The most important tools we use for managing lacerations are the instruments that come in the “lac kit.” These kits come from a variety of manufacturers and are commodity items that get purchased by a hospital, urgent care, or clinic with very little thought. To those making the purchases, cheap is best. This is not an area to cut corners. The quality of the instruments in these kits will directly affect you as a clinician and your patients as well. Cheap instruments fall apart. They don’t hold the needle well nor cut the suture thread reliably. The tissue forceps may not line up properly and may cause more tissue damage. Fine suture thread may get snagged in the hinge of the needle driver every time you tie a knot. This is not acceptable!
Regardless of what brand/manufacturer you, your urgent care or ED uses, make sure that they have instruments that are reliable. There is nothing more frustrating than having to open up a second kit in the middle of a repair because the needle driver won’t hold the needle. (Full disclosure-I have done some consulting work for Centurion Medical Products and Medline Industries. I do believe that Centurion’s single use instruments are the best available for managing lacerations.)
My passion about this topic led me to do a white paper examining how this issue affected clinicians. The results were pretty significant-almost all respondents have had laceration kit instruments break or cause significant issues for them. Most asked for better quality were told its not an option. Here is a link to the white paper. I encourage you to take a look, it may help you make the argument for better quality instruments.
Sincerely,
Dr. Patrick O’Malley
The Laceration Course, Course Director
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Last Updated on June 13, 2023
