- Email: [email protected]
A Dependable Tying Forceps for Fine Sutures*
NOTES, CASES, INSTRUMENTS
displacement, but the engorgement of the conjunctiva had completely disappeared. Movements of the eye were considerably better, even though its position could not be called normal. It was assumed that there was an orbital edema similar to the one of the lid, although remnants of an orbital tumor could not be definitely excluded. The vision was the same in both eyes (20/70, uncorrected) and no radium damage was apparent. No double vision was noted by the patient and he was extremely satisfied with being able to see out of the right eye. No recurrence of the growth was observed as late as May, 1948. COMMENT
The case is presented because of its un usual features. We realize that it is uncer tain that our radium treatment effected a permanent cure, and only continued obser vation and, if needed, another series of ra dium implants will promise a continued sat isfactory result. It can well be argued that a more radical procedure would be better and more certain. There is, however, no doubt that the method used in this case was the easiest on the patient and the least dis figuring. For a man past the age of 80 years, it seemed to us the method of choice. 408 West Second Street.
A DEPENDABLE TYING FORCEPS FOR F I N E SUTURES* WARREN D. HORNER,
M.D.
San Francisco, California
We now have finer eye sutures than we have forceps for tying them. This lack of a suitable forceps led me to experiment with various types of epilating forceps, since they are designed for grasping minute strands. ♦From the Division of Ophthalmology, Univer sity of California Medical School.
1001
By micrometer measurement, I found the diameter of eye lashes to vary between 0.0015 and 0.003 inches, with an average of 0.0025 inches (0.0063 mm.). The diameter of 7-0 silk cataract sutures varied less, av eraging 0.0026 inches. A cilium, therefore, is just a bit smaller than a cataract suture, a fact which makes a forceps properly de signed for grasping the one efficient in grasping the other. Some cilia forceps are too short to handle well, but the Beupre model is very adaptable and handy for suture tying. This forceps is an old favorite and has been listed in instru ment catalogues for the past 20.years. It is of spring-grip construction, and has taper ing and closely fitting smooth jaws set at an angle of 30 degrees. The instrument has a total length of about Ατ/2 inches (11.4 cm.) and handles well. The jaws hinge smoothly and present no projections apt to catch the suture in tying an ordinary single or double hemostat knot. A 7-0 suture can be grasped anywhere along the jaws from the tip to the base, a distance of a full centimeter. The jaws open to a width of 4 mm., which makes it easy to pick up a thread. A canvass of the instrument companies showed that the Beupre forceps was out of production for the present, but it is prob able that there is a considerable number of old models about our offices. The Paton needleholder is a delicate model closely resembling the Beaupré for ceps, except that its jaws are slightly wider and heavier, and are straight instead of angular, which is an added advantage. By a little honing, the serrated jaws can be suf ficiently smoothed down to grasp a 7-0 su ture securely. This model is available* and after the modification just mentioned makes an ideal tying forceps. Most other needleholders either lack the precise bite necessary for tying fine silk or do not open widely enough to facilitate picking up a thread. 490 Post Street (2). t E. B. Meyrowitz, New York.
displacement, but the engorgement of the conjunctiva had completely disappeared. Movements of the eye were considerably better, even though its position could not be called normal. It was assumed that there was an orbital edema similar to the one of the lid, although remnants of an orbital tumor could not be definitely excluded. The vision was the same in both eyes (20/70, uncorrected) and no radium damage was apparent. No double vision was noted by the patient and he was extremely satisfied with being able to see out of the right eye. No recurrence of the growth was observed as late as May, 1948. COMMENT
The case is presented because of its un usual features. We realize that it is uncer tain that our radium treatment effected a permanent cure, and only continued obser vation and, if needed, another series of ra dium implants will promise a continued sat isfactory result. It can well be argued that a more radical procedure would be better and more certain. There is, however, no doubt that the method used in this case was the easiest on the patient and the least dis figuring. For a man past the age of 80 years, it seemed to us the method of choice. 408 West Second Street.
A DEPENDABLE TYING FORCEPS FOR F I N E SUTURES* WARREN D. HORNER,
M.D.
San Francisco, California
We now have finer eye sutures than we have forceps for tying them. This lack of a suitable forceps led me to experiment with various types of epilating forceps, since they are designed for grasping minute strands. ♦From the Division of Ophthalmology, Univer sity of California Medical School.
1001
By micrometer measurement, I found the diameter of eye lashes to vary between 0.0015 and 0.003 inches, with an average of 0.0025 inches (0.0063 mm.). The diameter of 7-0 silk cataract sutures varied less, av eraging 0.0026 inches. A cilium, therefore, is just a bit smaller than a cataract suture, a fact which makes a forceps properly de signed for grasping the one efficient in grasping the other. Some cilia forceps are too short to handle well, but the Beupre model is very adaptable and handy for suture tying. This forceps is an old favorite and has been listed in instru ment catalogues for the past 20.years. It is of spring-grip construction, and has taper ing and closely fitting smooth jaws set at an angle of 30 degrees. The instrument has a total length of about Ατ/2 inches (11.4 cm.) and handles well. The jaws hinge smoothly and present no projections apt to catch the suture in tying an ordinary single or double hemostat knot. A 7-0 suture can be grasped anywhere along the jaws from the tip to the base, a distance of a full centimeter. The jaws open to a width of 4 mm., which makes it easy to pick up a thread. A canvass of the instrument companies showed that the Beupre forceps was out of production for the present, but it is prob able that there is a considerable number of old models about our offices. The Paton needleholder is a delicate model closely resembling the Beaupré for ceps, except that its jaws are slightly wider and heavier, and are straight instead of angular, which is an added advantage. By a little honing, the serrated jaws can be suf ficiently smoothed down to grasp a 7-0 su ture securely. This model is available* and after the modification just mentioned makes an ideal tying forceps. Most other needleholders either lack the precise bite necessary for tying fine silk or do not open widely enough to facilitate picking up a thread. 490 Post Street (2). t E. B. Meyrowitz, New York.