Often we neglect importance of one of the important and precious thing of surgeons armamentarium. Here's the slide escribing only the needle.

1. Surgical Needles
• Ideal surgical needle:
should be rigid to resist distortion
flexible to bend before breaking
slim to minimise trauma
sharp to penetrate tissue with minimal resistance
stable within a needle holder to permit accurate placement.
• Commonly, surgical needles are made from stainless steel.

2. • Composed of 3 parts:
• swage (connection point for the suture)
• Tip
• Body

3. Needle Anatomy
• Has 5 geometries:
1. length - distance of the circumference from the swage to the point
2. chord length - distance of the straight line from the swage to the point (which
determines the width of the bite)
3. radius- length of the line from the center of the circle
4. needle diameter - measured in mils (1/1000 of an inch) and 1 mil is about 25 um
5. bicurve - two radii on a needle, the radius near the point is usually shorter than
the radius of the body near the swage

5. Classification
1. Shape
Straight needles
Curved needles
2. Swaged end:
-Eyed needle: suture threaded with a needle through the eye during surgery.
economical because reusable,
-sharpness will be less
-big hole and more damage to tissue because of the passage of double-strand
suture and pulling it through the tissue ,that’s called “traumatic”.

6. • Eyeless needle (swage):
• All of the needles nowadays are swaged,
• suture is directly attached to needle by the manufacturer.
• Has a hole or channel formed at the end of it, hole is drilled with a laser to
provide a more smooth transition with suture.
• suture follows the needle through the tissue without causing injury, and the
thickness of needle and suture is less than an eyed needle, that’s why this needle
is called “atraumatic

7. Needle body:
• Body facilitates tissue penetration according to shape (round or triangle).
• Diameter of the body should be as close as possible to the diameter of suture
material to prevent tissue trauma and minimize bleeding and leakage.
• Includes four types:
• Straight body
• Half-curved (ski body)
• Curved body: 1/4 circle, 1/2 circle, 3/8 circle, 5/8 circle.
• Compound curved body

9. • 1/4 circle:It has a little curvature, use on convex surface and delicate surgery, typically
use on ophthalmic procedures, facial aesthetic, eyelids, fascia, and microsurgery.
• 1/2 circle:It has a large arc to use in confined sites, the application area is skin, muscle,
peritoneum, eye, abdominal surgery and gastrointestinal tract.
• 3/8 circle: most common, use in large and superficial wound and it’s impossible to use in
deep cavities. This needle applied in skin, hand surgery, fascia, muscle, subcuticular.
• 5/8 circle:For deep and confined cavities due to the needle design make a maneuvering
in small location easier. Application area Intraoral, urogenital, and anorectal procedures.
• 1/2 curved (ski needle):Curved portion for this needle passes through tissue easily, used
in laparoscopic technique and skin closure.
• j shape:Used on deep incision so it used in laparoscopic surgery without any injury to
visceral and applied in vagina and rectum.
• Compound curved:Used on oral, eye and anterior segment ophthalmic surgery.
• Straight needle:Can be used without needle holder as is the case of curvature needle
and there is a high risk of accidently sticking yourself. It uses in easily accessible tissue,
typically in abdominal surgery, rhinoplasty.

10. • Tip of needle
A)Taper or non-cutting needles
-penetrates tissue, without cutting, creating a round hole
Sharp tip at the point flattens to an oval or rectangular shape.
Sharpness is determined by the taper ratio (8-12:1) and the tip angle (20-
35°).
Needle is sharper if it has a higher taper ratio and a lower tip angle. -have
round body with sharp pointed tip
-generally used for viscera, muscle and light fascia
-should NOT be used for dense tissue like skin because the extra force needed to
penetrate the tissue causes extra trauma or bends the needle
taper cut tip a newer design that combines the round body with a cutting tip so
can be used for both delicate and dense tissue

11. B)Traditional cutting needle
• Conventional cutting needles have three cutting edges (a triangular cross-
section that changes to a flattened body). The third cutting edge is on the
inner, concave curvature (surface-seeking)
• Cut edge is where the tension is on the tied suture so this type of needle predisposes the
suture to cutting through the tissue
• use has generally been replaced by the reverse cutting needle

12. C)Reverse cutting needle
• Third cutting edge is on the outer convex curvature of the needle (depth-
seeking)..
• more efficiently uses the cutting surface when curve wrist during
• more resistant to suture cutting through tissue because the cut
direction of tension on the tied suture
• preferred by most surgeons

13. D)Beveled conventional cutting needle
• Developed with performance characteristics superior to those of other
conventional cutting needles.
• Composed of a unique stainless steel, ASTM 45500, that is heat-treated after the
curving process to enhance its resistance to bending.
• Angle of presentation of the cutting edge is decreased to enhance sharpness.
• Recommended for closure of lacerations