I recently encountered a situation in which a suturing needle was broken near the tip during an operation.
See picture below.
After I used the needle in suturing a wound, I remembered giving the instrument nurse the whole needle in one piece. When he threaded another suture into the eye of the needle and gave it back to me to do for my next suturing, I noticed the needle having blunt end this time instead of a pointed end. In short, the needle was broken. I told the nurse what I saw. He agreed the needle was broken but did not notice it until I told him. I told him to look for the broken part.
When I told him to look for the broken part of the suturing needle, I was already anxious of what would happen next. I was praying and hoping he would find the broken part easily. Otherwise, we may have to do an intraoperative x-ray of the patient’s body just to ensure that the broken part of the needle was not there. Fortunately, within two minutes, he was able to locate it in the instrument tray. With this, I sighed with relief.
Analyzing where the glitch was, apparently, the needle was already weak from re-use and re-sterilization. The needle broke when the nurse was about to thread a suture into the eye of the needle. The nurse did not even notice that the needle broke. It would be a different story if he saw the needle broke. But he didn’t. I was the one who noticed the breakage when he handed me the needle. (Usually, needles break during suturing. This time, the needle broke after suturing and when the nurse was threading a suture.)
Searching for missing whole needles during an operation can be a nightmare. What more, the broken parts of the needles.
Correct count before closure of an operative wound includes correct sponge, instrument and needle count. Correct needle count implies correct whole needle count.
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