Objective
The intraoperative loss of microsurgical needles is a common challenge. Efforts to retrieve them can prolong surgical time or necessitate postoperative imaging. This study aimed to analyze the search duration and recovery locations for lost 9-0 and 10-0 nylon suture needles to establish an evidence-based management protocol.

Material and Methods
We conducted a prospective observational study over a 12-month period. For each instance of a lost microsurgical needle, we recorded the time elapsed until recovery, the final location of the needle, and the suture size.

Results
A total of 12 lost needle incidents were documented. The majority of needles (10/12, 83.3%) were recovered within five minutes. The remaining two cases (16.7%) required search times exceeding 10 minutes. All needles were successfully located within the sterile surgical field; specific recovery locations included the surgical drapes (n=5), the magnetic instrument pad (n=3), adjacent gauze (n=2), and the surgical wound (n=2). No needles were found outside the immediate operative area.

Conclusions
A systematic 5-minute search focused on the immediate sterile field—including the surgical wound, flap, and surrounding materials—is highly effective for recovering lost microsurgical needles. Based on our findings, we recommend that if a needle is not located within this timeframe, surgeons should consider that the minimal risk of retaining such a small, inert object may not justify prolonged searches that increase operative duration and patient risk.

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