Surgical Sutures – Basics

prolene
Werneuchen / Public domain
MonofilamentPolyfilament
AbsorbableCaprosyn (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-absorbableNylon
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
absorbability

Suture needles:

ShapePoint geometry
StraightTaper: Round body that smoothly tapers to a point
Half curvedCutting: Triangular body, sharp cutting edge on inside
1/4 circleReverse cutting: Cutting edge on outside
3/8 circleTrocar point: Small triangular cutting point & round, tapered body
1/2 circleBlunt: Blunt tip
5/8 circle
Compound curve

Suture size and Time of removal by Location:

LocationType of suture*Timing of suture removal (days)
Arms4-07 to 10
Face5-0 or 6-03 to 5
Hands or feet4-0 or 5-010 to 14
Legs4-010 to 14
Palms or soles3-0 or 4-014 to 21
Scalp4-07 to 10
Trunk3-0 or 4-010 to 14


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