Suture
Suture types are the techniques we use when we surgically stitch someone. There are all kinds of suture techniques and its very beneficial to us to learn all of them
Multi-Framed (Braided) Sutures
Fine grooves between the suture thread and support the growth of bacteria throughout. This feature increases the risk. This suture provides a more secure knot thanks to its twisted structure.
- G-elastic;
Thanks to this function, the suture is stretched during tissue edema and returns to its original state when the edema dissolves.
Tissue Reaction
It is the inflammation of the stitches of the tissue. All seams are created more or less for foreign objects. Multi-frame suture types provide higher responsiveness than single-frame sutures compared to synthetic sutures. It increases the purpose of using more stitches than normal in the scar tissue.
- Absorbent suture
They are absorbed from the transplanted tissue and disappear. Absorption rate depends on its structure. This kind of suturing is very absorbent as the name suggests.
Catguts
This suture is not the preferred type of suture in dermatology. It is used in the anastomosis of subcutaneous bleeding vessels and in perineum and scrotum injuries where tissue tension is minimal.
- Repairing rapidly healing tissue that requires minimal support
- In relation to superficial blood vessels,
- Used for suturing subcutaneous adipose tissue.
The properties of foreign bodies and the reaction of tissues are very high. It may burst or break when dry.
It accounts for 98 percent collagens. After 7 days you lose 60% of the resistance. Since most of the suture structure is composed of collagen, it is absorbed into the body for 70 days by proteolysis.
- Natural Catgut; It is absorbed daily. It is obtained from the submucosa of sheep or cow, which is the serosa of the intestines of cattle. It is suitable for low stress surfaces.
- Chronic Catgut; This is achieved by enhancing the molecular bonding with the acid salt of normal Catgut, which is absorbed daily. This reduces tissue response while delaying absorption. It is used to tie veins in wounds left open for secondary healing.
Synthetic Absorbent Suture
- Polyglycolic acid (dexane);
This is the first synthetic absorbable suture to be absorbed daily. It has less tissue reaction and higher tensile strength compared to Catgut. It’s dangerous because of the multiple framing. Therefore, it is not suitable for use in infected wounds.
Used for eyebrows, fascia, capsules, tendons and subcutaneous skin closure.
- Polysaccharide acid (VICRYRL);
It is absorbed daily. It is a type of multi-frame sewing. Less tissue reaction than Dexan. Blood pressure is quite high.
Polyglyconate (MAXON);
It is absorbed daily. It is a monoframe suture. Knot security and tension strength is very important with this one. It is used for cutting all soft tissues, esophagus, intestinal anastomosis and bronchial closure.
- POLYGLEKAPROM (MONOCRILE);
Latest synthetic absorbable suture. High tensile strength. Minimal because there is very little tissue reaction. Usage despite being monoframe has been quite a lot. Easy and high knot security.
Natural Suture
- Silk;
Is made from moth cocoons. It consists of natural protein obtained. Pronounced with natural fiber protein and Causes tissue inflammation.
The use of silk, which is a multi-frame knot can be perfected. Have the risk of infection. When edema develops in the tissue, it becomes less elastic.
Sutures can cut tissue such as anus, Genital mucosa, lips, conjunctivitis, With temporary stitches during surgery can be replaced after the procedure.
- Cotton;
It comes from cotton.
- Steel wire; from steel mine
With the highest possible tensile strength material of the suture. Over time within the organization there’s even a problem losing the tension
These suture techniques used in dermatological surgery and may cause skin lacerations.
Synthetic Nonabsor Babl Suture
- Polypropylene (PROLEN SLIDING);
Synthetic plastic monoframe suture material. It has high tensile strength and can remain in the tissue for a long time. Thanks to its smooth surface, it can be easily removed from the tissue. There is minimal tissue reaction.
Vascular grafts do not lose tension after a few years and are easy to remove, making them suitable for continuous intra-radial sutures and vascular anastomosis.
- Nylon (ETHILON DERMALON);
There are monoflament type and multifilament type. High tensile strength results in excellent flexibility and minimal tissue reaction. Ideal for percutaneous sutures, subcutaneous sutures and macrovascular ligation.
Polyester (DACRONETHİBAND)
Multi-framed suture. Despite being multi-filament, the risk of injury and inflammation is significantly lower than with other multifilaments.
It has high tensile strength. It can stay in the organization forever without losing its power. Only metal sutures have higher tensile strength.
Commonly used for oral, genital, mucosal injury and facial closure.
- POLYBUTESTER (NOVAFIL);
These are the new special type polyester suture types, monoflement. It creates a minimal tissue reaction and maintains the tension in the tissue for a long time.
Sewing Styles
The same result can be obtained with a series of separate stitches consisting of individual knotted loops, as can a continuous suture that is knotted only at the beginning and at the end. In this second method, called cut stitch, even if one of the stitches is opened or broken, the stitch is not completely removed.