Basics of Sutures

3 main properties of a suture material

What are the 3 main properties of a suture material?

Properties

Absorbable/non absorbable sutures
Monofilament/ braided
Synthetic/ natural

Absorbable/non absorbable is classified by the days of suture breakdown. <60 days or >60 days. The absorbable sutures usually breaks down less than 60 days due to proteolytic action from the normal immune system by a release of enzymes to breakdown.

Monofilament/braided is classified according to the character of the suture. Monofilaments has a single rounded cross section, which is usually used to suture organs and tissues that leaks or has a high tendency to contract surgical site infection. Braided sutures has multiple sutures interlaced to each other and this creates a higher grip if the suture is tied. However it is associated with leaks and higher cutting tendency. It has a tendency to cut through tissue as how a giggly saw works. Usually braided sutures are used for tough tissues such as skin or tendons where movements and tension is high.

Synthetic/natural sutures are important to note. Sutures are a foreign material. Synthetic material has a lower tendency to cause an allergic reaction whereas a natural suture has a tendency to cause allergic reaction.
A history of natural sutures. Previously surgeons love to use catgut/cattle gut sutures which are a natural suture developed from the gut of a cattle because they are absorbable. There was a time where patients suddenly developed the Creutzfeldt-Jacob disease as a result of using catgut and nowadays it has been replaced by a synthetic absorbable suture vicryl.

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