Suture Types
Suture Types
Suture types can be varied on how it is used. Different medical areas require different suture applications.
What Are The Types Of Surgical Suture
- Plain Catgut
One of the natural suture types that is widely used around the world. Although its use has diminished due to the production of synthetic absorbent materials today, it remains the norm compared to modern suture materials. It derives 97% of its structure from the intestinal submucosa of sheep and goats.
- Chromic Catgut
Treating Catgut with chromic acid increases tensile strength and slows absorption. Chromium catgut causes a high rate of tissue reaction that interferes with the wound healing of sutures used in plain catgut, which is harder, stronger and more resistant to tissue deterioration.
Polyglyconate (Maxon)
Maxon is the latest synthetic absorbent suture on the market. Made of polytrimethylene carbonate. It has a monofilament structure.
The tensile strength after 14 days is 75%. It has a force and absorption profile in all of the suture types. The enthusiast population is easier than PDS (its stiffness is 60% lower).
Polygluconic caid (Dexone)
Manufactured in 1971 as a synthetic homopolymer of glycolic acid. This suture; biologically and physically superior to Catgut, is an important advance in the development of absorbable suture materials.
It is destroyed by hydrolysis in the body. Its destruction is completed in 50-70 days. Over 80% of Dexon’s original power is lost for 15 days. This material retains only 5% of its original tensile strength for 28 days and is fully retained for 90-120 days.
However, it has a multifilament structure, which makes it easier to pass bacteria to the wound compares to other suture types. Some of the benefits of using this material are: … high tensile strength, low tissue reaction and absorption within a given period.
Polygractin 910 (Vicryl)
In 1974, Vicryl was defined as a synthetic copolymer of glycolic acid and lactic acid. Causes rapid absorption. It is destroyed by hydrolysis. It is used to approximate the ligation of tissues and blood vessels.
- Polydioxanone (PDS)
A monofilament suture made of paradiazonone homopolymer. If it remains, it causes irritation. Wound support lasts 6 weeks. Due to its monofilament structure, it has a lower affinity for microorganisms than Vicryl and Dexon, but from all the suture types, this one is hard and difficult to operate.
Polyprolene (Prolene)
These are relatively new synthetic monofilament suture types obtained from Surgilen and Prolene linear hydrocarbon polymer polypropylene. This is a suture used in either tissue closure, cardiovascular skeleton, or eye surgery.
Polypropylene suture thread causes a minimal acute inflammatory response within the tissue, gradually developing capsules of fibrous connective tissue around the suture itself. Since it has little reaction with the tissue, it can be left for a long time. It is the most preferred suture material for skin and intradermal sutures, fascia and tendon repair, and as a permanent fixed suture in tissue.
Adverse reactions seen when using this suture are wound dehiscence, increased bacterial infectivity, minimal acute inflammatory tissue reaction, pain, edema, and rash in the wound area.
Nylon
Classified as non-absorbent, but absorbed with 15-20% hydrolysis per year. This kind of suturing is slippery when moistened, but its relatively high originality makes knots less secure.
Tensile strength is 81% at the end of the first year, 72% at the end of the second year, and 66% at the end of the eleventh year. The operability of Multi-Flaman Foam is similar to silk, but stronger than silk and less tissue-responsive than silk.
Silk (Melsilk)
Its structure is protein fiber. Due to its excellent operating characteristics, it is recognized as a performance standard by many surgeons. The tensile strength after 14 days is 100%. Although classified as a non-absorbable material, silk is absorbed by proteolysis and becomes undetectable in the wound area within 2 years.
Tensile strength decreases with absorption and disappears within a year. The biggest problems with silk sutures are:
- Acute inflammatory reaction caused by this substance
- The host reaction causes encephalitis with fibrous connective tissue, which slows wound healing due to its spiral structure and tends to absorb water into the tissue.
- Avoid use in infected or contaminated areas
Silk has been one of the most preferred materials for many years due to its easy knot and excellent manipulation properties and is the standard to compare with other suture types.
Polyethylene
This is a synthetic monofilament suture made of polyethylene. Similar to propylene, but with less knot safety and tensile strength.
- Polyester (Mersilene / Dacron (uncoated), Etibond / Ti-Cran (coated))
Polyethylene terephthalate polymer. Like nylon, it is formed by canceration and polymerization. It is a multifilament. It can be found in coated or uncoated form.
The coating reduces friction and increases flexibility to facilitate tissue passage. Polyester sutures are stronger than natural suture types and do not weaken when moistened. Maintains tensile strength for a long time like prolen. Often used for vascular anastomosis and prosthesis placement.
- Polybutester ( Nuvofil)
Made of polyglycol terephthalate and polytrimethylene terephthalate copolymer, Novofil is a monofilament suture that has many advantages of both prolene and polyester.
There are many more suturing techniques, but learning these ones and practicing them are important for your experience.