What are Absorbable Sutures?

When undergoing surgery, sutures are necessary to close wounds and promote healing. Traditionally, non-absorbable sutures were used, requiring a follow-up appointment to remove them. However, with advancements in medical technology, absorbable sutures have become increasingly popular. 

Absorbable sutures are typically made from materials the body can naturally break down. As the body breaks down these materials, they are gradually absorbed and eliminated, leaving behind a healed wound and eliminating the need for removal. 

During surgery, the use of absorbable sutures is generally similar to that of non-absorbable sutures. The surgeon will close the wound using the suture, tying it off to ensure proper wound closure.

However, not all absorbable sutures are created equal. Different types of absorbable sutures have varying strengths and breakdown rates, which can impact their effectiveness in wound closure.

Types of Absorbable Sutures

Let’s discuss the different types of absorbable sutures and how they may vary in terms of strength and breakdown rate: 

• Polyglactin (Mitsu) Sutures: Polyglactin sutures are popular for wound closure. They have excellent tensile strength and can maintain wound support for up to 42 days. They are made of a synthetic polymer designed to dissolve slowly and get absorbed by the body within 56 to 70 days.

• Catgut Sutures: Catgut suture is a type of absorbable suture made from the sub mucosa of sheep or goat intestines. Traditionally, it has been used for centuries in various surgical procedures, but it is less common today due to the availability of synthetic absorbable sutures. Catgut suture is known for its rapid breakdown rate.
• Poliglecaprone 25 (Filapron) Sutures: Poliglecaprone sutures are a type of absorbable sutures made of a synthetic polymer designed to break down quickly and be absorbed by the body within 90 to 120 days. They have excellent tensile strength and are perfect for procedures requiring Subcutaneous Layer Closure.
• Polydioxanone (Filaxyn) Sutures: Polydioxanone sutures are another synthetic option designed to dissolve slowly over time. They are particularly useful for procedures that require extended wound support, as they can maintain tensile strength for up to 180 days. They are often used in surgeries that involve internal organs or tissues. Filaxyn suture is often used in surgeries that require extended wound support, such as internal organ or Fascia tissue repair.

Benefits of Absorbable Sutures

There are several benefits to using absorbable sutures. Some of them are as follows:

• They are cost-effective and eliminate the need for a second surgery to remove the sutures, thus saving time and reducing the risk of complications.
• Absorbable sutures are also less likely to cause an inflammatory reaction, which can help reduce the risk of infection and promote faster healing.
• They offer excellent tensile strength and can maintain their integrity for an extended period, giving surgeons more time to complete the procedure without the sutures breaking or degrading.
• Absorbable sutures are available in different materials, allowing surgeons to choose the most appropriate type for the specific procedure.
• They are suitable for various surgical procedures, including orthopedic surgery, plastic surgery, and gynecological procedures.
• Lastly, absorbable sutures may reduce scarring as they do not leave behind permanent suture marks.

Recovery and Healing with Absorbable Sutures

After surgery, the healing process with absorbable sutures is generally similar to that with non-absorbable sutures. Patients may experience swelling and pain, which can be managed with medication and other therapies. Additionally, patients may need to follow specific care instructions, such as changing wound dressings or avoiding certain activities that may strain the wound.

Following your surgeon’s post-operative care instructions is essential to ensure proper wound healing. While absorbable sutures eliminate the need for suture removal, they still require proper care to prevent infection and ensure proper healing.

Conclusion

In conclusion, absorbable sutures offer a range of benefits for both surgeons and patients. They eliminate the need for suture removal, reduce infection risk, and improve wound healing outcomes. However, as a patient, it is important to know the type of sutures your surgeon plans to use and what to expect during and after your procedure. By understanding the benefits and limitations of absorbable sutures, you can play an active role in your healthcare and achieve the best possible outcomes. 

FAQs

Q: How do absorbable sutures differ from non-absorbable sutures?
A: Absorbable sutures are designed to break down over time and are made from materials that can be naturally absorbed and eliminated by the body. On the other hand, non-absorbable sutures are not intended to be broken down by the body and require removal by a healthcare professional.

Q: How long does it take for absorbable sutures to break down?
A: The breakdown time for absorbable sutures will vary depending on the material type used. Some absorbable sutures may break down within a few weeks, whereas others may take several months.

Q: Do patients need to follow special care instructions after surgery with absorbable sutures?
A: Yes, patients will still need to follow specific care instructions after surgery with absorbable sutures to ensure proper wound healing. This may include changing wound dressings, avoiding certain activities, and taking prescribed medications as directed by their healthcare provider.

Reference links:

• https://www.sciencedirect.com/topics/medicine-and-dentistry/polyglactin#:~:text=This%20suture%20has%20similar%20handling,but%20has%20more%20tensile%20strength.&text=After%20tissue%20placement%2C%20polyglactin%20retains,resorbed%20after%2056%E2%80%9370%20days.
• https://www.healthline.com/health/sutures#types
• https://www.sciencedirect.com/topics/nursing-and-health-professions/catgut-suture
• https://www.vin.com/apputil/content/defaultadv1.aspx?id=7259127&pid=14365&print=1#:~:text=Monocryl%20loses%2070%25%20to%2080,in%2090%20to%20120%20days.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044756/#:~:text=Complete%20absorption%20of%20PDS%E2%84%A2,at%2014%E2%80%9328%20days%20postimplantation.&text=PDO%20clips%20can%20take%20more%20than%20180%20days%20to%20fully%20degrade.
• https://www.merillife.com/blog/medtech/everything-you-want-to-know-about-absorbable-sutures

What is a cardiac valve?
The cardiac valves are structures in the heart that regulate blood flow through the heart’s chambers and into the major blood vessels. The cardiac valves are crucial for overall cardiovascular health. Problems with the valves can cause various health issues. Treatment options may include medication or surgery.

What is valve replacement surgery?
Valve replacement surgery is when a diseased or damaged heart valve is replaced with a new valve. Several types of valves can be replaced, like the aortic valve, mitral valve, tricuspid valve, and pulmonary valve. The specific procedure used to replace a valve will depend on the location, the type of valve being replaced, and the patient’s overall health.

Importance of Sutures in Valve Replacement Procedure
The significance of sutures in valve replacement procedures cannot be overstated. Their importance is stated as follows:

• Secure Replacement Valve in Place: Sutures are used to secure the replacement valve in place once it has been implanted. The suture material attaches the replacement valve to the surrounding tissue. It must be strong and secure, so the replacement valve stays in place and functions properly.  The suture material is usually passed through the surrounding tissue and then tied off, creating a secure connection between the replacement valve and the surrounding tissue. Hence, the suture material must be strong enough to withstand the forces exerted on the valve during normal cardiac function and be flexible enough to allow the valve to close and open properly. 

• Promotes Healing: Surgical sutures also play an important role in promoting healing after a valve replacement procedure. They help close the incision made during the surgery. Their placement and technique are essential in ensuring that the scar is minimal and as inconspicuous as possible. However, the type of suture used can also impact healing time and the risk of complications.

• Prevention of Complications: Each valve replacement requires a specific suture and suture technique to avoid risks and complications. Properly placed and tightened sutures can help minimize complications such as blood clots, heart failure, a periprosthetic leak, prosthesis-patient mismatch, and surgical site infections.

Importance of Suture Techniques and Materials in Valve Replacement Procedure

Suture Techniques
Multiple suture techniques may be used in valve replacement, including:

1. Interrupted Suturing: In this technique, individual sutures are used to secure the prosthetic valve to the surrounding tissue. The sutures are placed at regular intervals along the circumference of the valve annulus, ensuring a secure attachment.
2. Continuous Suturing: Continuous suturing involves the use of a single suture thread that is passed through the valve annulus in a continuous manner. This technique provides a more secure and watertight closure compared to interrupted suturing.
3. Modified Continuous Suturing: This technique is a variation of continuous suturing. Instead of using a single continuous suture, multiple short segments of suture thread are used. This allows for better control and adjustment of tension at various points around the valve annulus.
4. U-Shape Suturing: In this technique, U-shaped sutures are used to secure the prosthetic valve. The sutures are passed through the valve annulus and tied on either side, creating a U-shape that holds the valve in place.
5. Horizontal Mattress Suturing: This technique involves the use of sutures that pass through the valve annulus in a horizontal direction, creating a “mattress” effect. This technique provides good tissue approximation and helps distribute tension evenly.

Apart from these the major suturing technique that is used most often for suturing is the Pledgeted Suturing Technique

The pledgeted suturing technique is commonly used in valve replacement surgery to reinforce the suture line and provide added security. Pledgets are small pieces of felt or Teflon-like material that are placed on the sewing ring of the prosthetic valve. These pledgets act as a cushion between the suture and the delicate tissue of the heart, helping to distribute the suture tension more evenly and reduce the risk of tearing or tissue damage.
Here’s how the pledgeted suturing technique is typically performed in valve replacement surgery:

1. After the diseased valve is removed and the annulus (the ring of tissue where the valve sits) is prepared, the prosthetic valve is positioned in place.
2. The surgeon uses sutures (commonly non-absorbable sutures like braided polyester) to secure the valve to the annulus. These sutures are typically passed through the sewing ring of the prosthetic valve and then through the tissue of the annulus.
3. Prior to tying the suture, a pledget is placed on the ventricular (lower) side of the annulus. The pledget is positioned between the annulus tissue and the suture.
4. The suture is then tied, securing the prosthetic valve in place. The pledget acts as a protective layer between the suture and the heart tissue, minimizing the risk of tearing or cutting into the tissue.

The pledgeted suturing technique helps to provide a more secure attachment of the prosthetic valve while reducing the potential for damage to the delicate heart tissue. By distributing the tension more evenly, it can help improve the longevity and durability of the valve replacement.

Suture Materials

The choice of suture material depends on several factors, including the type of tissue being sutured, the surgeon’s preference, and the specific requirements of the surgery. A cardiac surgeon will determine the most appropriate suture material based on these considerations.

Currently the industry standard for the suture material being used for valve replacement is Polyester. Usually a braided polyester suture with a ½ circle Taper cut Needle in a combination of green and white colors and PTFE pledgets is used for securing the prosthetic valve in place. It has excellent handling characteristics and also provides good knot security.

Dangers of Choosing the Wrong Kind of Suture Material and Technique

Choosing the wrong suture material for valve replacement surgery can potentially lead to various complications and adverse outcomes. Here are some dangers associated with using an inappropriate suture material:

1. Suture Breakage: If an insufficiently strong suture material is used, there is a risk of suture breakage, particularly in high-stress areas. This can result in the prosthetic valve becoming loose or dislodged, compromising its function and potentially leading to valve failure.
2. Suture Degradation or Absorption: Using an absorbable suture material in valve replacement surgery can be problematic. Absorbable sutures are designed to break down and be absorbed by the body over time. However, in valve replacement surgery where long-term durability is crucial, the suture material needs to remain intact and provide long-lasting support. Absorbable sutures may degrade prematurely, leading to valve instability or failure.
3. Tissue Damage and Suture Cutting: Inadequate suture material can cause tissue damage, especially if it is too sharp or lacks proper cushioning. This can result in tissue tearing or cutting, leading to bleeding, leakage around the suture line, or compromised tissue integrity.
4. Infection Risk: The choice of suture material can influence the risk of post-operative infections. Certain suture materials may be more prone to harboring bacteria or promote bacterial adherence, increasing the likelihood of surgical site infections. This can have detrimental effects on the healing process and overall patient outcomes.
5. Tissue Irritation or Reaction: Inappropriate suture materials may cause tissue irritation, inflammation, or allergic reactions in some individuals. This can impede proper healing, lead to discomfort or pain, and potentially require additional interventions for resolution.

To minimize these risks, it is essential for the surgeon to carefully select the appropriate suture material based on factors such as tissue type, surgical technique, patient characteristics, and the specific requirements of the valve replacement procedure. Close adherence to established surgical guidelines and the expertise of the surgical team are vital in ensuring the use of the most suitable suture material to achieve optimal outcomes in valve replacement surgery.

Conclusion

With all the benefits of a new valve and increased longevity, it is no wonder that people are eager to undergo a cardiac valve replacement procedure. However, it is important to choose the correct procedure for you. Ensure you get proper preoperative and postoperative care for the best outcome from your treatment. Early consultation with a cardiac surgeon is the best way to determine which procedure is best for you. Suppose you are considering a valve replacement procedure. In that case, you should be aware of the steps involved in the procedure and the types of valves available.

FAQs
 
Q. What is the importance of surgical sutures in valve replacement procedures?
A. Surgical sutures are used to secure the replacement valve and ensure it functions properly. The suture material attaches the new valve to the surrounding tissue. Therefore, it must be strong and secure to withstand the forces exerted on the valve during normal cardiac function. Additionally, sutures play a crucial role in promoting healing after the surgery, helping to close the incision made during the procedure and minimize scarring.
 
Q. What are cardiac valves, and why are they essential for overall cardiovascular health?
A. Cardiac valves are structures in the heart that regulate blood flow through the heart’s chambers and into the major blood vessels. There are four main types of cardiac valves: the aortic valve, mitral valve, tricuspid valve, and pulmonary valve. These valves are essential for overall cardiovascular health because they ensure that blood flows through the heart in the correct direction, preventing backflow and ensuring all body parts receive the oxygen and nutrients they need.

Q. What are the different types of suture material that can be used in valve replacement procedures, and how are they chosen?
A. Currently the industry standard for the suture material being used for valve replacement is Polyester. Usually a braided polyester suture with a ½ circle Taper cut Needle in a combination of green and white colors and PTFE pledgets is used for securing the prosthetic valve in place. It has excellent handling characteristics and also provides good knot security.

Q. Which suture techniques may be used in valve replacement procedures, and how do they differ?
A. The pledgeted suturing technique is commonly used in valve replacement surgery to reinforce the suture line and provide added security. Pledgets are small pieces of felt or Teflon-like material that are placed on the sewing ring of the prosthetic valve. These pledgets act as a cushion between the suture and the delicate tissue of the heart, helping to distribute the suture tension more evenly and reduce the risk of tearing or tissue damage.
Here’s how the pledgeted suturing technique is typically performed in valve replacement surgery:

1. After the diseased valve is removed and the annulus (the ring of tissue where the valve sits) is prepared, the prosthetic valve is positioned in place.
2. The surgeon uses sutures (commonly non-absorbable sutures like braided polyester) to secure the valve to the annulus. These sutures are typically passed through the sewing ring of the prosthetic valve and then through the tissue of the annulus.
3. Prior to tying the suture, a pledget is placed on the ventricular (lower) side of the annulus. The pledget is positioned between the annulus tissue and the suture.
4. The suture is then tied, securing the prosthetic valve in place. The pledget acts as a protective layer between the suture and the heart tissue, minimizing the risk of tearing or cutting into the tissue.

The pledgeted suturing technique helps to provide a more secure attachment of the prosthetic valve while reducing the potential for damage to the delicate heart tissue. By distributing the tension more evenly, it can help improve the longevity and durability of the valve replacement.

Q. Which type of suture is the best for cardiac valve replacement surgery?
A. Polyester Sutures are considered the best for Valve replacement surgery as they provide excellent handling characteristics and good knot security.

Introduction

Any bodily abnormality may be genetic or caused due to injury, infection, exposure to radiation, or any reason that would affect a person’s appearance and, eventually, one’s self-esteem and sense of worthiness. As a medical specialty, plastic surgery covers a range of procedures that aim to improve a person’s appearance, repair and reconstruct bodily abnormalities and restore normal functions. Plastic surgery is a broad surgical field with two main areas: reconstructive surgery and cosmetic surgery. These surgeries often involve making incisions on the skin, which requires the use of sutures to close the wound and promote proper healing. Sutures are used to bring the edges of the skin together and hold them in place while the body naturally repairs itself. Various types of sutures are used in plastic and cosmetic surgeries, each with unique properties and benefits. Understanding the differences between these sutures is crucial for surgeons to choose the appropriate type for each patient and to achieve the best aesthetic outcome.

This article will discuss some of the most commonly used sutures in plastic and cosmetic surgeries and their advantages.

What is Cosmetic Surgery?

Surgery that focuses on improving and enhancing a person’s physical appearance is known as cosmetic surgery. Cosmetic surgery is performed on people who are otherwise healthy and want to improve or enhance their appearance for personal, aesthetic reasons.

The face, breasts, abdomen, arms, and legs are just a few of the body parts that might undergo cosmetic surgery. Breast augmentation, liposuction, rhinoplasty, facelifts, and stomach tucks are a few of the most popular cosmetic surgery operations.

Each patient’s personal goals and preferences are considered during the highly individualised cosmetic surgery procedure. Patients typically speak with the surgeon before a cosmetic operation to go over their expectations, goals, and any possible issues. The surgeon will then evaluate the patient’s health and suggest the best course of action.

Cosmetic surgery entails risks and potential problems, just like any other form. To pick a trained and experienced surgeon who can carry out the treatment safely and successfully, patients should carefully weigh the risks and benefits of the procedure.

What is Reconstructive Surgery?

Reconstructive surgery is performed to repair the abnormality of the person’s body part. This type of surgery mainly aims to treat any such abnormality, whether caused by birth or due to injury, disease, age, or any other reason and restore the normal appearance and function of such body parts.  

The discipline of plastic surgery is intricate and complex, requiring a lot of training and specific knowledge. Plastic surgeons must thoroughly understand anatomy, wound healing, and several surgical procedures. There are many various kinds of plastic surgery operations, such as liposuction, facelifts, rhinoplasty, and breast augmentation. Every procedure is carried out with the utmost care and precision and customized to the specific patient’s demands and goals.

It is important to remember that cosmetic and plastic surgery is different. Despite their frequent confusion, reconstructive and cosmetic operations are included in the broader field of plastic surgery. While cosmetic surgery seeks to improve the appearance of a generally healthy person, reconstructive surgery aims to restore function and normal appearance following an injury or sickness. 

Plastic surgery’s main aim is the reconstruction of facial and bodily defects and, by nature, is reconstructive. 

What are commonly used sutures in plastic and cosmetic surgery?

An ideal suture must cause the least injury to the tissue and skin, the least tissue reaction, one that is easy to handle, has high tensile strength, provides proper knot security, and can be used in any tissue. However, factors such as the wound type, infection risk, the healing time required, suture properties, patient’s skin type, age, and genetic history decide the selection of sutures in plastic and cosmetic surgery. 

Every single plastic and cosmetic surgery procedure has its own set of sutures, depending on the operation and the result expected from the surgery.

Titanium Sutures

Titanium suture is made of titanium alloy wire. It is strong yet has a low rate of infection. It is used alongside other less invasive sutures, like polyglactic catgut or polyglycolic acid. It is non-absorbable, which means they are not absorbed by the body. These sutures do not leave scars, so they are ideal for many cosmetic procedures like face lifts, augmentation surgeries, tummy tucks, and hair transplants. However, it is not recommended for liposuction procedures.

Chromic Catgut Sutures

Of all the sutures commonly used in plastic or cosmetic surgery procedures, chromic catgut suture is the strongest, made of natural fibre. It is highly absorbable, which is ideal for reconstructive surgeries. It can be used in many body parts like the face, hands, feet, and joints. It is flexible and pliable with high tensile strength, which makes it perfect for procedures like hand revisions, joint revision surgeries, and facial surgeries like brow lifts and facelifts. Chromic catgut sutures are available in both natural and black colours. The natural variety is more suitable for lighter skin tones, while the black one is ideal for darker skin tones.

Polyglactin Sutures

The most popular alternative for general soft tissue approximation is the Polyglactin Suture, made of a synthetic braid and suitable for treating wounds on the hands and face. This suture is also utilised during vascular anastomosis procedures, just like the Poliglecaprone suture. In contrast to catgut sutures, polyglactin sutures have a more predictable absorption level and usually cause a modest tissue reaction for the duration of the absorption process. Moreover, there is little to no tissue reactivity to this suture.

Monofilament suture: nylon and prolene

These sutures are made from synthetic fibre and are non-absorbable and strong. They are used for reconstructive surgeries like hand and foot surgeries, shoulder repairs, and facial procedures like brow lifts, blepharoplasties, and jawline revisions. Monofilament sutures are available in various colours, like green, blue, and red. Moreover, they are suitable for all skin types, making them an ideal choice for cosmetic surgery. 

Metallic threads: silver, gold, and platinum

These threads are metal and ideal for ear tuck surgeries and nose reshaping. However, they are not suitable for liposuction procedures. They are the most expensive sutures and must be cared for carefully by the surgeon.

Silk Fibre Suture: Cohesive and Non-cohesive

Silk fibre sutures are made from the filament of a silkworm. They are an ideal option for cosmetic surgeries like facelifts and laser resurfacing. They are also suitable for reconstructive surgeries like hand reconstruction and joint replacement. They can be used in a variety of body parts like hands, feet, face, ears, and lips. 

Short bowstring sutures

In this suture, a short string made of silk is tied around the base of the needle. The needle is then inserted into the body part, which makes this suture quite similar to a monofilament suture. However, it is available in a shorter length of 5mm compared to the 9mm of a monofilament suture. It is strong, flexible, and pliable, which makes it an ideal option for cosmetic surgeries such as eyelid surgery, facelifts, blepharoplasties, and body contouring surgeries.

Bottomline

There is no denying that plastic and cosmetic surgeries can change your life for the better. If you are thinking of getting one done, make sure you research thoroughly and find a qualified surgeon. Many types of sutures are used in plastic and cosmetic surgeries, each with advantages and disadvantages. 

Suture and Needle choices vary depending on the type of surgery and the patient’s needs. Therefore, knowing the differences between these different types of sutures and when to use them is important to get the best outcome from your surgical procedure. Using the wrong type of suture can lead to undesired surgical outcomes, damage to surrounding tissue or organs, and chronic pain. This can lead to undesired wound healing and complications during recovery, which may require re- suturing for proper wound healing. Suture usage vary on the type of Tissue, patient age as well as the Type of surgical procedure in which suturing needs to be performed. Suturing promotes wound healing by approximating the layers of the tissue and enabling the natural healing process. It also closes the wound thus avoiding the wound to get contaminated by the atmosphere.

What is a suture?

A suture is a surgical device used to close any surgical or traumatic wound requiring skin & tissue closure. A closure is intended to primarily repair skin and deeper layers of the tissue and fascia to fast-track wound healing. Some examples of sutures include monofilament sutures, monofilament polyester sutures, and large absorbable sutures. They are used for repairing cuts and wounds that are deep and open. Sutures are used to close wounds by first suturing the edges together and then using the suture to tie off the wound. After the wound has healed, the suture is either removed or absorbed naturally into the body.

Types of Sutures

Historically, similar to modern sutures, different forms of wound closure mechanisms were employed with needles made of bone and suture materials running from flax, bark, silk, human hair, reeds, etc. Today, there are many options for sutures. Hence, it becomes crucial to make the right suture choice, which means understanding the purpose, attributes, and features of each type of suture. It also means understanding the difference in filament types and the different needle types and under which clinical procedures they have been designed for use. The correct suture helps the surgeon with the right technique and choice of incision to execute and handle the surgical procedure, provide the correct strength, and secure the knots in a manner that can handle and tolerate wound changes during the healing process.

Suture material types are classified as follows:

Absorbable and Non-absorbable Sutures

Absorbable sutures, which get absorbed by the body naturally, are typically employed for deep temporary closure for tissues to heal, and the sutures lose most of their tensile strength over a period of time ranging from weeks to months. Non-absorbable sutures do not get absorbed by the body and hence are required to be removed after a few days of the surgery or may be left in the body permanently. These sutures are used for long-term tissue closures, wounds that take time to heal, like in the case of hernia fascia defects closure. 

Natural and Synthetic Sutures

Sutures are further classified into natural and synthetic sutures. Natural sutures are derived from natural substances. For example Catgut Sutures are usually derived from collagen derived from bovine Guts (used for internal lacerations or wounds). Another Examples of Natural sutures are silk sutures (used in general soft tissue closure and ophthalmic surgery). Catgut degrades by enzymatic reactions (breaking down of proteins partially as peptides or completely as amino acids). They can cause inflammation at the suture site. Synthetic sutures are derived from artificial sources and are made from materials like Nylon sutures (used for general closures and plastic surgery) which is non-absorbable in nature. Synthetic absorbable sutures like Polydioxanone (PDS) sutures (used in abdominal closures or pediatric cardiac procedures) degrade by hydrolysis (the polymer structure of the filaments gets broken down with water penetrating the suture strands) which causes less inflammation at the surgical site. 

Monofilament or Multifilament

Based on the structure, sutures are classified as Monofilament or Multifilament sutures.

Monofilament sutures are single filament sutures with less surface area and higher memory. By memory, we mean the tendency and capacity of a suture to return to its original shape, which makes a suture significantly prone to the knots loosening. They require greater handling and care in the form of more knots to ensure security and less fracture. Monofilament sutures have the capacity to pass through tissues easily, causing less inflammation. 

Whereas Multifilament sutures, as the name suggests, are braided or twisted sutures that are easier to handle by the surgeon as they hold the knots with greater security and less memory. They are prone to inflammation and infection. Multifilament sutures are more expensive than traditional sutures. 

The following are the most commonly used sutures in Surgeries: 

Monofilament sutures, made of a single synthetic strand, are typically used in skin

Closures and Ligation of blood vessels. 

Polypropylene sutures are the synthetic non absorbable sutures; these are typically used in soft tissue closures and are less likely to cause allergic reactions.

Dressings sutures are used to close wounds and stop bleeding. They are typically made of silk, Nylon, or synthetic materials. 

Epithelial sutures are used to close and repair minor wounds. They are made of proteins and are typically used with tissue types such as skin, mucous membranes, and cartilage.

Soft Tissue sutures are used to close wounds in soft tissue such as muscle and tendons. They are also used to support joints and may be made of polyester or polypropylene.

Some sutures are specially used to repair veins and arteries. They are made of polypropylene, Polyester & Nylon.

Needle Types 

The needle is indeed the next most important aspect of sutures after identifying the correct suture type. Needle quality and the appropriate needle choice for a given surgery go a long way to determining the success of the surgery. The surgical needle is mainly built from stainless steel, making it corrosion-resistant. In surgical parlance, the needle has three main parts – the Swage point, the body, and the point. The Swage point is where the surgical suture attaches to the needle by stringing through. The body connects the eye to the point and decides the shape of the needle. In most cases, the needle is curved, but in some cases, it is straight. Curved needles come in different circle lengths like ¼, ½, ⅓, or ⅜ of a circle. The nature of the wound or tissue helps a surgeon choose the needle curve length. The surgeon needs to know where the needle tip is at all times, as it aids in skin closures with minimum trauma. A wrong surgical needle type can lead to tissue injury. The ideal needle is one that is flexible enough to bend yet rigid enough to withstand distortion. It should be sharp to pierce through tough tissues yet thin to cause minimum trauma. Stability of the needle to ensure accurate placement is also equally required. Thus, an appropriate surgical needle must be sterile, corrosion-resistant, and firm enough to prevent any bending or distortion, prevent tissue trauma and injury, and ensure easy penetration. 

Different types of needles are based on the tip, like taper needles or cutting ones. Cutting needles have a tip with three sharp edges. In a typical conventional cutting needle, the cutting surface is inside the needle. In contrast, a reverse cutting needle used most commonly for sewing skin has it on the outside. Whereas taper needles are round and can be either blunt or sharp and are recommended for soft and delicate tissues and tendon repair. They typically pierce the skin without cutting it and spread the tissue as it passes through.

Summary

The right type of suture will prevent issues with excessive bleeding, damage to surrounding tissue or organs, and chronic pain. The thickness of the tissue, the location of the tissue, the risk of infection, and the amount of tension, along with different anesthesia requirements and patient age, play an important role in determining which type of suture to use. There needs to be more than the right type of suture to yield the desired surgical results. The correct choice of needle is equally essential and needed for a wound to be sutured with accuracy, precision, and minimal trauma, ensuring fast healing and preventing tissue reaction and inflammation.

FAQs :

Why is it important to use the correct suture technique?

It is important to use the correct suture technique for precision, minimal trauma to the wound at the surgical site and for faster healing.

Why is knowledge of suture material so important?

The knowledge of the right suture material is very important to the surgeon to maximize tissue healing and ensure scar aesthetics and minimal tissue trauma and inflammation at the surgical site.

What factors influence the surgeon’s choice of suture materials?

The main factors that influence a surgeon’s choice of suture materials are

• Healing time of the wound or tissue
• Wound type and strength
• Properties of the suture material
• Faster attachment of suture and tissue