|
Sutures are a fundamental component in all surgical practice and specialties.
Suture characteristics:
- Absorbable vs. Non-absorbable
- Monofilament vs. braided
- Natural vs. synthetic
Suture properties:
- Tensile strength
- Needle properties (cutting, blunt, tapered cut)
- Needle shape (J, straight, curved etc)
- Manufacturers also look at other properties such as elasticity, capillarity, fluid absorption, knot strength. Seldom do they have significant clinical relevance in day to day use.
Size of suture material
If the size is denoted as 3-0, 2-0, the higher the numerical value of the number on the left smaller the diameter of the suture.
Also 1-0 = 0, Therefore you do not usually come across label 1-0
If the size is denoted as 0, 1, 2 etc, the higher the numerical value of the number the bigger the diameter of the suture.
Different suture material available for use today:
Prolene: (polypropylene)
Non absorbable, synthetic, mono-filament suture. Also has significant memory, (i.e. if folded or bent will hold that position). Used for securing meshes (3-0 /2-0 prolene�), vascular anasatamoses / repairing vessel (5-0/6-0 smaller sizes typically used, 4-0 may be used in the aorta) where permanence is key.
Vicryl: (polyglactin)
Absorbable, synthetic, braided suture. Has a wide variety of uses, from vascular ties to suture of subcutaneous tissue. Vciryl rapide can be used for skin closure as a subcuticular stitch and has a median tensile strength of approximately
50% tensile strength will be lost after 6 weeks, (Vicryl rapide 2 weeks)
PDS: (Polydioxanone)
Absorbable, synthetic, monofilament suture. Smaller sizes (3-0 PDS) is used for bowel anastomoses. Larger diameter sutures (especially the looped suture) is used for mass closure of laparotomy wounds.
50% tensile strength lost after 6 months
Silk:
Non-absorbable, natural, braided suture. Typically used for external puposes, securing drains etc.
Monocryl:
Absorbable, synthetic, monofilament suture. Widely used for skin closure
50% tensile strength lost after 7 days
Other suture materials
Nylon (Ethilon) - non absorbable, synthetic, braided)
Catgut - absorbable, natural, seldom used
The ideal suture material:
- Cheap
- No tissue reaction (minimal inflammation)
- Inert(non allergenic, non electrolytic)
- Maximum initial tensile strength / high breaking strength
- Easy to handle
- Universal use
- No memory
- Easily sterilised
Author:
Mr Kasun Wanigasooriya MBCHB, MRCS
| Speciality:
General Surgery
| Date Added:
30/06/2014
|