Wasteful use of the needle holder by surgeons accounts for more loss time than poor technique with any other medical instrument. There is greater possibility of time loss since a needle holder is used in series with another surgical tool (the needle), when taking a stich there are several steps. Other medical tools are more often used singly, or runs in conjunction with another medical instrument, in a single step maneuvers. There is chances to waste time with each clamping & unclamping of the needle holder, as well as between other steps.
the main reasons for lost time is "stammering" and "stuttering"" using the needle holder. Stuttering describes the non-productive repetition of steps needed to be completed only once. When you get interruption in a step that could be done in only 1 motion.
Stuttering is:
1. If you change the needles direction, distance and angle from the point in the jaws of the needle holder after receiving a suture from the scrub nurse.
2. Repeatedly going out & into of a wound without taking a stitch, to replace the needle's forehand-backhand direction, point of distance, angle, change the point of exposure.
Stammering happends after the needle is started into the tissue. Stammering is:
1. Multiple pushes nearer the eye of the needle.
2. You may need to do some more reapplications of the holder during extraction.
3. Superfluous motions while drawing an appropriate length of suture objects through the wound, once a stitch is taken.
Doing this may make you lose time, may waste further of your time if the needle moves to a less accessible stance when released by the needle holder during unnecessary repositioning.
Another common mechanism of time loss while suturing is the absence of synchronized team effort between surgeon, scrub nurses and assiants.
More than skill, self-discipline, is required to use a needle holder efficiently.
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