The Surgical Needle

A variety of modern surgical needles are available to today's surgeon. However, a surgeon's preference of surgical needles, is usually influenced by experience, ease of use, and the postoperative result, such as scar quality. This article describes the selection of needle designs available, and their intended clinical applications. Key factors in the basic design of the surgical needle include, the quality of its alloy, surface coating, and needle geometry. The needle alloy provides strength and ductility. Silicon coating maintains the sharpness and consistency of penetration of the needle. Sharpness is also determined by the angle of the point and taper ratio of the needle. Needle sizes range from extremely fine microsurgical needles to very thick needles for sternal closure. Needlepoint type is selected based on the particular tissue type where they are used. A conventional cutting needle is used for tough tissue, such as skin, whereas a reverse cutting needle is selected to reduce the risk of tissue cutout. Round-body needles are used in tissues that are easy to penetrate and in crucial procedures such as tendon repair, where suture cutout would be disastrous. A blunt-point, round-body needle dilates rather than cuts, and is preferred in abdominal fascial closure, to prevent inadvertent visceral injury and bleeding. The taper-cut needle punctures and then dilates and is used for vascular anastomosis. Although the needle and suture choice are entirely the surgeon's, this article hopefully may serve as a reference for those who are deciding on these issues critically.