b. You should prepare the sutures in the order in which the surgeon will use
them. The circulator will pass the suture packets to the sterile area either by flipping
them into the basin on the back table or by opening the outer wrapper with the scrub
reaching for it with gloved hand or sterile instrument. Suture material without an
attached needle is referred to as a "tie." The scrub will open individual packets of ties
using the following procedures.
(1) Tear foil or plastic packets across the dotted line of the packet.
(2) Remove the suture material from the packet, unwind or unfold the
material, cut the strand for the proper length, and place these strands under the rolled
end of the towel on the Mayo tray. As you work in preparing the ties, you must work
over the sterile field to avoid contaminating the tie. Avoid letting the suture ends drop
over the edge of the instrument table. Figures 3-26 through 3-29 illustrate the handling
and preparation of suture materials.
General rules on handling suture material include the following:
(1) Limit handling to the absolute minimum.
(2) Never stretch, jerk, or "test" the strengths of the suture.
(3) Avoid crushing strands in instruments.
(4) Do not run gloved hands over suture to straighten kinks.
(5) Do not open and prepare too many sutures in advance
d. After you have placed all the required ties under the rolled towel on the
Mayo tray, unroll the end of the towel and place under the tray. The ties are always
removed from the Mayo tray toward the sterile field, never away from the sterile field.
PREPARATION OF SURGICAL NEEDLES
Most suture have swaged needles attached to the suture material. The swaged
needles are left in the inner folder of the suture packet until the surgeon is ready to use
them. If free or eyed needles are used, a needle holder or needle rack is prepared in
advance for the operation based on standard local policy. Needles must never be loose
on the sterile field. All needles are sharps and must be counted.