What is Suture
What is Suture is the question to ask when we talk about stitching someone for medical reasons. Suture techniques are very different and requires different ones depending on the place on the body.
Stitches
The materials used to prevent the disintegration of the damaged tissue during the surgical procedure and to control the bleeding situations that may occur are called stitches. They can be also called suture.
What Is a Suture
The materials used to prevent the damaged tissue from breaking down as a result of various applications during the surgical procedure and to control the bleeding conditions that may occur are called stitches.
It has passed through the word “souture”, which is a French word in our language. The suture that has been used in surgical procedures for more than 4,000 years has been used in ancient civilizations by obtaining horsetail hair.
Today, in line with technological developments, sewing materials are produced using biocompatible materials and have a much more ergonomic structure.
Suture Types and Classification
Sutures are divided into two main groups as absorbable and non-absorbable materials.
The ideal suture should create uniform tensile strength, hold the wound securely during the healing process, and have minimum dimensions for easier absorption. In addition, it should be predictable, easy to use, produce minimal reaction and be knotted securely.
The suture types of need chosen varies greatly according to the clinical scenario. For example, as a rough guide, mass closure of a midline laparotomy (abdominal cavity) may require the use of a PDS suture, a vascular anastomosis (vascular junction), possibly a prolene suture, a hand-sewn intestinal anastomosis. Use of a vicril suture and a drain supply silk suture.
The type of surgical suture used is also a factor that affects the suture techniques and suture removal. Different types of procedures are performed for each suture type.
Absorbable Sutures
Absorbable sutures are one of the main subsections of sutures. Seams that lose most of their tensile strength or tensile strength within 60 days are included in this class. Absorbable suture types are as follows:
- Surgical intestine:
These absorbable sutures, also known as intestinal sutures, are handled in 3 different groups. It is rarely used due to its weak strength and high tissue reactivity.
Quickly absorbed gout is produced by preheating. It can be used in low tension areas where the wound is well supported with deep stitches and the stitches are difficult to remove, for the attachment of skin grafts. It maintains its strength for 3-5 days.
- Vicryl Polysorb (Poliglactin):
It has a synthetic braided polymer structure that preserves its strength 75% at the end of the 2nd week and 50% at the end of the 3rd week. Vicryl suture has minimal tissue reactivity and does not cause tissue rupture.
PDS II (Polydioxanone)
Being a monofilament polymer type with long tensile strength (70% in the first two weeks and 50% in the first four weeks), PDS II sutures can remain in the body for more than 6 months.
However, since it is a monofilament type, the knot security is lower than the others. It can be used in minimal tissue reactions and cartilage repair cases where inflammation may cause significant discomfort.
Maxon (Polytrimethylene): A type of monofilament that combines the long-term effect of the PDS suture and the strong knotting property of the vicryl suture, maxon suture is 80% in the first two weeks, 60% in the first four weeks and complete absorption in 6 months. It can be used in minimal tissue reactions.
Biosyn (Glycomer): Generally similar to monocryl suture and offers long-term durability as a maximal suture.
Caprosine (Polygytone)
The cprosyn suture, which is a synthetic absorbable suture, can remain in the body for up to 60 days. It can be used in many different areas with its durable polymer material, smooth passage through the tissue and minimized infection potential.
During healing, patients may experience less discomfort and fewer wound complications.
Non-Absorbable Sutures
It can be used in the surgery of slow-functioning tissues such as fascia and tendons. In addition, abdominal wall closure or vascular anastomosis operations are preferred.
- Nylon (Ethilon, Dermalon, Nylene, Norulon): Surgilon and Nurolon sutures are better than others, but nylon suture thread prices are quite high.
- Polybutester (Novafil): It is a monofilament suture type with excellent flexibility.
- Polypropylene (Prolene, Surgilene): As a monofilament polymer with a very low friction coefficient, polypropylene milk makes it the preferred suture for subcuticular sutures. It is preferred as an aesthetic suture and is used in areas such as face repairs.
- Silk (Dysilk): It has low tensile strength and high friction coefficient, high capillarity and high tissue reactivity.
Monofilament and Multifilament Sutures
Suture materials are also subclassified according to their structures as monofilament and multifilamen sutures.
- Monofilament suture:
Single-stranded suture group. Nylon, PDS or prolene sutures are included in this group. It has a lower risk of infection but also a weaker knot security.
- Multifilament suture:
They are used as a combination of several filaments such as braided silk or victorian sutures. They keep their shape to create good knot security. But they run the risk of infection.
Different suturing techniques are important because we use them in different areas. Their healing time and applications are varied. That’s why its important to know all kinds of suture types.