Absorbable Sutures Definition
Absorbable sutures definition can be a challenging subject. Because there are so many different suture types, what can be used depends on the patience, doctor and the wound.
Absorbable sutures are sutures that break. Water penetrates the sutures and causes the polymer chain to break. As a result, synthetic absorbable material tends to elicit less tissue response than normal or chromic gut. Many synthetic absorbable polymer sutures are available today.
Material of the Suture
- Natural sutures:
These are sutures made from materials found in nature. Materials such as catcut, collagen, silk, cotton and linen are used in the production of these sutures. Although these sutures are economical, they are not preferred because of the high risk of tissue reaction and unpredictable absorption times. This kind of absorbable suture types are best used on the skin.
- Synthetic sutures:
Sutures made from non-naturally found materials created by man. The risks of tissue reaction are minimal and they have predictable absorption times. Some of these materials are dexon, maxon, steel, vicryl, PDS, dacron, mercilne, nylon, ethylene, polypropylene and prolene. This materials are in absorbable sutures definition, but also some of them can be used as non absorbable.
Monofilament Sutures
These are an absorbable suture material that consist of a single string, have the feature of easy passage through the tissue, have a non-capillarity feature (do not carry the spaces where bacteria can settle), have a smooth structure, have low friction power, have minimal tissue trauma and cause less reaction. It is very suitable for cosmetic wounds (they are used a lot in plastic surgery).
They are the most suitable sutures for contaminated and traumatic wounds, for example, these types of sutures are preferred in overweight and diabetic patients. It is easier to knot in monofilament sutures, but their knot security is weak, so more knots should be tied when these sutures are used. When they are held with a tool, they lose their tensile strength to a large extent and they can break easily, so we should not hold these ropes with a tool as much as possible. You should only ask your doctor the quesiton of how long does it take for absorbable stitches to dissolve because the asnwer depends on you and your wound.
They have a very strong memory, so when we take the thread out of its box, it does not open like a flat strip in front of us, and they are usually in the form of a round ring. Therefore, before starting the sewing, we need to hold the thread at both ends and stretch it, otherwise we may encounter unwanted knots during sewing. There are absorbable or non-absorbable types. So these can take part in absorbable sutures definition. They can be of natural or synthetic nature.
Multifilament Sutures
These sutures consist of multiple threads being brought together and knitted or wrapped. As they are strong, flexible and soft, their knot security is high. Since they are flexible, they are easier to use and more robust. They are wear resistant. They are mostly preferred in the surgery of intra-abdominal organs.
It has capillary features (there are indentations and protrusions on the thread). Capillarity can be reduced by coating, but cannot be completely destroyed, so it is not suitable for use on infected or high risk of infection wounds. Due to their capillarity properties, they hardly pass through the tissue and there is a high risk of tissue damage and reaction. They can be of natural or synthetic nature. They are in the absorbable sutures definition but there are non-absorbable types as well.
Absorbable Sutures Types
Absorbable sutures definition can be expalined as sutures that are washed by tissue enzymes or body fluids in the tissue over time and generally lose their tensile strength within 60 days. The suture provides tissue support in a predictable time, does its job and is absorbed by the body over time by hydrolysis (synthetic) / enzymatic (natural) reaction. No foreign body remains in the body.
They are generally used to cover the deepest parts of the wound, they can also be used on the skin surface according to the patient and wound condition. These surgical threads, which are produced in different tissues such as monofilament and multifilament, are very easy to use.
The rate of absorption of these sutures may vary depending on the type of suture, type of tissue (wet or moist areas), general health status of the patient (febrile illness, infection, nutritional deficiency increase the rate of absorption). Examples of absorbable sutures brand names and materials are chromic, plain(catgut), vicryl, PDS, Dexon, maxon.
Non-Absorbable Sutures
These are sutures that are not digested by body enzymes or hydrolyzed by body fluids, that is, they remain in the body as a permanent foreign body. Since non-absorbable sutures are easy to use and have a soft structure, they are frequently preferred in surgical operations today. This is the difference between absorbable sutures definition and non absorbable suture.
Non absorbable suture uses are also preferred because they can be knotted easily and provide permanent tissue support. They are produced in different tissues as monofilament and multifilament. Silk, stainless steel, polyester, cotton, polypropylene (prolene), nylon types are examples of non-absorbable sutures.
Non absorbable sutures are used in Cardiovascular surgery, Dermatologic surgery, Hernia surgery, Soft tissue bonding and ligation, Ophthalmologic surgery, Plastic surgery, Micro surgery, Pediatric surgery, Gynecologic surgery, Urology and Orthopedic surgery, tissue closure and abdominal wall closure operations. They are also suitable for use on difficult tissues such as palms, soles, and mucous membranes. These non absorbable suture examples are important because when it comes to difficult tissues, there are only few options.