Surgical Sutures – Basics

	Monofilament	Polyfilament
Absorbable	Caprosyn (Polyglytone 621) Monocryl (Polyglecaprone 25) Biosyn (Polyglecaprone CV-23) Maxon (Polytrimethylate carbon) PDS (Polydiaxonone)	Catgut Vicryl rapide (Polyglactin 910 rapide) Vicryl (Polyglactin 910) Dexon (Polyglycolic acid)
Non-absorbable	Nylon Ethilon (Monofilament polyamide) Prolene (Polypropylene)	Silk Dacron Ethibond (Polyester) Braided nylon (Surgilon, Nurolon) Supramid

Monofilament sutures:

• Smooth and strong
• Less chances of bacterial contamination
• Knot tied may become loose

Polyfilament/Multifilament sutures:

• Easier to handle and knot tied doesn’t slip
• Bacteria may lodge in crevices of sutures – not suitable in presence of infection

Natural sutures:

• Ingredient: Proteins
• Degradation: Proteolysis
• Strength distribution: Uneven
• Inflammatory reaction: High
• Absorption rate: Rapid

Synthetic sutures:

• Ingredients: Copolymers
• Degradation: Hydrolysis
• Strength distribution: Even
• Inflammatory reaction: Low
• Absorption rate: Slow

Absorbability:

There are 2 principal methods, by which the sutures are absorbed:

1. Proteolytic enzyme degradation
2. Hydrolysis

Suture needles:

Shape	Point geometry
Straight	Taper: Round body that smoothly tapers to a point
Half curved	Cutting: Triangular body, sharp cutting edge on inside
1/4 circle	Reverse cutting: Cutting edge on outside
3/8 circle	Trocar point: Small triangular cutting point & round, tapered body
1/2 circle	Blunt: Blunt tip
5/8 circle
Compound curve

Suture size and Time of removal by Location:

Location	Type of suture*	Timing of suture removal (days)
Arms	4-0	7 to 10
Face	5-0 or 6-0	3 to 5
Hands or feet	4-0 or 5-0	10 to 14
Legs	4-0	10 to 14
Palms or soles	3-0 or 4-0	14 to 21
Scalp	4-0	7 to 10
Trunk	3-0 or 4-0	10 to 14