General Surgery

Suturing – Instrument holding

Key principles

Maintain a light grip on the needle holders

  • Thumb and ring finger, first knuckle only
  • Not a death grip!
  • Advanced: no thumb in the ring – use your thumb pad to open and close the ratchet

 

Thumb forceps held like tweezers or a pencil

  • No overhand grips
  • Advanced: don’t set them down

 

Rotate arm and wrist to move the needle

  • Avoid pushing the needle through with a straight force
  • If your needle is straightening on you, you aren’t rotating your arm

Needle holders are positioned over the knot for tying

  • Between the strands of suture
  • Not underneath either strand

Don’t pull up on the knot

  • Keep needle holders close to the skin
  • Don’t move the needle holders up and down
  • Use your opposite hand to wrap the suture around the needle holders

Control your suture

  • Keep your hands where you can see them
  • Wrap or fold the suture into your other hand to keep it under control

How to use your thumb forceps to stabilize the needle

General

License

Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Large Animal Surgery - Supplemental Notes by Erin Malone, DVM, PhD; Elaine Norton, DVM PhD; Erica Dobbs, DVM; and Ashley Ezzo, DVM is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.