Keith needles

[Cholinergic]

Does anyone prefer closing skin with Keith needles? I worked with one doctor who preferred to use them. She let me close with it too, but it was challenging. I would imagine that they are much easier to stick yourself with, too. Nevertheless, I guess it would be worth practicing with these as well, right?

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[rayofdiana]

I've seen a couple people do it for subcutics, and I'd like to try. It seems to get a smoother approximation of edges. Also, I've decided that I need to invent a surgical thimble for them, thus cementing my name in the history of gyn surg! (Kidding.)

 

[Global Disrobal]

The majority of our residents and attendings use it. I am comfortable with either, but can tell you from personal experience that its slower with the keith but does come together nicely (especially when you enter 90 degrees to the incision and rotate to parallel).

The issue with sticking is when the surgeon doesn't use a pair of pick ups and tries to do everything with their fingers, and also when using the keith on scar tissue.

 

[pruritis_ani]

I use it, and love it. It did take a few closures to get comfortable, but now it is not much slower than staples, if at all. And, it makes discharge time a bit easier, and patients are frequently under the impression that the scar will be smaller...none of these are bad things!

Use your forceps, and sticks are almost a non issue.

 

[prince1]

what is keith needle is it round or cutting needle
do u know any learning video for ob/gyn surgery . examination, lectures ,etc
if u know please tell me & how to get it

 

[Cholinergic]

I probably just need to practice (as with everything else). Seems I would have better control having my fingers closer to the needle than using a needle driver.

 

[Winged Scapula]

Keith needles come standard in central line kits and I rather enjoy using them as it was what I trained on "back in the day" when my mother taught me how to sew.

Can't say I ever gotten one in the OR to close with...are they loaded with Monocryl or some other dissolving suture? I've only seen them loaded with silk and nylon.

 

[chrisisinnocent]

Keith needles come standard in central line kits and I rather enjoy using them as it was what I trained on "back in the day" when my mother taught me how to sew.

Can't say I ever gotten one in the OR to close with...are they loaded with Monocryl or some other dissolving suture? I've only seen them loaded with silk and nylon.

I have seen them used once in a C section with scar revision (repeat C section and the old scar was very ugly). Cannot recall what was loaded on it.

 

[smq123]

I have seen them used once in a C section with scar revision (repeat C section and the old scar was very ugly). Cannot recall what was loaded on it.

I believe that I've seen them loaded with prolene....?

 

[Global Disrobal]

I use mine loaded with 4-0 monocryl. A word of caution (from personal experience): avoid using them on repeat scars and instead go with an SH needle.

 

[MugsyMD]

I love Keith needles - and PS2 needles take tooooooo long to close - I can close an incision in about 2 minutes with a Keith needles - and then I DO NOT use steri-strips - I use Dermabond on top - let it dry completely - THEN apply a pressure dressing!
Attending Ob/Gyn

 

[MugsyMD]

I use a Keith with 3-0 vicryl - and do a Knotless technique - I do NOT tie knots for the closure - if you don't know how - I'm sure you can figure it out - i.e. vicryl is a braided suture and can hold if place just under the skin about 2 inches from each corner. The monocryl is slippery and REQUIRES a know - so I don't use it. I will also close even QUAD-peats with suture if it is appropriate - dependent on the patient of previous scar(s).

 

[Global Disrobal]

Thanks for the information on your preference MugsyMD. Just FYI, I do go with Monocryl, and rather than using a traditional knot, I complete the closure with a French knot and run/tunnel the tail under the skin (1 inch or so).

As for your comment regarding use on "Quad-peats," I don't doubt that it's possible, but how do you prevent the "bunching" of the skin without throwing super close throws?

As for patient selection, I totally agree. I almost always avoid sutures in patients with previous keloids or vertical incisions.

Thanks for the information.

 

[MugsyMD]

I use 3-5 interrupted sutures with vicryl hence it gets the edges approximated - I also like to take my time with a repeat - so I use bovie all the way down, hence less blood loss and cleaner edges. The doing the 3-0 suture with the keith does not bunch the edges and the dermabond also helps out!