SUTURES

SURGICAL SUTURES
Uses of Surgical Sutures

 Used by the doctors to close wounds or

other tissues
 Most common medical devise used by
doctors during surgeries
 Helps in holding body tissues together
after a surgery or an injury
CLASSIFICATION OF SURGICAL
SUTURE

 Material of the suture

 Actual Structure
 Being made of Synthetic or
natural material
▪MATERIAL OF THE SUTURE
 Categorized as either absorbable suture or
non-absorbable
 Enzymes in the body can naturally digest the
absorbable suture
 Non-absorbable sutures are usually
removed after a few days of the surgery. They
may also be left in the body permanently,
based on the type of surgery that the patient
has undergone.
•ABSORBABLE SUTURES
 Catgut Sutures
• A catgut suture is a natural, monofilament absorbable
suture which has good tensile strength. The suture retains
optimal strength in order to hold tissues together. Catgut is
a smooth and flexible suture with good knotting, and based
on its size, it completely disappears between 60 to 120
days. The eventual disintegration of this suture makes it
good to use in healing tissues rapidly, such as oral mucosa
• Treated with chromic salt and the suture color is dark
brown.
• Catgut Sutures are made from longitudinally slitting the
intestinal sub mucosa of sheep and goat followed by a
process of twisting and polishing giving the sutures a
virtually monofilament finish.
 Polydioxanone Sutures

• A type of synthetic monofilament suture,

the polydioxanone suture or is used to
repair various kinds of soft-tissue wounds,
abdominal closures. Surgeons also use this
suture during paediatric cardiac
procedures.
 Poliglecaprone Sutures (MONOCRYL)

• The Poliglecaprone suture is a synthetic monofilament

suture, generally used to repair soft tissues. It is commonly
used for the purpose of subcuticular dermis closures on a
patient’s face, and as a ligature. These sutures promote
scar-free, aesthetic healing. The suture material is used in
case of vascular anastomosis procedures that connect blood
vessels.
• This material shouldn’t be used for cardiovascular or
neurological procedures. This suture is most commonly
used to close skin in an invisible manner.
 Polyglactin (Vicryl).
• This synthetic braided suture is good for repairing
hand or facial lacerations. It shouldn’t be used for
cardiovascular or neurological procedures.
• Polyglactin sutures typically have a mild tissue
reaction, for the duration of the absorption
process but are a better alternative to catgut
sutures as the absorption level of this suture is
more predictable.
•NON-ABSORBABLE SUTURES
 Made up of special silk, or synthetics like
polyester, poly propylene or nylon.
 Non-absorbable sutures may or may not
include coatings that enhance their
performance characteristics and are typically
used to close skin wounds.
 The suture is removed after a few weeks.
 Typically used in heart surgeries like vascular
anastomosis procedures (due to the constant
movement and pressure on the heart).
 Cause less scarring since they provoke a
much lower level of immune response, which
is why they are also used in surgeries where
 Nylon. A natural monofilament suture.
 Polypropylene (Prolene). A synthetic
monofilament suture.
 Silk. A braided natural suture.
 Polyester (Ethibond). A braided synthetic
suture.
•ACTUAL STRUCTURE
 Second, the suture material can be classified
according to the actual structure of the
material.
 Monofilament sutures consist of a single
thread. This allows the suture to more easily
pass through tissues.
 Braided sutures consist of several small
threads braided together. This can lead to
better security, but at the cost of increased
potential for infection.
SUTURE REMOVAL

 When your sutures are removed will depend

on where they are on your body. According
to American Family Physician, some general
guidelines are as follows:
 scalp: 7 to 10 days
 face: 3 to 5 days
 chest or trunk: 10 to 14 days
 arms: 7 to 10 days
 legs: 10 to 14 days
 hands or feet: 10 to 14 days
 palms of hands or soles of feet: 14 to 21 days
 To remove your sutures, your doctor will first
sterilize the area. They’ll pick up one end of
your suture and cut it, trying to stay as close
DESCRIPTION AND TYPES OF SUTURE
NEEDLES
 Typically, these needles are rigid enough and
can resist distortion, but also flexible enough,
such that they can bend before breaking.
Depending on the wound being repaired, the
doctor also uses a slim needle that can
minimise trauma. At the same time, it should
be sharp enough so that it can penetrate the
tissue with negligible penetration. The needle
should be stable so that it permits accurate
placement. Suture needles are usually made
of stainless steel and are composed of the
following elements:
 The needlepoint which gently pierces the tissue, starting at the
body’s maximal point and running at the needle’s end. It can
be sharp or blunt.
 The blunt suture needles are designed to penetrate into
muscle and fascia. It can be used to reduce the risk of
potential blood-borne infections arising due to needle-stick
injuries.
 The sharp suture needle pierces and spreads the tissues with
little cutting and is used in areas in which leakage needs to be
prevented.
 The shape of the different types of suture needles varies as
per the curvature and is described in proportion with the circle
completed. The most used curvatures include ¼, ½, 3/8, 5/8,
etc.
 needles are designed to penetrate into muscle and fascia. It
can be used to reduce the risk of potential blood-borne
infections arising due to needle-stick injuries.
ANATOMY OF THE NEEDLE
 The next important aspect of sutures is the
needle. The needle is made up of three
main parts, the eye, body, and point.
 The eye is where the suture attaches to
the needle; this can be an actual needle
eye, where the string threads through or a
point where the suture thread gets swaged
on to the needle (most modern needles
are of this latter type).
 The body is the most substantial part of
the needle and connects the eye to the
point and determines the shape of the
needle. The needle can be straight or
curved, which is more common.
 The circle of a curved needle comes in
different lengths, but most curves are 1/4,
1/2, 3/8, or 1/3 of a circle. The curve is
vital in helping the surgeon know where
the tip of the needle is at all times. Most
skin closure sutures are curved, and
usually 3/8 of a circle.
 Needle tip can be taper or cutting
 Cutting needles have a tip with three sharp
edges, with a conventional cutting needle
having the cutting surface inside the needle
and a reverse cutting needle having it on
the outside of the needle. Reverse cutting
needles are commonly used for sewing skin.
 Taper needles are rounded and can be either
sharp or blunt. They work by piercing the
tissue without cutting it, essentially spreading
the tissue as it passes through it. These are
good for soft and delicate tissues.
Suture Basics

 As the numerical indicator increases, the

width of the suture decreases, indicating a
more fine thread composition. Based on
the tissue characteristics and amount of
tension one expects the suture to endure,
the choice can be made for a specific
suture thread size. Generally, the more
fine the tissue, the less tension of the
wound, and the minimization of scarring
usually indicate the need for a finer, higher
number sized suture.
 For wounds that have deep tissue, dense
connective tissue, or will be under high
tension and require good consistent
apposition, a thicker, or lower number
suture should be implemented.