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Its a fact that the common surgeon will lose more time with a needle holder as opposed to any other surgical instrument. Its very likely to have a loss of time because your using your needle holder in conjuction with another medical tool (the needle), and there is a series of many steps in taking a stich. Other medical tools are more often used singly, or runs in conjunction with another medical instrument, in one-step maneuvers. There is opportunity to waste time with each clamping & releasing the clamp of the needle holder, as well as between other steps.
the main reasons for lost time is "stuttering" and "stammering" using the needle holder. When you do a non-productive repetition of steps to be completed only once. This is called Stuttering. Stammering describes interruption during a step that could be done with one motion.
Stuttering includes:
1. If you change the needles direction, angle and distance from the point in the jaws of the needle holder after getting a suture from the scrub nurse.
2. Repeatedly going out & into of a wound without doing a stitch, to reposition the needle's forehand-backhand direction, point of distance, angle, change the point of exposure.

Stammering happends after the needle is started into the tissue. This includes:
1. different attempts pushes nearer the eye of the needle.
2. One or more reapplications of the holder during extraction of the needle from the tissue.
3. Superfluous motions when drawing an appropriate length of suture objects through the wound, when a stitch is taken.

Stammering, with the exception of losing time due to redundant maneuvers, may waste further time if the needle moves to a less easy stance when released by the needle holder during unnecessary repositioning.

Another common mechanism of time loss while suturing is the absence of coordinated team effort between surgeon, his assistants, & scrub nurse.

Self-discipline, more than skill, is required to use a needle holder efficiently.
All needle holder jaws will wear out the tread in regular suturing. Gold handle needle holder jaws are made of tungsten carbide and can be replaced. Basic needle holder jaws (The kind without the gold handles) cant be replaced.
If any bioburden or discoloration is discovered on the jaw or box lock, the surgical instrument sets must be reprocessed through sanitization. A stiff brush will most likely remove the bioburden. If it's not clean, it can't be sterile. at the assembly table; it is not suitable to clean your surgical instruments.
Jaw wear is an issue with all differnt types of needle holders. A process like diamond dusting enables the needle holder to grasp very fine suture needles. Most agitated metal surfaces do wear smooth over time. before.
Due to the pressure of stainless steel wire being twisted, the jaws of wire twisters are susceptible to cracking. This malfunction allows differnt parts of the tungsten carbide jaw to drop into the medical instruments site. Look at the jaws before tray assembly and if theirs a few pieces gone or the jaw wear is visible, don't use the surgical instrument. Schedule the wire twister for repair.