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The intraoperative loss of suture needles can prolong procedures and compromise safety, often occurring when a needle holder is unintentionally dropped and opens. This study explored the mechanism of needle loss through a nationwide survey, controlled drop simulations, and finite element analysis. Among 3649 OR nurses surveyed, 75.4% identified instrument transfer—specifically dropping the needle holder onto the instrument table—as the most common cause of loss. In 1500 simulated drops, unexpected opening occurred in 30.6% of cases, primarily when the holder landed flat or on its ring. Finite element analysis revealed that impact‐induced clamp ring deformation displaces locking teeth beyond their biting depth, triggering release. Larger, heavier holders increased both opening risk and needle flight velocity. Design modifications, such as reinforcing the clamp ring and deepening locking teeth, along with cushioned surfaces, may reduce loss events and improve perioperative safety.

Despite focus on prevention of needlestick injuries, intraoperative injuries involving suture needles have increased in the past two decades. When interruptions occur during surgery, a practitioner’s focus is disengaged, creating an “error space;” re‐engagement of the practitioner takes exponentially longer as each subsequent interruption occurs during the procedure. Human factors studies focus on the interaction between individuals and the environment in which they work (eg, processes, equipment). Researchers use a human factors approach to understand distractions during surgery. Using this methodology, wound closure is viewed as a standalone process and the effect of distractions and interruptions on suture needle injuries is examined. Competing priorities combined with interruptions present opportunities for altered situational awareness, which can lead to injury. This article redefines wound closure as a vulnerable time with great potential for error—a time during which distractions and interruptions can lead to suture needle injuries and other unexpected outcomes.

Sutures are widely used in dental procedures, from simple extractions to complex surgeries like dental implant placements. The number of stitches applied varies with the size of the surgical wound, influenced by the thread length attached to the needle. Although needle tips are designed for optimal mechanical performance, their sharpening can lead to increased delicacy and susceptibility to deformation due to repeated contact with soft tissues. This study aims to perform a morphological analysis, using Scanning Electron Microscopy (SEM), to examine how the tips of suturing needles, differing in brand and morphology, are affected after multiple passes through soft tissues. We analyzed suture needles of two distinct morphologies from various manufacturers after use for 1 to 8 stitches on 192 patients. Deformations at the needle tips, measured along the axis and as protrusions from their profile, were proportional to the number of tissue penetrations, independent of the manufacturer. Tapered needles exhibited greater resistance to deformation. Our findings suggest that the tested suturing needles are effective for a limited number of tissue penetrations, indicating the need to restrict their use based on the number of stitches performed.

Background Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event. Case presentation In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician. Conclusion CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.

Retained surgical foreign bodies have been a cause of concern since physicians began operating on patients. Retained surgical foreign bodies in the common bile duct (CBD) are rare and may cause cholangitis and jaundice. We report the case of a patient who initially presented with fever and right upper-quadrant abdominal pain. He had received cholecystectomy and choledochojejunostomy 28 years ago and had been well since then. Abdominal computed tomography (CT) revealed left-lobe liver abscess and a linear curve of high-density material. Endoscopic retrograde cholangiopancreatography (ERCP) displayed mild dilatation of the common bile duct (CBD) and choledojejunostomic fistula of the middle CBD. A curved, linear, rusty, metallic surgical suture needle was detected and successfully removed under ERCP.

Laparoscopic exploration of the common bile duct (CBD) has emerged as a predominant method in hepatobiliary surgery owing to its minimally invasive nature and favorable outcomes compared to traditional open surgery. Suturing the CBD during laparoscopic procedures is critical for ensuring proper bile drainage and reducing postoperative complications. This retrospective study enrolled patients who underwent laparoscopic exploration of the CBD for choledocholithiasis at the Wujin Hospital Affiliated with Jiangsu University between January 2016 and December 2023. Patients were stratified into two groups: individuals who underwent double-needle bi-direction sutures (Bi-direction group, BG) and those who underwent traditional barbed sutures (Normal group, NG). Demographic characteristics, intraoperative parameters, postoperative results, and hospitalization particulars were collected and analyzed. Following propensity score matching, each group comprised 33 patients. The BG exhibited a significantly shorter postoperative extubation time and hospital stay compared to the NG. No significant disparities were noted in intraoperative parameters or postoperative laboratory results between the two groups. Employing double-needle bi-direction barbed sutures for common bile duct (CBD) closure in laparoscopic procedures seems viable and correlates with reduced postoperative recovery durations. The use of double-needle double-barbed sutures for CBD closure in laparoscopic procedures appears to be feasible and associated with shorter postoperative recovery times. Further research is warranted to validate these findings and explore potential benefits in larger patient cohorts and different clinical settings.

Wound closure with surgical sutures is a critical challenge for flexible endoscopic surgeries. Substantial efforts have been introduced to develop functional and smart surgical sutures to either monitor wound conditions or ease the complexity of knot tying. Although research interests in smart sutures by soft robotic technologies have emerged for years, it is challenging to develop a soft robotic structure that possesses a similar physical structure as conventional sutures while offering a self-tightening knot or anchor to close the wound. This paper introduces a new concept of smart sutures that can be programmed to achieve desired and uniform tension distribution while offering self-tightening knots or automatically deploying secured anchors. The core technology is a soft hydraulic artificial muscle that can be elongated and contracted under applied fluid pressure. Each suture is equipped with a pressure locking mechanism to hold its temporary elongated state and to induce self-shrinking ability. The puncturing and holding force for the smart sutures with anchors are examined. Ex-vivo experiments on fresh porcine stomach and colon demonstrate the usefulness of the new smart sutures. The new approaches are expected to pave the way for the further development of smart sutures that will benefit research, training, and commercialization in the surgical field.

Background This study aimed to identify and review associations between the types of sutures used for uterine compression suture (UCS) and its outcomes in postpartum hemorrhage. Methods An electronic search using PubMed and Scopus databases was performed. We included the English articles reported from January 1, 1997, to May 31, 2017, using search words or terms regarding the types of suture and needle used for UCSs. We only included studies describing the sutures in the systematic review. Results We found 196 studies and included 76 (38.8%) in our analysis. We collected data on maternal outcomes for 924 patients and categorized them. Of the 76 studies, suture sizes 0, 1, and 2 were used in 6, 44, and 32 articles, respectively (some studies used multiple sutures). Of the 45 studies mentioning the needles, curved and straight needles were used in 35 and 10, respectively. The results of our review revealed that about 80% of previous articles used Catgut and Polyglactin 910 sutures. Because no studies that compared the efficacy of different size of sutures were identified, we investigated the differences using the cases reported in previous studies mentioned above. In the first analysis, we compared the uterine preservation rate between size 1 and size 2 sutures. We found no significant difference in uterine preservation rate (92.8%: size 1 vs. 94.2%: size 2, p  > 0.05) but found significant difference in transfusion rate (62.4% vs. 79.1%, p  < 0.01). With the hypothesis that non-transfusion cases were less severe, we excluded these cases from second analysis. Although our second analysis of only Catgut or Polyglactin showed strong selection bias, we observed that uterine preservation rate was significantly higher in cases with size 2 suture than in those with size 1 suture (86.9% vs. 93.5%, p  = 0.033). Conclusions Our systematic review showed that approximately 80% of cases were treated by Catgut and Polyglactin 910. Due to the heterogeneity of cases included in this review, it is difficult to estimate which suture is better for UCSs. More robust studies are necessary to enable the identification of the superior suture for performing UCSs.