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Suture Types, Needle Types, and Instruments


Give us the tools, and we will finish the job. Winston Churchill

Despite sufficient knowledge of anatomy, pathophysiology, and disease processes, a surgeon will be lost in the operating room without a comprehensive knowledge of the surgical tools at his or her disposal. Learning the nomenclature and specific utility of all the various tools in the operating room can be a daunting task for a surgeon in training. The focus of this chapter is to outline the most common tools encountered. It is by no means an exhaustive list, and thus it is imperative to stay up to date as new suture material, needles, and instruments are developed.

I

Suture Material

A

The Optimal Suture

  • 1.

    Easy to handle

    • a.

      Properties inherent to the suture material. Some suture is more rigid than others. Some suture has high degree of memory—it retains its coiled shape from packaging. Manipulation should require minimal concentration and should have a high degree of ease when securing knots.

  • 2.

    High tensile strength

    • a.

      Tensile strength is defined as the maximal stress the suture material can withstand before breaking.

    • b.

      Suture with high tensile strength can secure tough tissue or tissue prone to high shear and mechanical forces.

  • 3.

    Minimal tissue reaction

    • a.

      Suture results in local tissue inflammation due to presence of a foreign body. Ideal suture has minimal local tissue inflammation.

  • 4.

    Antimicrobial properties

    • a.

      Suture can harbor microbes within the individual strands. Ideally, suture material should limit the number of microbes it introduces to the body or can be coated with antimicrobial substances.

  • 5.

    High plasticity and elasticity

    • a.

      Plasticity is defined as the ability to be easily shaped or molded.

    • b.

      Elasticity is defined as the ability of a material to resume its normal shape after being stretched or compressed.

    • c.

      These qualities allow suture to adapt to anchoring tissue as it expands and contracts.

  • 6.

    Low cost

B

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