B. Braun Sutures Suture materials for veterinary surgery

Transcription

1 B. Braun Sutures Suture materials for veterinary surgery B. Braun Vet Care GmbH Veterinary Expertise by B. Braun and Aesculap

2 2 Closure Technology

3 Table of contents Page Suture material packaging 4 Pharmacopoeia 6 Needlethread combinations 7 Needles for veterinary surgery Easyslide the special atraumatic needle 8 Needle characteristics and B. Braun needle nomenclature 9 Knot types and knot technique 1 Tissuespecific recommendations for users Overview 11 Indications 12 Suture size 14 Absorbable sutures Safil Quick Monosyn Safil Violet MonoPlus 26 Catgut Plain 7 Catgut Chrom 72 Nonabsorbable sutures Premilene Dafilon Supramid Synthofil Dagrofil Silkam Steelex Dental sutures 44 Ophthalmic sutures 54 Sutures for Equine surgery 64 Cassette packs 66 Meshes Absorbable meshes 76 Nonabsorbable meshes 78 Tissue adhesive 82 Surgical needles 84 Practical accessories 88 3

4 Suture material the complete range for veterinary surgery Absorbable sutures Safil Quick Polyglycolic acid Absorption time shortterm Catgut Plain Natural collagen shortterm Monosyn Glyconate midterm Safil Violet Polyglycolic acid midterm Catgut Chrom Natural collagen midterm MonoPlus Polypdioxanone longterm Nonabsorbable sutures Premilene Polypropylene, monofil Dafilon Polyamide, monofil Supramid Polyamide, pseudomonofil Synthofil Polyester, polyfil, coated Dagrofil Polyester, polyfil, uncoated Silkam Silk, polyfil, coated Steelex Stainless steel, polyfil 4

5 Meshes Safil Mesh Safil Mesh bag Premilene Mesh Optilene Mesh Polyglycolic acid Polyglycolic acid Polypropylene Polypropylene 5

6 Suture material packaging DDP the user friendly directdispense packaging DDP (Direct Dispense Packaging) Clearly labelled product information Easy product identification Double sterile packaging with transparent outer pellpack Tearingoff opening system, indicated by coloured arrows Needlethread combinations Direct and precise gripping of the needle, with the needle holder Sutures without needle (precuts) Easy, kink and knotfree dispensation of individual sutures thread by thread Cassette packs Cassette packs Comfortable and easy handling of suture materials of any required length 6

7 Package labelling Product name 2 Suture description Needle code and illustration Suture length Suture size 6 Article number/ordering number 7 Marked tearing point 8 Batch number Expiry date: year and month Contents/foils per pack 7

8 Pharmacopoeia The pharmacopoeia defines the minimum requirements on suture materials: Thread diameter Knot tensile strength Linear tensile strength The European Pharmacopoeia (EP) uses the metric system (referred to as»metric«) for classifying the suture size. All figures are in 1/1 mm. The figures represent the lower limits. The effective diameter of a suture mostly exceeds this value, usually in the upper reaches of tolerance range of each suture. Size designation for surgical suture materials American Pharmacopoeia European Pharmacopoeia Suture Diameter American Pharmacopoeia Suture materials absorbable and nonabsorbable Suture materials absorbable and nonabsorbable mmrange Catgut USP size metric size mm USP size 11,1,1,19 1,2,2,29 9,3,3,39 8,4,4,49 7,5,5,69 6,7,7, ,1, ,5,15, ,2, ,5,25, ,3, ,5,35, ,4, ,5, ,6, ,7, ,8, ,9, ,1,99 6 8

9 Needlethread combinations Based on decades of research and development, B. Braun is offering a wide range of suture materials that are perfectly suited to the requirements of todays veterinary surgery. B. Braun Vet Care recommends the use of atraumatic needlethread combinations: B. Braun atraumatic needlethread combinations excel by their lasting quality and a precise finish. Thanks to the smooth transition between needle and suture, the suture canal is minimized to the size defined by the needle, while micro tissue ruptures are avoided. Atraumatic Needlethread combinations minimal wound trauma solid union of needle and thread smooth transition between needle and thread always a new, sterile and sharp needle no timeconsuming threading needle and suture sizes adjusted to individual indications Traumatic needles wound trauma due to double thread suture suture damaged when being clamped in the spring eye no firm seating of the suture in the spring eye timeconsuming threading of the suture into the normal eye 9

10 Needles for veterinary surgery Easyslide the special atraumatic needle Highquality stainless steel series 3 result of extensive research and clinical experience High bending breaking resistance highly smooth surface finish flattened needle body to prevent needle rotation in the needle holder Laserdrilled ends optimal atraumatic needlethread transition B. Braun needle nomenclature 1. The first letter defines needle curvature: H = 1/2 circle D = 3/8 circle V = 1/4 circle P = progressive/asymptotic G = straight 2. The second letter defines needle body: R = roundbody needle S = cutting needle L = Lancet (spatula) needle 3. Special needle variants are marked by a third letter: C = short cutting tip M = micro point MP= precision point T = trocar point m = micro needle 4. The number defines the straightened length of the needle, in mm. 5. The letter s behind the number heavy bodied needle a = angle degrees b = needle length c = cord length d = needle diameter r = radius 1

11 Important needles and needle code descriptions Round bodied needle The round body of this needle is tapered to a fine needle tip, thus ensuring tissuepreserving penetration. The needle body is flattened to prevent the needle from rotating in the needle holder. This needle is designed for soft tissues. HR = DR = 1/2 circle; round body 3/8 circle; round body Round bodied needle with trocar point Needle with strong cutting point of four edges that blend into a round tapered body. This needle ensures good penetration in tough tissues with minimum tissue trauma. HRT = 1/2 circle; round body, trocar DRT = 3/8 circle; round body, trocar Reverse cutting needle Needle with a triangular cross section and an apex cutting edge on the outside of the needle curvature. This point ensures easy initial penetration. HS = 1/2 circle, cutting DS = 3/8 circle, cutting GS = straight, cutting DSMP = 3/8 circle, cutting, precision point Lancet (spatula) needle This needle is a further development of the spatula needle. The danger of an unintentional injury of deeper tissuelayers is significantly reduced by the special shaped lancet tip. HLm = 1/2 circle, micro lancet DLm = 3/8 circle, micro lancet PLm = progressive/asymptotic, micro lancet VLM = 1/4 circle, micro point 11

12 Knot types and knot technique Knot types right wrong right right Knot technique The square knot, weaver s knot is a reliable knot and locks most closely. This knot is suitable for ligatures and can also be applied as a slip knot. The granny knot tends to loosening, is unreliable and is therefore not recommended, generally. The surgical knot is used very often and is indicated especially when a suture is applied under tension. Not suitable for ligatures! A slip knot should be applied when the first loop of the knot slips open and needs retightening with the subsequent loop. This applies especially when tying knots in deeper layers. For this technique monofilament sutures should be used, preferably. Guidelines for correct knotting Do not position the knot directly above the edge of the wound, but adjacent to it, if possible. Avoid friction damage to the suture when tying the knot! The simplest knot (for any given material) is always the best! The finished knot must be tight enough that any later shift of the knot is so prevented. Avoid tissue strangulation (risk of tissue necrosis)! The first knot is the crucial one! Any subsequent knots are only to secure the first knot. Apply as many securing knots as necessary, but as few as possible (minimum 3 securing knots). right 1 = 1 1 = 1 = 1 1 x 1 1 x 1 x 1 wrong 1 = 1 opposite application (square knot = weaver s knot) 1 x 1 nonopposite application (socalled granny knot) Always tie the knot as small as possible and keep the suture ends as short as possible! 2 = 1 2 x 1 12

13 Tissuespecific recommendations for users Overview Tissue types Minimum requirements Suture material holding forces (5% loss of tensile strength in this many days) Tips and tricks for wound closure Absorbable sutures Nonabsorbable sutures Mucosa 3 5 Early wound healing, shortterm preservation of tensile strength required, rapid absorption Safil Quick Monosyn Skin 7 12 Monofil thread; absorbable suture material with medium loss of tensile strength (no suture removal) Monosyn Dafilon Intestines 7 14 Soft, rubbery tissue; tissuepreserving monofil thread; no sawing effect; no capillarity, to avoid provoking fistula formation Monosyn MonoPlus Bladder 7 14 Monofil suture material; phindependent degradation profile Monosyn MonoPlus Uterus 1 16 Suture material with short to medium loss of tensile strength and excellent handling properties Monosyn Safil Quick Muscle > 18 High blood perfusion, but not very stressresistant; should be severed bluntly and adapted loosely when sutured MonoPlus Monosyn Abdominal wall/ Linea alba > 18 Extremely poor blood perfusion; monofil, longterm absorbable suture material; always apply away from muscle tissue (to avoid possible loosening of the suture) MonoPlus Fascias > 18 Strong, longterm support of wound healing required MonoPlus Synthofil Hernias > 35 Livelong weak spot, longterm suture material with high initial tensile strength or nonabsorbable suture/meshes MonoPlus Premilene Synthofil Tendons/ligaments > 35 Slow healing process; longterm suture material with high initial tensile strength MonoPlus Premilene Steelex Joint capsule > 35 Strong, longterm support of wound healing required MonoPlus Premilene > 35 Adaptive sutures only, in most cases; Bone nonabsorbable always to be reinforced by osteosynthesis MonoPlus Steelex 13

14 Tissuespecific recommendations for users Recommendations on using absorbable and nonabsorbable sutures Absorbable sutures 5 % retention tensile strength Safil Quick polyfil Polyglycolic acid Mg coated Catgut Plain monofil Natural collagen Monosyn monofil Gluconate Safil polyfil Polyglycolic acid Glyconate coated Catgut Chrom monofil Natural collagen Chrome treated MonoPlus monofil Polypdioxanone Shortterm absorbable Midterm absorbable Longterm absorbable Indications Skin Subcutis Mucosa Small intestine Colon Bladder (infected) Ureter/Urethra Uterus Ligature ovary Ligature general Muscle Abdominal wall/linea alba Hernias Fascias Tendons Ligaments Joint capsule Orthopaedics Blood vessels Nerves Dental Eye lid Eye 7DAYS 7DAYS DAYS DAYS 18 DAYS / / 35 DAYS Material of choice very good good suitable unsuitable 14

15 Nonabsorbable sutures Product Premilene monofil Polypropylene Dafilon monofil Polyamide Supramid pseudomonofil Polyamide Synthofil polyfil Polyester coated Dagrofil polyfil Polyester Silkam polyfil Silk Steelex polyfil Stainless steel Indications Skin Subcutis Mucosa Small intestine Colon Bladder (infected) Ureter/Urethra Uterus Ligature ovar Ligature general Muscle Abdominal wall/linea alba Hernias Fascias Tendons Ligaments Joint capsule Orthopaedics Blood vessels Nerves Dental Eye lid Eye Material of choice very good good suitable unsuitable 15

16 Tissuespecific recommendations Thread gauge recommendations for dogs Indications Thread gauges 5/ 4/ 3/ 2/ , ,5 4 5 Skin Subcutis Mucosa Small intestine Colon Bladder Ureter/Urethra Uterus Ligature ovar Ligature general Muscle Abdominal wall/linea alba Hernias Fascias Tendons Ligaments Joint capsule Orthopaedics Blood vessels Nerves Dental Eye lid Recommendations 16

17 Thread gauge recommendations for cats Indications Thread gauges 5/ 4/ 3/ 2/ , ,5 4 5 Skin Subcutis Mucosa Small intestine Colon Bladder Ureter/Urethra Uterus Ligature ovar Ligature general Muscle Abdominal wall/linea alba Hernias Fascias Tendons Ligaments Joint capsule Orthopaedics Blood vessels Nerves Dental Eye lid Recommendations 17

18 Absorbable sutures Safil Quick Quick and smooth Excellent handling Safety during the critical wound healing phase Quickly absorbed by the body Degradation profile equivalent to catgut plain Even 7 days after its implantation, Safil Quick still supports wound healing with 5 % of its initial tensile strength. Complete mass absorption in 42 days. Safil Quick description Structure Chemical composition Polyfilament Braided Coated Polyglycolic acid Magnesium stearate coated Gammairradiated Colour Undyed Knot tensile strength retention 7 days p.i. 5 % 14 days p.i. 15 % 18 days p.i. % Mass absorption Indications Contraindications Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 42 days Mucous membranes Gynaecology Dental Indications that require permanent support by implantation of midterm or nonabsorbable suture material 18

19 Safil Quick Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle roundbodied needle HR 17 7 C4612 C4613 C mm HR 22 7 C4629 C463 C mm 1/2 circle reverse cutting needle HS C mm HS C46229 C mm 3/8 circle reverse cutting needle DS 16 7 C46212 C46213 C mm DS C4622 C mm DS 19 7 C4642 C46421 C mm DS C46535 C mm DS 24 7 C46234 C46235 C46236 C mm 3/8 circle reverse cutting needle with precision tip DSMP C46619 C mm DSMP 19 7 C46529 C4653 C mm DSMP 24 7 C46657 C mm C = box of 36 B = box of 24 G = box of 12 19

20 Absorbable sutures Monosyn the new standard in softtissue surgery Broad spectrum of indications phindependent degradation Excellent knotpull tensile strength Ideal for ligatures Ideal degradation profile and excellent knot security through a combination of soft amorphous and hard crystalline substances. Monosyn description Structure Chemical composition Monofilament Uncoated Colour Violet Knot tensile strength retention 7 days p.i. 7 % 14 days p.i. 5 % 21 days p.i. 2 % Mass absorption Indications Contraindications Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 Glyconate (Glycolid, trimethylene carbonate, εcaprolacton) 6 9 days Skin Mucous membranes Subcutis Gastrointestinal Urology Ligatures Castration Muscle Indications that require permanent support by implantation of longterm or nonabsorbable suture material 2

21 Monosyn Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR 17 7 C223 C224 C mm HR 22 7 C2214 C2215 C mm HR 26 7 C2224 C2225 C2226 C2227 C2228 C mm HR 26s 7 C2284 C2285 C2286 C2287 C2288 C mm HR 37 7 C2245 C2246 C2247 C2248 C mm HR 4s 7 C2266 C2267 C2268 C mm HR 48 9 C2276 C2277 C2278 C mm 1/2 circle round bodied needle with trocar point HRT 17 7 C22323 C22324 C mm HRT 26 7 C2234 C2235 C2236 C mm HRT 37 7 C22316 C22317 C mm HRT 4 9 C22527 C mm HRT 48 9 C mm 21

22 Absorbable sutures Monosyn Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /8 circle round bodied needle with trocar point DRT 18 7 C22343 C mm DRT 22 7 C22354 C mm DRT 26 7 C22365 C mm DRT 32 7 C22377 C mm 1/2 circle reverse cutting needle HS 26 7 C22236 C mm HS 26s 7 C22241 C22242 C mm HS 37s 7 C22247 C22248 C mm 3/8 circle reverse cutting needle DS C mm DS C mm DS 19 7 C2224 C mm DS 24 7 C22215 C22216 C mm DS 3 7 C22231 C22232 C mm 22

23 Monosyn Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, ,5 4 5 Precuts 3 x 45 C25 C26 C27 C28 5 x 7 C225 C226 C227 C C235 C236 C237 C238 C = box of 36 B = box of 24 G = box of 12 23

24 Absorbable sutures Safil Violet gentle, strong, safe and versatile Glyconate coated Excellent knoting ability Easy handling Universal application Smooth passage through tissue Strong in tensile strength Versatile in application. Safil Violet description Structure Polyfilament Braided Coated Chemical composition Polyglycolic acid 1 % Glyconate coated Colour Violet Knot tensile strength retention 14 days p.i. 7 % 18 days p.i. 5 % 3 days p.i. % Mass absorption Indications Contraindications Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = days Subcutis Abdominal wall closure Muscle Gynaecology Gastrointestinal Ophthalmology Indications that require permanent support by implantation of longterm or nonabsorbable suture material 24

25 Safil Violet Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR 17 7 C14812 C14813 C14814 C mm HR 17s 7 C C mm HR 22 7 C14829 C1483 C14831 C mm HR 26s 7 C14889 C1489 C14891 C14892 C mm HR 3 7 C14846 C14847 C14848 C14849 C mm HR 37s 7 C14894 C14895 C14896 C14897 C mm HR 4s 9 C C C C mm HR 43 7 C C C mm HR 48 7 C14899 C1486 C14861 C14862 C mm HR 48 9 C14856 C C C mm HR 6 7 C14866 C mm C = box of 36 B = box of 24 G = box of 12 25

26 Absorbable sutures Safil Violet Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle, loop HR 4s Loop 15 B mm HR 65 Loop 24 B mm 1/2 circle round bodied needle with trocar point HRT 17 7 C C C C C mm HRT 22 7 C C14833 C C mm HRT 26 7 C C C mm HRT 37s 9 C C C C mm HRT 48 9 C14852 C mm 1/2 circle round bodied needle with trocar point, loop HRT 43s Loop 15 B B mm HRT 48 Loop 15 B mm 1/2 circle reverse cutting needle HS C14823 C mm HS C C mm HS 26 7 C C C mm HS 26s 7 C14829 C mm 26

27 Safil Violet Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle HS 37s 9 C C C C mm HS 48 9 C C C mm 3/8 circle reverse cutting needle DS C14827 C mm DS C C C mm DS C C14822 C mm DS 19 7 C C14842 C C mm DS 24 7 C C C C mm DS 3 7 C C C C mm 3/8 circle reverse cutting needle with precision point DSMP 19 7 C C mm DSMP 24 7 C C mm Precuts 3 x 45 C C C C C C x 7 C13844 C13845 C13846 C13847 C13849 C C13824 C13825 C13827 C13828 C13829 C

28 Absorbable sutures MonoPlus if healing takes time Longterm tensile strength for safe wound adaptation No capillarity Atraumatic passage through tissue Excellent handling due to high flexibility High knot safety The flexibility, which is better than the industry standard, was achieved through shortchain bonding of the dioxanone molecules. MonoPlus description Structure Chemical composition Monofilament Uncoated Polypdioxanone Colour Violet Knot tensile strength retention 21 days p.i. 8 % 35 days p.i. 5 % 7 days p.i. % Mass absorption Indications Contraindications days Abdominal wall closure Fascias Orthopaedics Gastrointestinal Hernias Vascular surgery Indications that require permanent support by implantation of nonabsorbable suture material Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 28

29 MonoPlus Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR 17 7 C2413 C2414 C mm HR 22 7 C24133 C24134 C24135 C mm HR 26 7 C2424 C2425 C2426 C mm HR 26s 7 C2485 C2486 C2487 C mm HR 3 7 C2434 C2435 C2436 C2437 C mm HR 37s 7 C2455 C2456 C2457 C mm HR 4s 9 C24467 C24468 C mm HR 48 9 C2477 C2478 C mm 1/2 circle round bodied needle, loop HR 4s Loop 15 C24567 B mm HR 48 Loop 15 C249 B mm HR 65 Loop 15 C mm HR 76 Loop 15 B mm 29

30 Absorbable sutures MonoPlus Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle with trocar point HRT 17 7 C24283 C24284 C24285 C mm HRT 22 7 C24294 C mm HRT 26 7 C2435 C mm HRT 3 7 C mm HRT 37 9 C24517 C mm HRT 4s 9 C24545 C mm HRT 43s 9 C24352 C mm HRT 48 9 C24332 C mm 1/2 circle round bodied needle with trocar point, loop HRT 4s Loop 15 C24342 B mm HRT 43 Loop 15 B mm HRT 48 Loop 15 C24394 B mm HRT 48 Loop 2 B mm 3

31 MonoPlus Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle HS 23ss 7 C mm HS 26s 7 C24185 C24186 C24187 C mm HS 37 9 C2414 C2415 C mm HS 37s 7 C24156 C24157 C mm HS 4s 9 C24121 C mm HS 4 9 C24117 C mm HS 48 9 C24127 C mm C = box of 36 B = box of 24 G = box of 12 31

32 Nonabsorbable sutures Premilene Polypropylene of highest quality and grade Sustained high tensile strength High knot safety Optimal handling Excellent passage through tissue Excellent tissue compatibility The nonabsorbable monofilament for a wide spectrum of indications. Premilene description Structure Monofilament Nonabsorbable Chemical composition Polypropylene Colour Blue Indications Contraindications Skin Intracutaneous Vascular surgery Hernias Tendons/ligaments Nerves Ophthalmology None known Recommended knot technique 2 = 1 = 1 = 1 = 1 1 = 1 = 1 = 1 = 1 32

33 Premilene Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR C912 C913 C mm HR C94 C941 C942 C mm HR 4 1 C91 4 mm 1/2 circle round bodied needle, Loop HR B mm Loop 1/2 circle round bodied needle with trocar point HRT C9312 C mm HRT C9341 C9342 C mm 1/2 circle reverse cutting needle HS C9269 C927 C mm 3/8 circle reverse cutting needle DS C9219 C922 C mm DS C9519 C952 C mm DS C9434 C9435 C mm DS C9234 C9235 C9236 C mm DS 3 75 C9246 C9247 C mm 3/8 circle reverse cutting needle with precision point DSMP C9673 C mm DSMP C968 C9681 C mm C = box of 36 B = box of 24 G = box of 12 33

34 Nonabsorbable sutures Dafilon (Nylon) Skin closure safe, good and inexpensive Good knotpull tensile strength Smooth passage through tissue Good histocompatibility High knot safety Gold standard in ophthalmology (Nylon) The good histocompatibility is of particular advantage for skin closure and in ophthalmology. Dafilon description Structure Monofilament Pseudononabsorbable Chemical composition Polyamide Colour Mass absorption Indications Blue Black (Nylon) 2 4 years Skin (intra, sub, skin) Ophthalmology (see chapter Ophthalmology suture materials ) Contraindications Indications where sustained stability of the suture is essential (> 2 years) Recommended knot technique 2 = 1 = 1 = 1 = 1 1 = 1 = 1 = 1 = 1 34

35 Dafilon Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle HS 26 9 C C mm HS 3 75 C mm HS C mm 3/8 circle reverse cutting needle DS C C C mm DS C C93225 C C mm DS C93519 C93524 C mm DS C C C mm DS C C C93536 C mm DS 3 75 C C C C mm DS C93254 C C C mm 3/8 circle reverse cutting needle with precision point DSMP C C mm DSMP C C mm Straight cutting needle GS 6 75 C C mm C = box of 36 B = box of 24 G = box of 12 35

36 Nonabsorbable sutures Supramid flexible, strong, reliable No capillarity High knot safety Smooth passage through tissue Tissuepreserving Exceptional handling qualities due to combined benefits of monofil and polyfil threads. Supramid description Structure Pseudomonofilament Pseudononabsorbable Chemical composition Colour Mass absorption Indications Polyamide 6.6 thread core Polyamide 6 sheath Black White 2 4 years Skin (intra, sub, skin) Hernias Ligatures Contraindications Indications where sustained stability of the suture is essential (> 2 years) Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 36

37 Supramid Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle, black HS C71235 C71243 C mm HS C C C mm HS C C C mm 1/2 circle reverse cutting needle, white HS 3 75 C mm HS 4s 12 C mm HS C mm 3/8 circle reverse cutting needle, black DS C C71225 C C mm DS C71428 C mm DS C C C C mm DS C C mm DS 3 45 C C C mm DS C71254 C C C mm Precuts, black 5x45 C C C C C21267 C21275 C21291 C21215 C = box of 36 B = box of 24 G = box of 12 37

38 Nonabsorbable sutures Synthofil braided polyester in B. Braun quality High knotpull tensile strength Excellent knot security Good histocompatibility Sustained tensile strength The special coating significantly reduces the risk of tissue damage during suture passage. Synthofil description Structure Chemical composition Colour Polyfilament Braided Coated Polyester Polyethylene/vinyl acetate coated Green Indications Hernias Fascias Abdominal wall Skin Contraindications none known Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 38

39 Synthofil Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle HS C8123 C81248 C mm HS C81225 C mm HS C C81242 C mm HS 37s 75 C81251 C mm 3/8 circle reverse cutting needle DS C C8122 C C mm DS C81529 C mm DS C81234 C C C mm DS 3 75 C C81248 C mm DS C C C C mm Precuts 3x45 C C C C C31627 C C3163 2x75 C31456 C31464 C31472 C31499 C C31253 C31261 C3127 C31296 C3121 C = box of 36 B = box of 24 G = box of 12 39

40 Nonabsorbable sutures Dagrofil the lowprice polyester suture High tensile strength Sustained tensile strength High knot safety Proven quality. Dagrofil description Structure Chemical composition Polyfilament Braided Uncoated Polyester Colour Green Indications Hernias Fascias Abdominal wall Skin Contraindications none known Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 4

41 Dagrofil Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR C84297 C843 C mm HR C84416 C84424 C mm HR 3 75 C84467 C84475 C84483 C mm 1/2 circle reverse cutting needle HS 3 75 C C mm HS C mm 3/8 circle reverse cutting needle DS C C84226 C mm DS C C mm DS 3 75 C C C mm DS C C mm Precuts 3x45 C34625 C C C C x75 C3446 C34479 C34495 C C34268 C34276 C34292 C34216 C = box of 36 B = box of 24 G = box of 12 41

42 Nonabsorbable sutures Silkam gentle and welltried Good knot security Comfortable handling Silk threads will lose tensile strength during their progressive degradation in the body. Silkam description Structure Chemical composition Colour Indications Polyfilament Braided Coated, pseudononabsorbable Silk Wax and silicone coating Black White (see cassette packs) Dental Contraindications Indications where sustained stability of the suture is essential Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 42

43 Silkam Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle round bodied needle HR C76293 C7637 C mm HR C7644 C76412 C7642 C76439 C mm 1/2 circle reverse cutting needle HS C C C mm HS C76247 C C C mm HS 37s 75 C C76297 C mm 3/8 circle reverse cutting needle DS C C76222 C76221 C mm DS C C76521 C76521 C mm DS C76235 C C mm DS C C76261 C76261 C mm DS C C C mm 3/8 circle reverse cutting needle with precision point DSMP C mm DSMP C mm C = box of 36 B = box of 24 G = box of 12 43

44 Nonabsorbable sutures Steelex the universal steel suture Maximum tensile strength Good knot security Excellent histocompatibility The suture for orthopaedic surgery. Steelex description Structure Chemical composition Polyfilament Twisted (monofilament, see cassette packs) Stainless steel Colour Metallic Indications Orthopaedics Tendons Ligaments Abdominal wall closure Sternum sutures Skin Contraindications Allergies against components of stainless steel Recommended knot technique 2 = 1 = 1 = 1 1 = 1 = 1 = 1 44

45 Steelex Length 5/ 4/ 3/ 2/ 1 2 Needles cm 1 1, , /2 circle reverse cutting needle HS G mm 3/8 circle reverse cutting needle DS G mm DS G61234 G mm DS 3 45 G mm C = box of 36 B = box of 24 G = box of 12 45

46 Dental sutures In recent years there has been a continuous development of operating techniques in oral surgery. For operations where nonabsorbable suture materials were used, previously, there are highquality synthetic absorbable B. Braun sutures available now. For efficient and safe oral surgery, B. Braun also offers a range of needles that are perfectly adapted for the respective suture material. Indication Recommended needle Recommended suture 5 % retention tensile strength Surgery on the hard palate and in the oral cavity HS needle DS needle Safil Quick Monosyn polyfil monofil 7 days 14 days DSMP needle Safil Violet polyfil 18 days Synthofil polyfil nonabsorbable Silkam polyfil nonabsorbable Flap operations Periodontal surgery Interdental gaps GR needle HRT needle Monosyn monofil 14 days Safil Violet polyfil 18 days DRT needle MonoPlus monofil 35 days HRC needle Premilene monofil nonabsorbable PRCm needle Silkam polyfil nonabsorbable Oral microsurgery DSMP needle Safil Quick polyfil 7 days DRC needle DLm needle Safil Violet polyfil 18 days MonoPlus monofil 35 days Premilene monofil nonabsorbable 46

47 Absorbable sutures Safil Quick Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 3/8 circle reverse cutting needle, undyed DS 12 7 C4622 C mm 3/8 circle reverse cutting needle with precision point, undyed DSMP C mm 3/8 circle microlancet needle, green 2xDLm 6s 3 G mm DLm 6s 3 G4762 G mm 2xDLm 6s 45 G mm C = box of 36 G = box of 12 47

48 Dental sutures Absorbable sutures Monosyn Länge 9/ 8/ 7/ 6/ 5/ 4/ 3/ Nadeln cm,3,4,5,7 1 1,5 2 1/2 circle round bodied needle with trocar point, violet HRT 17 7 C22322 C22323 C22324 C mm HRT 26 7 C2234 C mm 3/8 circle reverse cutting needle, undyed DS 12 7 C23412 C23413 C mm 3/8 circle reverse cutting needle with precision point, undyed DSMP C23642 C mm DSMP C2362 C2363 C mm 48

49 Absorbable sutures Safil Violet Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 1/2 circle round bodied needle with trocar point, violet HRT 17 7 C C C mm HRT 22 7 C C mm 1/2 circle reverse cutting needle, violet HS C14823 C mm HS C C mm 3/8 circle reverse cutting needle, violet DS C14826 C14827 C mm DS C C C mm DS C C14822 C mm C = box of 36 G = box of 12 49

50 Dental sutures Absorbable sutures Safil Violet Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 3/8 circle microlancet needle, violet DLm 6 8 G148611* 6 mm DLm 6 15 G mm DLm 6s 3 G mm 2xDLm 6 3 G mm 2xDLm 6s 3 G mm 2xDLm 6s 45 G mm * monofil 5

51 Absorbable sutures MonoPlus Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 Straight round bodied needle, violet 2xGR C24984 C mm 1/2 circle round bodied needle with trocar point, violet HRT 17 7 C24283 C24284 C mm HRT 22 7 C24294 C mm 3/8 circle round bodied needle with short cutting tip, violet 2xDRC 1 7 C24721 C mm DRC 12 7 C24232 C mm C = box of 36 G = box of 12 51

52 Dental sutures Nonabsorbable sutures Premilene Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 1/2 circle round bodied needle with trocar point, blue HRT C9312 C mm HRT C9325 C mm 3/8 circle round bodied needle with trocar point, blue DRT C936 C mm DRT C9319 C932 C mm 1/2 circle round bodied needle with short cutting tip, blue 2xHRC 17 9 C957 C mm 2xHRC 22 9 C958 C mm 3/8 circle round bodied needle with short cutting tip, blue 2xDRC 1 75 C9545 C mm DRC C955 C mm 52

53 Nonabsorbable sutures Premilene Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 3/8 circle reverse cutting needle with precision point DSMP C966 C967 C mm DSMP C9617 C9618 C9619 C mm DSMP C9629 C mm Progressive curved round bodied micro needle with short cutting tip, blue 2xPRCm 6 6 G mm 2xPRCm 1 75 G9669 G mm 3/8 circle microlancet needle, blue DLm 6s 15 G mm 2xDLm 6s 3 G mm C = box of 36 G = box of 12 53

54 Dental sutures Nonabsorbable sutures Synthofil Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 1/2 circle reverse cutting needle, green HS C8123 C81248 C mm HS C81225 C mm 3/8 circle reverse cutting needle, green DS C C mm DS C C8122 C mm 3/8 circle reverse cutting needle with precision point, white 2xDSMP C mm 54

55 Nonabsorbable sutures Silkam black Length 9/ 8/ 7/ 6/ 5/ 4/ 3/ Needles cm,3,4,5,7 1 1,5 2 Straight round bodied needle, black GR C mm 1/2 circle round bodied needle with trocar point, black HRT C mm 1/2 circle reverse cutting needle, black HS C76232 C7624 C mm HS C C C mm HS C mm 3/8 circle reverse cutting needle, black DS C76566 C76275 C76283 C mm DS C C C76213 C mm 3/8 circle reverse cutting needle with precision point, black DSMP C7667 C mm DSMP C C C mm C = box of 36 G = box of 12 55

56 Ophthalmic sutures Eye operation put particularly high demands on the quality of the suture material and the geometry of the needle. To meet these requirements, B. Braun is producing a further development of the spatula needle the lancet needle especially for application in eye surgery. Indication Recommended needle Recommended suture 5 % retention tensile strength Eyelid operations and operations close to the eye DRT needle DS needle Safil Violet Monosyn polyfil USP 4/8/ monofil 18 days 14 days DSMP needle Safil Quick polyfil 7 days Premilene monofil nonabsorbable Dafilon monofil USP 4/6/ nonabsorbable Operations on the eye Lancet needles (Spatula needles): HLm needle DLm needle VLm needle PLm needle Safil Violet monofil USP 1/9/ 18 days Safil Quick polyfil 7 days Premilene monofil nonabsorbable Dafilon (Nylon) monofil USP 1/8/ nonabsorbable 56

57 Absorbable sutures (to avoid the risk of repeated anaesthesia) Safil Quick Monosyn for use on the conjunctiva, without application of tensile forces for use on the eyelid Safil Violet for use on the conjunctiva, with application of tensile force for suturing the inner layers in cases of lid injury for conjunctivoplasty, non perforating suture technique (in combination with lancetneedle) Nonabsorbable sutures Premilene Dafilon (Nylon) excellent biocompatibility for the eye Eyelid sutures following tumor operations, entropium, ectropium, canthoplasty closure of corneal incisions in cases of phaco and cornea injuries Tissue adhesive VetSeal Corneal erosion 57

58 Ophthalmic sutures Absorbable sutures Safil Quick Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle microlancet needle, undyed 2xDLm 6s 3 G mm DLm 6s 3 G4762 G mm 2xDLm 6s 45 G mm 1/4 circle lancet needle with micro point, green VLM 1 45 G mm 3/8 circle round bodied needle with trocar point, undyed DRT 12 7 C mm 3/8 circle reverse cutting needle, green DS 12 7 C4622 C mm 58

59 Monosyn Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 1/2 circle round bodied needle with trocar point, violet HRT 17 7 C22322 C22323 C mm 3/8 circle reverse cutting needle, undyed DS 12 7 C23412 C23413 C mm 3/8 circle reverse cutting needle with precision point, undyed DSMP C23642 C mm DSMP C2362 C2363 C mm C = box of 36 G = box of 12 59

60 Ophthalmic sutures Absorbable sutures Safil Violet Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle microlancet needle, violet DLm 6 8 G14861* G148611* 6 mm DLm 6 15 G mm DLm 6s 3 G mm 2xDLm 6 3 G mm 2xDLm 6s 3 G mm 2xDLm 6s 45 G mm 1/2 circle microlancet needle, violet 2xHLm 6 3 G mm 2xHLm 8 45 G mm 1/4 circle lancet needle with micro point, violet 2xVLM 8 45 G G mm * monofil 6

61 Absorbable sutures Safil Violet Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 1/2 circle round bodied needle with trocar point, violet HRT 17 7 C C mm HRT 22 7 C mm 3/8 circle reverse cutting needle, violet DS 9 45 C mm DS C14826 C14827 C mm C = box of 36 G = box of 12 61

62 Ophthalmic sutures Nonabsorbable sutures Premilene Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle microlancet needle, blue DLm 6s 15 G mm 2xDLm 6 3 G mm 2xDLm 6s 3 G9596 G mm 62

63 Nonabsorbable sutures Premilene Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle round bodied needle with trocar point, blue 2xDRT C mm DRT C936 C mm 3/8 circle reverse cutting needle, blue DS C926 C927 C mm DS C9211 C9212 C mm 3/8 circle reverse cutting needle with precision point, blue DSMP C966 C967 C mm DSMP C9617 C9618 C9619 C mm C = box of 36 G = box of 12 63

64 Ophthalmic sutures Nonabsorbable sutures Dafilon (Nylon) Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle microlancet needle, black DLm 6 15 G G mm DLm 6s 15 G G G mm 2xDLm 6 3 G G mm 2xDLm 6s 3 G G mm DLm 6s 45 G mm 1/2 circle microlancet needle, black HLm 6 15 G G mm 2xHLm 6 3 G G mm Progressive curved microlancet needle, black 2xPLm 5 2 G mm 64

65 Nonabsorbable sutures Dafilon Length 1/ 9/ 8/ 7/ 6/ 5/ 4/ Needles cm,2,3,4,5,7 1 1,5 3/8 circle reverse cutting needle, blue DS C9326 C93278 C mm DS C C C mm 3/8 circle reverse cutting needle with precision point, blue DSMP C93622 C mm DSMP C93681 C9369 C mm C = box of 36 G = box of 12 65

66 Suture for Equine surgery Absorbable suture Safil EquineSet Safil CaesareanSet Superb knot holding capability Excellent handling Excellent histocompatibility The suture material of choice for equine surgery. Safil E and C description Structure Polyfilament Braided Coated Chemical composition Polyglycolic acid 1 % Magnesium stearate coated Colour Green USP 2 USP 6 Knot tensile strength retention 14 days p.i. 7 % 18 days p.i. 5 % 3 days p.i. % Mass absorption Indication 6 9 days Abdominal wall closure Fascias Muscle Subcutaneous suture Caesarean section Contraindications Indications that require permanent support by implantation of longterm or nonabsorbable suture material Recommended knot technique 2=1=1=1 1=1=1=1 66

67 Safil ESet Green Length Needles cm 3, /2 circle round bodied needle HR B488 B mm 1/2 circle round bodied needle with trocar point HRT B mm 1/2 circle reverse cutting needle HS B mm Safil CSet Green Length Needles cm 3, PreCuts 15 B38711 B38712 B38713 Ligature reel 25 G38724 G38721 G G38723 Reel 5 G3823 G38231 G38232 G38233 B = box of 24 G = box of 12 67

68 Cassette packs Absorbable sutures Small animals Safil Cassette Violet Gentle, strong, safe and versatile Glyconate coated Excellent knot holding capability Excellent histocompatibility Universal application Once opened, the content of the cassettes should be used within 6 months! Safil C Violet description Structure Polyfilament Braided Coated Chemical composition Polyglycolic acid 1 % Gluconate coated Colour Violet USP 4/ USP 1 Knot tensile strength retention 14 days p.i. 7 % 18 days p.i. 5 % 3 days p.i. % Mass absorption Indication 6 9 days Subcutis Abdominal wall closure Muscle Gynaecology Gastrointestinal Contraindications Indications that require permanent support by implantation of longterm or nonabsorbable suture material Recommended knot technique 2=1=1=1 1=1=1=1 68

69 Safil C Violet Cassette packs Length 5/ 4/ 3/ 2/ 1 2 m 1 1, , F13812 F13813 F13814 F13815 F13816 F = Cassette packs 69

70 Cassette packs Absorbable sutures Large animals Safil Cassette Green equivalent absorption time to catgut chrom High grade PGA Universal application Excellent histocompatibility Superb knot pull tensile strength Once opened, the content of the cassette should be used within 6 months! Safil C Green description Structure Polyfilament Braided Coated Chemical composition Polyglycolic acid 1 % Magnesium stearate coated Colour Green USP 2 USP 6 Knot tensile strength retention 14 days p.i. 7 % 18 days p.i. 5 % 3 days p.i. % Mass absorption Indication 6 9 days Caesarean section Abdominal wall closure Fascias Muscle Subcutaneous suture Contraindications Indications that require permanent support by implantation of longterm or nonabsorbable suture material Recommended knot technique 2=1=1=1 1=1=1=1 7

71 Safil C Green Length Needles cm 3, Cassette packs 15 F F3818 F3819 F3811 F = Cassette packs 71

72 Cassette packs Absorbable Sutures Catgut Plain Safe Economical B. Braun quality Dispensed Natural absorbable in any required suture length. made of pure collagen, manufactured from bovine intestine, from designated BSE free countries! Catgut Plain description Structure Monofilament Twisted Chemical composition Natural purified collagen Colour Natural beige Knot tensile strength retention 7 1 days p.i. 5 % Mass absorption Indications 7 9 days Skin Ligature ovary Uterus Contraindications Indications that require permanent support by implantation of midterm or nonabsorbable suture material Recommended fixation 2=1=1=1 1=1=1=1 72

73 Catgut Plain Length 4/ 3/ 2/ m 2 3 3, Cassette packs 1 F11443 F F F F F F F F F F = Cassette packs 73

74 Cassette packs Absorbable Sutures Catgut Chrom Safe Economical B. Braun quality Dispensed Natural absorbable in any required suture length. made of pure collagen, manufactured from bovine intestine, from designated BSE free countries! Catgut Chrom description Structure Chemical composition Colour Monofilament Twisted Treated Natural purified collagen Chrome treated Brown Knot tensile strength retention days p.i. 5 % Mass absorption Indications 9 12 days Subcutis Ligature overy Uterus Contraindications Indications that require permanent support by implantation of longterm or nonabsorbable suture material Recommended knot technique 2=1=1=1 1=1=1=1 74

75 Catgut Chrom Length 4/ 3/ 2/ m 2 3 3, Cassette packs 1 F F F F11546 F F F F F F F = Cassette packs 75

76 Cassette packs Nonabsorbable sutures Safe Comfortable Economical B. Braun quality Dispensed in any required length. Dafilon, blue Length 4/ 3/ 2/ m 1, , F19344 F F F F F19349 Supramid, black Supramid, white Length 4/ 3/ 2/ m 1, , F F F F F F F F F11844 F F F F F F

77 Dagrofil, green Length 4/ 3/ 2/ m 1, , F F F12446 F F F F Silkam, white Silkam, black Length 4/ 3/ 2/ m 1, , F F F F F11248 F F F F F F F F11346 F F F F F F Steelex (monofilament), metallic Length 4/ 3/ 2/ m 1, , F F F F F16147 F F F = Cassette packs 77

78 Meshes Absorbable Safil Mesh Safil Mesh bag for temporary wound and organ support Ideal degradation profile High burst strength Very elastic and pliable No risk of late secondary infections Complete degradation by hydrolysis within 69 days. Safil Mesh and Safil Mesh bag description Structure Polyfilament Mesh Absorbable Uncoated Chemical composition Polyglycolic acid 1 % Colour Undyed Weight Safil Mesh: 56 g/m 2 Safil Mesh bag: 43 g/m 2 Pore size Safil Mesh:,75 mm Safil Mesh bag: 1,4 mm Knot tensile strength retention 14 days p. i. 7 % 18 days p. i. 5 % 3 days p. i. % Mass absorption Indication 69 days Safil Mesh: Temporary wound support abdominal wall chest wall 78

79 Safil Mesh and Safil Mesh bag description Indication Contraindications Recommended knot technique Safil Mesh bag: Organ stabilisation and haemostasis corpression in cases of trauma or operations Kidney Spleen Indications that require permanent support by implantation of nonabsorbable suture material 5 mm from the edge of the mesh with absorbable suture Safil Mesh Size Content/Box Article no. 18 x 28 cm 1 piece x 25 cm 1 piece x 12 cm 3 pieces x 6 cm 3 pieces x 8 cm 3 pieces Safil Mesh bag Spleen 26 x 3 cm 1 piece Kidney 8 x 15 cm 1 piece

80 Meshes Nonabsorbable Premilene Mesh the classic polypropylene mesh Nonabsorbable Permanent formstability Elastic Biocompatible Transparent For durable and tensionfree hernia therapy. Premilene Mesh description Structure Chemical composition Colour Monofilament Mesh Nonabsorbable Polypropylene Undyed Weight 82 g/m 2 Thickness Pore size Indications,48 mm,8 mm Hernia repair Reconstructive surgery Contraindications Recommended fixation in infected regions 6,5 to 12,5 mm from the edge of the mesh with nonabsorbable suture 8

81 Premilene Mesh Size Content/Box Article no. 2,5 x 1 cm 1 pieces x 1 cm 1 pieces ,5 x 15 cm 1 pieces x 15 cm 1 pieces x 3 cm 1 pieces x 36 cm 5 pieces ,5 x 7,5 cm 1 pieces x 15 cm 1 pieces x 3 cm 5 pieces

82 Meshes Nonabsorbable Optilene Mesh Elastic the elastic lightweight mesh Nonabsorbable New honeycomb like structure Allround elasticity Highly flexible Transparent Adapts to the natural anatomy. Optilene Mesh Elastic description Structure Chemical composition Colour Monofilament Mesh Nonabsorbable Polypropylene Undyed Weight 48 g/m 2 Thickness Pore size Indications Contraindications Recommended fixation,55 mm 3,6 x 2,8 mm Hernia repair Reconstructive surgery Incisional hernia in infected regions 6,5 to 12,5 mm from the edge of the mesh with nonabsorbable suture 82

83 Optilene Mesh Elastic Size Content/Box Article no. 3 x 3 cm 5 pieces x 15 cm 5 pieces x 15 cm 5 pieces ,5 x 15 cm 5 pieces

84 Tissue Adhesive VetSeal suturefree wound closure Effective protection against bacteria infection Wound healing without complications High mechanical strength Excellent cosmetic results Economical Easy, fast and safe wound closure. VetSeal description Structure Chemical composition Colour Indications Tissue adhesive Dyed Selfdissolving Nbutyl2cyanoacrylat Green Skin Mucosa in oral surgery Surgical incision Corneal erosion Contraindications Note Intracorporal application Infected and deep puncture wounds. VetSeal can be removed from surgical instruments with acetone. 84

85 VetSeal, green Content/Box Article no. 5 ampules of 3 ml Applications 1 1 Remove cap and cut off tip bevel to give drop size needed. 2 2 Wound preparation Wound must be dry and clean Position wound edges correctly Wounds under tension and wounds longer than 2 cm require additional suture support. 3 3 Application of VetSeal Apply sparingly until a thin layer becomes visible Do not apply VetSeal into the wound! 4 4 Polymerization process Hold wound edges in place for approximate 46 seconds 85

86 Surgical needles 3/8 circle needles Length Round bodied needles Cutting needles Needles Figure mm Needle code Article no. Needle code Article no. 3/8 circle needles, heavy needles 12 DR 12 BL 58 N DS 12 BL 98 N DR 94 BL 59 N DS 94 BL 99 N 85 DR 85 BL 6 N DS 85 BL 1 N 1 8 DR 8 BL 61 N DS 8 BL 11 N 2 73 DR 73 BL 62 N DS 73 BL 12 N 3 68 DR 68 BL 63 N DS 68 BL 13 N 4 63 DR 63 BL 64 N DS 63 BL 14 N 5 58 DR 58 BL 65 N DS 58 BL 15 N 6 54 DR 54 BL 66 N DS 54 BL 16 N 7 5 DR 5 BL 67 N DS 5 BL 17 N 8 46 DR 46 BL 68 N DS 46 BL 18 N 9 42 DR 42 BL 69 N DS 42 BL 19 N 1 38 DR 38 BL 7 N DS 38 BL 11 N DR 34 BL 71 N DS 34 BL 111 N 12 3 DR 3 BL 72 N DS 3 BL 112 N DR 27 BL 73 N DS 27 BL 113 N DR 23 BL 74 N DS 23 BL 114 N 15 2 DR 2 BL 75 N DS 2 BL 115 N DR 18 BL 76 N DS 18 BL 116 N 86

87 3/8 circle needles Length Needles Figure mm Needle code Article no. 3/8 circle reverse cutting needles, fine needles 1 3 DS 3 BL 61 N DS 24 BL 62 N 3 2 DS 2 BL 63 N 4 15 DS 15 BL 64 N 5 12 DS 12 BL 65 N BL = box of 12 87

88 Surgical needles 1/2 circle needles Length Round bodied needles Cutting needles Needles Figure mm Needle code Article no. Needle code Article no. 1/2 circle needles, heavy needles 1 8 HR 8 BL 161 N HS 8 BL 21 N HR 73 BL 162 N HS 73 BL 22 N 3 68 HR 68 BL 163 N HS 68 BL 23 N 4 63 HR 63 BL 164 N HS 63 BL 24 H 5 58 HR 58 BL 165 N HS 58 BL 25 N 6 54 HR 54 BL 166 N HS 54 BL 26 N 7 5 HR 5 BL 167 N HS 5 BL 27 N 8 46 HR 46 BL 168 N HS 46 BL 28 N 9 42 HR 42 BL 169 N HS 42 BL 29 N 1 38 HR 38 BL 17 N HS 38 BL 21 N HR 34 BL 171 N HS 34 BL 211 N 12 3 HR 3 BL 172 N HS 3 BL 212 N HR 27 BL 173 N HS 27 BL 213 N HR 23 BL 174 N HS 23 BL 214 N 15 2 HR 2 BL 175 N HS 2 BL 215 N HR 18 BL 176 N HS 18 BL 216 N 88

89 1/2 circle needles Length Needles Figure mm Needle code Article no. 1/2 circle round bodied needles /2 circle round bodied needles, fine needles /2 circle cutting needles, fine needles HR 72 BL 318 N 63 HR 63 BL 319 N 54 HR 54 BL 32 N 1 45 HR 45 BL 321 N 2 36 HR 36 BL 322 N 3 29 HR 29 BL 323 N 4 23 HR 23 BL 324 N 5 2 HR 2 BL 325 N 68 HR 68 BL 539 N 6 HR 6 BL 54 N 1 52 HR 52 BL 541 N 2 42 HR 42 BL 542 N 3 36 HR 36 BL 543 N 4 3 HR 3 BL 544 N 5 24 HR 24 BL 545 N 6 22 HR 22 BL 546 N 7 2 HR 2 BL 547 N 8 18 HR 18 BL 548 N 1 3 HS 3 BL 611 N 2 24 HS 24 BL 612 N 3 19 HS 19 BL 613 N 4 15 HS 15 BL 614 N 5 12 HS 12 BL 615 N BL = box of 12 89

90 Practical accessories Suture rack the efficient and clearly arranged storage device for suture boxes. Each suture depot tier holds 4 boxes. Product Ordering no. Suture depot tier Holder for suture rack for holding up to 1 suture racks in a clear arrangement (to be used as a wallmounted or standup holder). Product Ordering no. Wall mounting Cassette packs holder for the practical storage of cassette packs. Product Ordering no. Box for 6 packs F Box for 3 packs F