What is the basis for needle-holder selection for suturing?

Updated: Mar 05, 2020
  • Author: Desiree Ratner, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

No standardized sizing system or nomenclature is available for needle holders. Needle control and performance is affected by the stability of the needle within the needle holder; thus, for a secure needle hold and prevention of rocking, turning, and twisting, the jaws of the needle holder must be appropriate to the needle size. Often, the surface contact with the needle-holder jaws and the bending moment of the needle are maximized with an ovoid cross-section of the needle body.

In addition, the handle of the needle holder must be appropriate for the depth needed for the suture placement. A mechanical advantage for exerting force through the needle point is created by the difference between the length of the handle and the jaw.

The needle-holder clamping moment is a measure of the force applied to a suture needle by the needle holder, and the needle-yield moment is the amount of deformation that can occur before a needle is permanently deformed. Thus, when the needle-holder clamping moment is greater than the needle-yield moment, the needle is likely to be permanently deformed, which may lead to complications.


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