Suture Materials
Suture Types
Fibres
Monofilament suture : single fibre - less tissue reaction - knot holding properties poor - need more knots to avoid slipping
Braided suture : consists of several fibres twisted together - more tissue reaction - inflammation - may harbour infection - silk, cotton, mersilene
Sizes
Thickness - expressed as 1-0, 2-0, 3-0 and so on.
2-0 suture is thinner than 1-0 and 3-0 thinner than 2-0 and so on.
Where as No. 2 thicker than No.1 and No.3 thicker than No.2 and so on.
Strength
Thick suture is stronger than thin suture. e.g. 4-0 suture is stronger than 6-0 and No. 2 suture is stronger than No.1
Absorbable suture
Breaks down after a particular number of days and gets absorbed and there is no foreign body left in the tissues. Used in deeper tissues. No need to remove the sutures.
Previously made from the intestines of sheep ( called catgut)
Now made from synthetic polymer fibers - braided or monofilament - easier to handle, low cost, low tissue reaction, good performance and non-toxic
Natural Absorbable sutures
Catgut sutures : Plain catgut and Chromic catgut sutures
Synthetic Absorbable sutures
Polyglycolic Acid sutures : Vicryl, PGA sutures : coated and braided
Polyglactin 910 sutures : PGLA sutures : coated and braided
Poliglecaprone sutures : Monocryl, PGCL sutures - monofilament
Polydioxanone sutures (PDS) sutures - monofilament
Non absorbable suture
Not metabolizable and hence not absorbed
Do not disappear, remains forever in the tissues
Used in superficial structures like skin and can be removed later
Used in ligating big blood vessels and aponeuroses (herniorrhaphy), heart
Made of silk, polpropylene (Prolene), polyester, nylon, staineless steel wires
Stainless steel wires used in orthopedic surgery and in sternal closure in cardiac surgery
Needles
Straight needle
Curved needle - Par of a circle - according to the length of the radius the needle is more curved or less curved
Cutting needle - traditional cutting needle - reverse cutting needle
