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SHORT TECHNIQUE
Year : 2018  |  Volume : 28  |  Issue : 2  |  Page : 38-40

Emergency intraoperative construction of a suture needle from a hypodermic/injection needle


1 Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
2 Department of Anaesthesia, Government Medical College, Miraj, Maharashtra, India

Date of Submission06-May-2014
Date of Decision07-Apr-2020
Date of Acceptance08-May-2020
Date of Web Publication1-Aug-2020

Correspondence Address:
Dr. S Dhanke Prashant
C/o S. P. Dhanke, B-201, Vrindavan Palms Society, Behind Arti Nagari, near Gandhare, wayale nagar, khadakpada, Kalyan (West), Pin code 421301. District- Thane, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njss.njss_27_14

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  Abstract 


This article provides surgeons with a simplistic method to convert an injection needle into a suture needle in the operating theater itself. In the following procedure, we take an injection needle and a suture material (polypropylene number 1) and create a curved suturing needle ready to be used with minimal fuss and with the help of simple instruments. This method will definitely save time and the cost of an extra suture.

Keywords: Emergency construction, injection needle, polypropylene, steps


How to cite this article:
Prashant S D, Subodh P U, Prakash R D, Hamza T Q. Emergency intraoperative construction of a suture needle from a hypodermic/injection needle. Niger J Surg Sci 2018;28:38-40

How to cite this URL:
Prashant S D, Subodh P U, Prakash R D, Hamza T Q. Emergency intraoperative construction of a suture needle from a hypodermic/injection needle. Niger J Surg Sci [serial online] 2018 [cited 2020 Oct 31];28:38-40. Available from: https://www.njssjournal.org/text.asp?2018/28/2/38/291233




  Introduction Top


Currently, needles are mostly manufactured using surgical stainless steel (AISI 420)[1],[2] and silk is used for the thread.[3],[4] Steel is the perfect material for this function due to its toughness, biocompatibility, and corrosion resistance and because it is easy to machine.[3] Tissue inflammation upon contact with the thread and intrinsic trauma caused by needle insertion, are the main suture–tissue interactions.[5],[6],[7]

A worn needle can hinder the intervention as it does not penetrate the tissue easily, can tear the tissue, make it difficult to correctly position sutures, and make the intervention longer.[3],[8],[9]

Often, we may come across a scenario that a suture needle breaks during surgery, and we are left with a suture without a suturing needle. If we wish to continue using the same thread, then the only available option is to insert its end through the eye of a cutting/round needle. At the end of it, we got to fixate that by tying a knot as close as possible toward the needle. This adds another resistance toward smooth suturing.

The purpose of this article is to demonstrate the use of a hypodermic/injection needle as an emergency suture needle after sheer modifications in the operating theater itself.

Hence, this article provides us with a simplistic technique to overcome the above-stated problem.


  Materials and Methodology Top


Materials

  1. Standard hypodermic/injection needle (18G)
  2. Suture material (Polypropylene number 1 in the example)
  3. Needle holder
  4. Artery forceps.


Procedure

Step 1

  1. Take a standard sterile hypodermic/injection needle 18 G [Figure 1]
  2. Break the needle hub manually with the help of the needle holder and artery forceps.
Figure 1: Step 1: (a) Injection needle (18G). (b) Breaking the needle hub

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Step 2

Insert the suture (polypropylene number 1) through the needle such that sufficient portion of the needle contains the suture material [Figure 2].
Figure 2: Step 2: Inserting suture into the needle

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Step 3

  1. With the help of the needle holder, tightly compress the proximal part of the needle (previously hub) such that the suture is tightly fixed to it [Figure 3]
  2. Ascertain the fixity [Figure 4].
Figure 3: Step 3: Fixing suture into the needle

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Figure 4: Step 4: (a) Bending the needle (b) needle ready to use

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Step 4

  1. With the help of the artery forceps and needle holder, bend the needle carefully to get the approximate semicircular shape
  2. The needle is ready to use.



  Discussion Top


One of the important drawbacks of this technique is the unnecessary biopsy which happens during suturing. It can be avoided by occlusion of the needle by thread/suture material itself, though not completely.

As these needles are not primarily manufactured for suturing, wear and tear occurs early and may cause tissue damage if the use is prolonged.

Strauss[10] suggests that reuse of insulin needles causes micro and macro trauma to the needle tip, resulting in a hook shape that can lacerate tissues, potentiating the release of growth factors and microscopic needle fragments into fatty tissues. It is postulated that growth factors may further trigger the immune response and exacerbate lipohypertrophy. The loss of the silicone lubricant on the shaft of the needle may lead to an increased force required to push the needle through the skin, which may contribute to bending and breaking.

However, as we use it only for short duration in case of breaking or loss of suture needle, this probability could be annulled.

Thus, this article throws light on how to convert a hypodermic/injection needle into a suture needle without having a knot in the operating theater itself. This will save time and the cost of an extra suture. As this needle was used by us in a single institute in emergency situations only, we do not suggest that these results can be extrapolated to the general population. More studies are essential for further knowledge, benefits, and risks of this technique.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mangan D. Metallurgical, manufacturing and surface finish requirements for high purity stainless steel system components. J Parenter Sci Technol 1991;45:170-6.  Back to cited text no. 1
    
2.
Verellen D, De Neve W, Van den Heuvel F, Storme G, Coen V, Coghe M. On the determination of the effective transmission factor for stainless steel ovoid shielding segments and estimation of their shielding efficacy for the clinical situation. Med Phys 1994;21:1677-84.  Back to cited text no. 2
    
3.
Van Winkle W Jr., Hastings JC. Considerations in the choice of suture material for various tissues. Surg Gynecol Obstet 1972;135:113-26.  Back to cited text no. 3
    
4.
Meinel L, Hofmann S, Karageorgiou V, Kirker-Head C, McCool J, Gronowicz G, et al. The inflammatory responses to silk filmsin vitro and in vivo. Biomaterials 2005;26:147-55.  Back to cited text no. 4
    
5.
Edlich RF, Panek PH, Rodeheaver GT, Turnbull VG, Kurtz LD, Edgerton MT. Physical and chemical configuration of sutures in the development of surgical infection. Ann Surg 1973;177:679-88.  Back to cited text no. 5
    
6.
Varma S, Johnson LW, Ferguson HL, Lumb WV. Tissue reaction to suture materials in infected surgical wounds – A histopathologic evaluation. Am J Vet Res 1981;42:563-70.  Back to cited text no. 6
    
7.
DeNardo GA, Brown NO, Trenka-Benthin S, Marretta SM. Comparison of seven different suture materials in the feline oral cavity. J Am Anim Hosp Assoc 1996;32:164-72.  Back to cited text no. 7
    
8.
Edwab RR. Choosing suture materials and needles. Dent Econ 1995;85:78-9.  Back to cited text no. 8
    
9.
Szarmach RR, Livingston J, Edlich RE. An expanded surgical suture and needle evaluation and selection program by a healthcare resource management group purchasing organization. J Long Term Eff Med Implants 2003;13:155-70.  Back to cited text no. 9
    
10.
Strauss K. An unexpected hazard of insulin injection. Pract Diabetes Int 2002;19:63.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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