … min. bleeding & leakage. • Cardio, GIT, Bladder procedures.

  9. TYPE w.r.t. SHAPES OF NEEDLE BODY • Straight … GIT, Nasal cavity, nerve, oral cavity, Pharynx, skin, tendon, vessels. • Half-curved … skin [rarely used], laproscopy • ¼ circle … eye procedures, microsurgery • 3/8 circle … • ½ circle • 5/8 circle … anal, nasla, pelvis, Urogenital. • Compound curved … eye anterior segment.

  10. MOSTLY USED • 3/8 & ½ circle: • Aponeurosis, biliary tract, cardiovascular sys. Dura, eye, GIT, muscle, myocardium, nerve, perchondrium, periostium, pleura, skin, tendon, urogenital

  11. THE POINT • Extends from the extreme tip of the needle to the maximum cross-section of the body.

  12. TYPES w.r.t. POINT OF NEEDLE • CUTTING NEEDLES • REVERSE CUTTING NEEDLES • SIDE CUTTING NEEDLES • TAPER POINT NEEDLES • TAPERCUT SURGICAL NEEDLES • BLUNT POINT NEEDLES

  13. CUTTING NEEDLES • 2 Opposing cutting edges • Classical: • Triangluar cutting blade  flattened body on straight & curved needles. • PC PRIME [ precision cosmetic] • Narrow point, fine wire diameter, fine tapper ratio, penetrate soft tissue. • Ideal for: • Skin, & sutures which have to pass through dense, irregular and relatively thick connective dermal tissue.

  14. REVERSE CUTTING NEEDLE • Third cutting edge is located on the outer convex curvature of the needle. • Used for : tough, difficult to penetrate tissue as: skin, tendon sheath. • Also in ophthalmic & cosmetic surgery.

  15. SIDE CUTTING NEEDLES[SPATULA NEEDLES] • Sides are cutting & upper & lower surfaces are not. • Permit to separate or split through the thin layers of sclera & corneal tissue.

  16. TAPPER POINT NEEDLES • ROUND NEEDLES • Pierce and spread tissue without cutting it. • Point tappers to sharp tip, Body then flattens to an oval or rectangular shape.

  17. TAPERCUT SURGICAL NEEDLES • Combination of Taper point needle & Reverse cutting edge tips • Three cutting edges extend 1/32” back from point and rest of the round taper body. • Cardiovascular surgery on calcified tissue, dense, fibrous tissue, periostium.

  18. BLUNT POINT NEEDLE • Dissect fabrile tissue rather than cutting it. • Have taper body and rounded, blunt point and will not cut through tissue. • Liver & kidney.

  19. NEEDLE HOLDERS • SMOOTH JAW • JAW WITH TUNGSTEN CARBIDE PARTICLES • JAWS WITH TEETH

  20. TIPS • Grasp the needle at 1/3 part from the eye. • Don’t grasp needle too tightly as the jaws needle holder may deform • Always check for alignment of jaws so as needle doesn’t rock, twist or turn. • Handle needle and needle hodler as a unit. • When scrub pass needleholder to surgeon, needle should be pointing in direction in which it will be used & suture strand not entangled.

  21. To pull needle out through tissue use needle holder not hemostat. • Immediately after use discard needle used. • One – for – one .

  22. PLACING NEEDLE IN TISSUE • Apply force in tissue to be sutured in same direction as the curve of the needle. • Don’t take excessively large bites of tissue with small needle • Don’t force dull needle. • Don’t damage taper end • Heavier gauge … tougher tissue. • Smaller gauge … soft tissue

  23. If needle breaks, collect every piece. • If glove is punctured by needle, • Discard needle immediately • Change gloves • Have serological tests done for Hep. B, C & HIV

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