Selection and use of surgical needles ALLOY* INTELLIGENT GEOMETRY ADVANCED NEEDLE COATING 5
A Unique Needle Range ETHIGUARD Blunt Point Needles Taper Point Needles VISI-BLACK Needles CC Needles CC Taper Point Improving safety Gentle separation of fibrous tissue Consistency pass after pass Visibility is their strength Easy penetration of calcified coronary tissues HEMO-SEAL Needle Sutures MULTICURVE Needles TAPERCUT Needles PRIME Needles CALCIFIED CORONARY CALCIFIED CORONARY A fitting choice for vascular surgery For confined access procedures Easy penetration of dense tough tissue Excellence in skin closure 6
Superior Resistance To Bending 1 5 4 ETHALLOY Needles Moment (n=cm) 3 Conventional Alloy Needles +40% Needle Point Taper Ratio Needles can taper to a point or have cutting edges. Needle Body Ribs In larger needles there is a ribbed section to provide a secure grip. Square Body Needles can also have a square body for increased strength. Swage A hole is drilled into the end of the wire and the needles the needles are laser drilled which 7
Needle Shape The choice of needle shape is frequently governed by the accessibility of the tissue to required. The basic shapes involved are: 1/4 Circle 3/8 Circle 1/2 Circle 5/8 Circle J Shape Compound Curve Straight 8
Round Bodied needles is possible. After the passage of the needle, the tissue closes tightly round the suture ereas for muscle or fascia heavier wire TAPERPOINT Needle the needle holder in this area confers extra stability on sutures. Taper Point needles are available in a range of wire tissue in gastrointestinal or vascular procedures whereas TAPERPOINT Plus than a conventional round shape. the conventional round bodied cross section. This design tissue layers. visibility against tissue and where blood is present in the 9
ETHIGUARD Blunt Point Needle the ETHIGUARD Needle can also be used for suturing friable tissue such as the liver. Blunt Point Needle friable tissue such as the liver. CC Needle The unique point design of the CC Needle provides this needle is particularly secure in the needle holder. TAPERCUT Needle 10
Reverse Cutting Needle The body of this needle is triangular in cross section, havingthe apex cutting edge on the outside of the needle particularlyincreases its resistance to bending. TROCAR POINT Needle Based on the traditional TROCAR POINT, this needle has a body.the design of the cutting head ensures powerful penetration,even when deep in dense tissue. 11
Cutting Needles PRIME and PRIME MULTIPASS needles with an exclusive needle tip design. The cross sectional control. A square body on the needle greatly increases needle holder. PRIME needles are available with either a reverse advanced MULTIPASS needle coating technology. 250 200 150 100 50 PENETRATION 800 700 500 400 300 SUPERIOR RESISTANCE TO BENDING 0 1. pass 10. pass 20. pass Average 200 Cutting Needles Conventional Cutting Needle This needle has a triangular cross section with the apex of the triangle on the inside of the needle curvature. The effective cutting edges are restricted to the front body which continues for half the length of the needle. Reverse Cutting Needle The body of this needle is triangular in cross section, having the apex cutting edge on the outside of the needle and particularly increases its resistance to bending. 12
Spatula Needle considerably less force to penetrate corneal scleral tissue of the of the cornea and the real possibility of reduced Spatula Needle produce superb penetration characteristics. In addition, the square body greatly increases resistance to bending the needle at the correct angle for secure accurate suture Spatula Needle needle to penetrate between the layers of scleral or corneal tissue. 13
SPATULATED Needle needles, this is designed for scleral suturing which of cut out or cut down by a third edge is essential. Reverse Cutting Needle The third cutting edge of this needle lies on the CONTROL RELEASE Needle Sutures 1. The needle is held securely in the needle holder. Suture is grasped needle, pulling strand taut. 2. The needle is released with a straight tug of the needleholder. 14
Use of Needle Holders needle and in particular, distortion of the curvature. Excessive force should not be applied when gripping the needle, particularly with Tungsten Use of Surgical Needles 1 The force required to achieve passage of the needle through tissue should be applied in a direction following the curvature of the needle. 15
Needle New Graphic Taper Point (Round Bodied) Taper Point Plus (modified point) ETHIGUARD Blunt Point Needle Blunt Point TAPERCUT Needle CC Needle TROCAR Point Conventional Cutting Reverse Cutting PRIME Needle Conventional Cutting PRIME Needle Reverse Cutting CS ULTIMA Spatula Needle Spatula 16
Plus Antibacterial Sutures ETHICON developed VICRYL* Plus, MONOCRYL* Plus and PDS* Plus Surgical Site Infections (SSIs). ETHICON Plus Sutures contain IRGACARE* MP (triclosan), an antibacterial technology that helps inhibit bacterial 1. 2. response as traditional sutures 3. 4. The 4. VICRYL* Plus, MONOCRYL* Plus and PDS* Plus Sutures with 5 : Staphylococcus aureus Staphylococcus aureus (MRSA) (MRSE) MONOCRYL* Plus and PDS* Plus Sutures Sutures are also effective against: References: S98. 17
ABSORBABLE SUTURES PHYSICAL COLOR REMAINING TENSILE STRENGTH ABSORPTION KNOT CHARACTERISTICS (% of the original strength) RATE TYING 1 w. 2 w. 3 w. 4 w. 6 w. VICRYL Rapide Multifilament, Violet 50% 0% Polyglactin 910 coated Undyed (5 days) (10-14 days) 42 days 1=1=1=1 ABSORBABLE SUTURES MONOCRYL Polyglecaprone 25 Monofilament Violet 60% 30% 90-120 days MONOCRYL Plus Antibacterial Undyed 50% 20% 1=1=1=1** Polyglecaprone 25 VICRYL (6-0 and larger*) Polyglactin 910 Multifilament, Violet / 2=1=1 / VICRYL Plus Antibacterial coated Undyed 75 % 50 % 25 % 56-70 days 1=1=1=1 Polyglactin 910 PDS II (3-0 and larger*) Monofilament Violet / Polydioxanone Undyed 80 % 70 % 60 % 182-238 days 1=1=1=1** PDS* Plus Antibacterial NON-ABSORBABLE PHYSICAL COLOR KNOT SUTURES CHARACTERISTICS TYING PROLENE 1=1=1=1/ Polypropylene Monofilament Blue / Undyed 2=1=1** PRONOVA 1=1=1=1/ Poly(hexafluoropropylene-VDF) Monofilament Blue 2=1=1** NON-ABSORBABLE SUTURES ETHIBOND Multifilament, 2=1=1 / Polyester coated Green / White 1=1=1=1* MERSILENE Polyester Multifilament Green / White 2=1=1 ETHILON 1=1=1=1/ Polyamide Monofilament Black / Blue 2=1=1** NUROLON Multifilament, Black Polyamide coated 2=1=1 SILK Multifilament Black/White/Blue 1=1=1=1 STEEL Monofilament / Multifilament Undyed 1=1=1=1 * = Check the catalog for information on thinner sizes ** = Additional throws may be particularly appropriate when knotting any monofilament material 18