Hand-held straight needles, such as Keiths, eliminate the need of a needle holder & therefore are simpler, in certain cases it faster and more precise. Unlike needle holders, hand-held needles, don't need both hands to reposition the needle for the next stitch. A straight needle will give better opportunity to direct its point without breaking or bending, once the tissue has been entered. On the flip side, a curved needle's course is essentially preprogrammed by the shape of the curve as sin as the needle enters the tissue.
A straight needle can never change its attitude to an inaccessible one by turning, as can occur when a curved needle slips in a needle holder's grab. Furthermore, after inserting a hand-held needle it is not needed to let go completely to re-grab it for extraction. When the straight needle goes through & enters the tissue held between the index, thumb & middle fingers, can be regrasped by the thumb and index finger near the point, while still maintaining pressure and control of the swage end with the side of the ring finger. Your finger tip can act as a thimble-covered fingertip of a needle worker. Extracting, inserting & readying the needle for the next stitch thus becomes one continuous, useful movement of the right hand, you can use your left hand for other manipulations if you like. The main disadvantage of straight needles useful only on convex surfaces (e.g., skin) and other organs that can be delivered out of the wound (e.g., tiny bowel).
A Rochester awl may be used to put wire sutures through the bone, Sort of like during closure of sterna-splitting cut. Using the thumb and index finger as a depth stop, and with minimal pressure start drilling or rotating clockwise and counter-clockwise switching back & forth, You can then insert the needle to the depth that you'd like without any risk of slipping deeper than what you want. To extract the awl with wire attached is done by a back and forth of surgical instruments. This motion gives less traction than needed with a steady pull.
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