Suture Materials

Most sutures with the suture material swaged onto the base of the needle

Shapes vary from a quarter circle to five-eighths of a circle, depending on how confined the operating field is

Choice of the needle should ‘alter the tissue to be sutured as little as possible’ and is dependent on:

  • The tissue being sutured (when in doubt about the selection of a tapered point or cutting needle, choose the taper for everything except skin sutures)
  • Ease of access to the Individual tissue preference.
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Properties of suture material

  • Handling of a suture
    • Memory
      • The tendency to stay in one position
      • Leads to difficulty in tying sutures and knot unravelling
    • Elasticity
    • Knot strength
      • The force required for a knot to slip
      • Important to consider when ligating arteries
  • Tensile strength
    • The force necessary to break a suture
    • Important to consider in areas of tension (linea alba)
  • Tissue reaction
    • Undesirable since inflammation worsens the scar
    • Maximal between Day 3&7

Types of sutures

  • Monofilament (Ethilon or Prolene)
    • Consists of a single smooth strand
    • Less traumatic since they glide through tissues with less friction
    • May be associated with lower rates of infection.
    • More likely to slip and should be secured with 5 or 6 ‘throws’ (in contrast to 3 throws with multifilament)
    • Preferred for skin closure because they provide a better cosmetic result
  • Multifilament (Mersilk or Mersilene)
    • Consists of multiple fibres woven together
    • Easier to handle and tie and knots are less likely to slip.

Classification of sutures

Non-absorbable suture material

Composed of materials which can be:

  • Naturally occurring (Mersilk, cotton and steel)
  • Synthetic (Prolene, Ethilon)

Absorbable suture material

Composed of biodegradable materials which can be?

  • Naturally occurring (degraded enzymatically)
  1. Catgut (no longer used in routine practice)
  • Consists of processed collagen from animal intestines
  • Broken down after seven days
  1. Chromic catgut
  • Consists of intestinal collagen treated with chromium
  • Loses tensile strength after 2-3 weeks and is broken down after three months
  • Synthetic
  1. Degraded non-enzymatically by hydrolysis when water penetrates the suture filaments and attacks the polymer chain
  2. Tend to evoke less tissue reaction than those occurring naturally.

What’s on the packaging:

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