Wound Closures

- Suture Needles
- Suture Material
- Stitch Scissors
- Micro Suturing Needle Holders
- Needle Holders
- Reflex™ Wound Clip Products
- Wound Clips & Appliers

Click here to browse our entire Wound Closures selection in our online store.

FAQ's
These are all common questions that we receive from our customers. If you have a question about any of our products, please email us at: info@roboz.com

What scissors do you recommend for cutting suture material?

Roboz Surgical Instrument Co. supplies several different stitch scissors for use in suturing. Stitch scissors usually have a notch that holds the suture firmly in the jaws while it is being cut. Without the notch, the relatively hard suture material would tend to be forced out of the jaws as they are closed. For fine suture work, Roboz supplies the RS-5950 Spencer Stitch Scissor (very delicate, 3 1/2" length). The RS-7074 and RS-7076 are slightly larger and less delicate (4 1/2" and 5 1/2" respectively). The RS-7069 Wire Cutting Stitch Scissor is more rugged.

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What is a tying platform?

A tying platform is a slightly elevated surface near the tip of the forceps to aid in suturing. The elevated surface catches the suture to help make a knot. The McPherson micro dissecting forceps (RS-5068) are an example of forceps with a tying platform.

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Do you make wound closure clips smaller than 9mm?

Yes. Roboz Surgical Instrument Co. manufactures the RS-9258 Reflex 7mm Wound Clip. It is applied using the RS-9250 Reflex Applier. This applier holds 20 clips. All Roboz Surgical Instrument Co. wound clips, including the 7mm clips, can be removed by using the RS-9263 Wound Clip Remover.

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Tech Notes
Tech Notes contain additional information on the features and applications of our instruments

Loading the Reflex Wound Clip Appliers

Summary: Instructions on loading the 9mm and 7mm Reflex Wound Clip Appliers.

1. Open the applier by gently pushing the spring clip forward with the tip of your thumb. Once the spring clip is free, remove the spring and plunger assembly

2. Insert a full fork of wound clips. Be sure to insert the pointed tab end of the fork to endure proper function.

3. Replace the spring and plunger assembly. Snap the spring clip into the locked position. You will notice the pointed tab end protruding from the opposite end. To complete the loading, gently pull the fork from out from the instrument. For best results, do not attempt to load more than one pack of clips at a time.

Click here to watch a video of the loading procedure.

WARNING: The Reflex wound clip appliers can only be loaded with Reflex brand wound clips of the corresponding size.

Suture Material

Summary: Suture material is classified into absorbable and non-absorbable types.

There are 2 types of suture material, absorbable and non-absorbable. Some non-absorbable will actually absorb but the degradation rate is so slow that it is classified as non-absorbable. They are made of either natural or synthetic materials. Sutures are available with or without needles attached. Keep in mind that the higher the number of the suture material the thinner it is, for example, some of the smallest material made for sutures is a size 10-0 and some of the larger materials are 3-0, and 4-0.

Roboz Surgical Instrument Co. sells a variety of sutures including Gut Chromic and Silk Black Braided. Listed below are all suture materials available but not necessarily through Roboz.

Absorbable Sutures

Surgical Gut (Catgut) was called kitstring or kitgut because it was used for the strings on a violin. Catgut derives from the change in meaning of the term “kit” to young cat. It is formaldehyde treated collagen from the small intestines of sheep or cattle, which have several plies, twisted together then machine ground and polished to resemble monofilament. It is not autoclavable because the heat reaction will denature the protein. It is available in 2 types: Plain and Chromic. Plain produces severe tissue reaction with great reduction in tensile strength. It is seldom used.

Chromic is chromium salt treated which increases tensile strength and resistance to digestion and decreases tissue reactivity. There are 3 types of chromic gut: Mild, Medium, and Extra with the respective absorption rates of 10, 20, and 40 days. Medium is the most commonly used type.

Polyglycolic Acid (PGA) is another type of absorbable suture. It is a noncollagenous synthetic, braided, monofilament, and polymer of glycolic acid with an absorption rate of 100-120.

Non-absorbable Sutures

Silk- Silk is spun from the cocoon of a silk worm then twisted or braided. This suture has strong tissue reaction with a 2-year degradation rate. It has excellent handling properties, high knot strength and tensile strength.

Nylon- Nylon suture is either mono or multifilament and biologically inert. This suture creates minimal tissue reaction and is a highly recommended skin suture.

Stainless- a stainless steel suture is biologically inert. It is autoclavable and is hard to tie into knots and the ends can be sharp and irritating to skin.

Polypropylene- this suture is blue or clear in color and is the least thrombogenic. It is inert and causes very little tissue reaction. It is commonly used in vascular surgery and it retains strength upon implantation.

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Suture USP Size Conversion Chart

Summary: Converts the USP suture size to millimeters

For more detailed information on each individual item, please review the Suture Materials & Needles section of the Roboz Surgical Instrument Co, web store.

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Applications for Various Suture Materials

Summary: Suggested uses for various suture types.

Polyglycolic Acid- Most frequently used in procedures where eventual absorption is required.

Polyglyconate- Recommended for use in all types of soft tissue approximation. Some examples are; facial closures, caesarean sections and anastomosis.

Surgical Gut, Plain Gut, Mild Chromic, Chromic Gut- Recommended for general wound closure. Some examples are anastamosis, Orthopedics, Urology, OB/GYN, and Urological procedures.

Nylon- Recommended for general wound closure in microsurgical procedures, skin closures, cardiovascular, opthamology, and orthopedic procedures.

Surgical Silk- Recommended for use in general closures, cardiovascular surgery, neurosurgery, plastic, and orthopedic surgery. It is not used where infection is present or in urinary and biliary tracts.

Polyester- Used in orthopedics and general surgical procedures and also in cardiovascular, and ophthalmic surgery.

Stainless Steel- Recommended for areas where infection is present because it is biologically inert and is a very strong material. Commonly used in orthopedics, urology, plastic surgery, thoracic surgery and in the repair of eviscerated wounds.

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Suture Technique

Summary: Proper suturing technique is needed to ensure desired results during surgery.

The most commonly used and versatile suture in cutaneous surgery is the simple interrupted suture. This suture is placed by inserting the cutting edge needle (a cutting edge needle has a sharp edge on the inner curve of the needle that is directed toward the wound edge) perpendicular to the epidermis. The needle must go through the epidermis and the full thickness of the dermis, and exit perpendicular to the epidermis on the opposite side of the wound. The 2 sides of the stitch should be symmetrically placed in terms of depth and width. In general, the suture should have a flask-shaped configuration, that is, the stitch should be wider at its base (dermal side) than at its superficial portion (epidermal side). If the stitch encompasses a greater volume of tissue at the base than at its apex, the resulting compression at the base forces the tissue upward and can cause eversion of the wound edges. This method decreases the likelihood of creating a depressed scar as the wound heals.

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Needle Holders

Summary: Needle holders are essential in order to properly grasp suture needles.

A needle holder is used to grasp the needle at the distal portion of the body, one half to three quarters of the distance from the tip of the needle, depending on the surgeon’s preference. The needle holder is tightened by squeezing it until the first ratchet catches. The needle holder should not be tightened excessively because damage to both the needle and the needle holder may result. The needle is held vertically and longitudinally perpendicular to the needle holder.

Incorrect placement of the needle in the needle holder may result in a bent needle, difficult penetration of the skin, and/or an undesirable angle of entry into the tissue. The needle holder is held by placing the thumb and the fourth finger into the loops and by placing the index finger on the fulcrum of the needle holder to provide stability. Alternatively, the needle holder may be held in the palm to increase dexterity

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Wound Closure Clips

Summary: Staples can provide a fast wound closure method.

Stainless steel staples provide a fast method for wound closure and have been associated with decreased wound infection rates. Staples have been shown to be less reactive than traditional suturing material. Stapling does not affect tissue defenses since it requires minimal skin penetration, and, thus, fewer microorganisms are carried into the lower skin layers. Staples are more expensive than traditional sutures and also require great care in placement, especially in ensuring the closure of wound edges. However, with proper placement, resulting scar formation is cosmetically equivalent to that of other techniques.

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Reflex Clip Remover (for use with 9MM and 7MM clips)

Summary: Steps for removing stainless steel wound clips using the Reflex Clip Remover.

Step 1. Grasp the Reflex Clip Remover between your thumb and forefinger.

Step 2. Insert the forceps tip between the curls of the wound clip.

Step 3. Apply pressure to open the wound clip and lift the clip away from the incision.

The Reflex Clip Remover can be used with all sizes of the Reflex Wound Clips and on almost any brand of Reflex-style wound clips.

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