Surgical Suture

What Is a Surgical Suture?

A surgical suture is one of the most common medical devices used by doctors during surgeries. The suture helps in holding body tissues together after a surgery or an injury. The application of a suture essentially involves the use of a needle along with an attached thread. Today, doctors have access to a wide variety and types of surgical sutures of different sizes, shapes and thread materials.

Most people often confuse the word suture with stitches. However, a suture is simply the name of the medical device used by the doctor to repair the wound, whereas stitching is merely the technique the doctor uses to close the wound.

Types of Surgical Sutures

There are various types of surgical sutures and they can be classified based on different parameters.

Based on Absorbability

All sutures are classified as either absorbable or non-absorbable depending on whether the body will naturally degrade and absorb the suture material over time.

1. Absorbable Sutures

This refers to surgical sutures that are broken down by the body by various biological processes including hydrolysis and enzymatic degradation and as such do not need to be removed at a later time. The process of degradation depends on the material and ranges from ten days to eight weeks.

Absorbable sutures are mostly used to suture internal body tissues.

Examples of Absorbable sutures are Catgut, Polydioxanone (PDS), Polyglactin (Vicryl) and Polyglycolic acid.

2. Non-absorbable Sutures

Non-absorbable sutures, as the name implies are surgical sutures that cannot be absorbed by the body as such need to be removed at a later time.

Sometimes, they are left in situ permanently. Non-absorbable sutures are used either on skin wound closure, where the sutures can be removed after a few weeks or in stressful internal environments where absorbable sutures will not suffice.

Examples of non-absorbable sutures include Silk, Nylon, Polyester, Polypropylene. Also, Stainless steel wires are commonly used in orthopedic surgery and for sternal closure in cardiac surgery.

Common periods of time for removal are as follows, but times vary according to the health care professionals that perform the procedure:

Face: 3-5 days

Neck: 4-6 days

Scalp: 7-12 days

Trunk: 6-10 days

Upper extremity: 8-14 days

Extensor surface of hands: 10 days

Lower extremity: 14-28 days

Joints: 14 days

Dissolvable sutures may disappear in a week or two, but some take several months.

Based on Structure

Surgical sutures can also be classified based on the structure of the material.

1. Monofilament Sutures

The monofilament suture material is made of a single strand; this structure is relatively more resistant to harboring microorganisms. It also exhibits less resistance to passage through tissue than multifilament suture does.

However, great care must be taken in handling and tying a monofilament suture, because crushing or crimping of the suture can nick or weaken it and lead to undesirable and premature suture failure.

Examples of monofilament sutures are Nylon, Prolene, Polydioxanone (PDS).

2. Multifilament Sutures

The multifilament suture material is composed of several filaments twisted or braided together. It generally has greater tensile strength and better pliability and flexibility than monofilament suture material, and it handles and ties well.

Examples of multifilament sutures are silk, vicryl, polyglycolic acid (PGA).

In conclusion, the correct choice of suture is very important for wound healing. In addition to using the correct size and selecting the correct material, using the correct instrumentation and suturing technique is important to reduce tension and scarring.

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