Needle holders.

Abstract

In previous centuries, surgical needles were hand held. Suturing was inevitably crude and hand-threaded needles were used to close wounds using silk, linen or, later, catgut stitches. Hand-held needles were curved or straight, as discussed in the next article. In Victorian times and into the mid-20th century, many surgeons performed wound closure, suture transfixion, tissue repair, and anastomoses with skills, employing hand-held needles. A few earlier needle holders were designed to grip straight or J-shaped needles end on, so as to push the needle points into tissues by a forward movement. However, with finer work in the evolving craft, requiring more accurate placement of sutures, instruments grasping a needle at right angles to the shafts of the holders became the preferred way of controlling smaller curved needles. Straight needles remain mainly hand-wielded and are pushed or dragged through the tissues. The correct positioning of the modern curved needle in the jaws of the holder should ideally be at two-thirds of the distance from the point of the needle. This is to allow adequate penetration by the needle and to prevent its buckling if placed too close to the non-working end. Care is always needed when mounting or dismounting the needle to avoid stick injuries.