Why Should We Use Non-Absorbable Sutures?
Why should we use non-absorbable sutures is a question that can answered by doctors or hospitals. If you are having problems with your suture, you must ask for a doctors help.
The main purposes in suture selection are not to damage the tissue during the procedure. Only approximation of the wound lips and not being tense accelerates the healing. Tangled knots should not be tied, stitches should not be tied too tightly. There is no perfect seam, there is only the most suitable seam. Studies have shown that only 25% of surgeons tie knots correctly.
Types of Sutures
The in vivo degradation of sutures divides them into two main groups, absorbable and nonabsorbable sutures; in other words, those that can melt and those that do not. Stitches that last more than 60 days are called nonabsorbable. This terminology should be considered partially incorrect, since some nonabsorbable sutures lose their tensile strength during this 60-day period.
Although non-absorbable wax, paraffin wax, silicone, polytetrafluoroethylene are traditional coating materials, the search for new coating materials continues, especially for absorbable sutures. This is because the coating materials of absorbable seams are not suitable for non-absorbable seams. Although the coating of suture materials facilitates easy passage through tissue and usage properties, they reduce knot reliability. This may seem difficult but some wounds can answer the question why should we use non-absorbable sutures.
Non-Absorbable Sutures
It can be used in the surgery of slowly functioning tissues such as fascia and tendons. It is also preferred in operations for closure of the abdominal wall or vascular anastomoses. These are the reasons for why should we use non-absorbable sutures. Every type of wound needs different care and non absorbable suture types;
Nylon (Ethilon, Dermalon, Nylene, Norulon): It is also known as subcutaneous suture. Surgilon and Nurolon sutures are better than others, but nylon suture prices are quite low, so this is a very popular suture material.
Polybutester (Novafil): It is a type of monofilament suture with excellent flexibility.
Polypropylene (Prolene, Surgilene): It has good plasticity, limited flexibility, poor node security, and is relatively expensive. It is preferred as an aesthetic suture and is used in areas such as facial repairs.
Silk (Dysilk): It has low tensile strength and high friction coefficient, high capillarity and high tissue reactivity. It is also described as a braided natural suture.
Polyester (Mersylene Suture): It is a braided multifilament suture with high strength and low tissue reactivity. It has a low coefficient of friction value. Flexibility; polyester sutures are excellent for mucosal surfaces without the reactivity of silk. These are the materials that used when we answer the quesiton what are 3 types of sutures.
Monofilament and Multifilament Sutures
Suture materials are further divided into subclasses according to their structure as monofilament and multifilament sutures. There are so many different kind of suture materials that the important question is not the why should we use non-absorbable sutures, but what kind of suture is bes for me. Suture materials are grouped as synthetic and natural according to the raw materials from which they are produced.
Monofilament suture: It is a single striped suture group. Nylon, PDS or prolene nonabsorbable monofilament sutures are included in this group. It has a lower risk of infection but also a weaker node security.
Multifilament suture: They are used as a combination of several filaments such as braided silk or vikri suture. They retain their shape to create good knot security. But they do carry the risk of infection.
Natural suture: Sutures made of natural fibers. They are rarely used, as they cause a greater tissue reaction.
Synthetic sutures: Sutures made of man-made materials. They tend to be more predictable than natural sutures in terms of tensile strength and absorption properties.
Absorbable Suture Materials
Maxon (Politrimethylene): Maxon suture, a type of monofilament that combines the long-lasting effect of the PDS suture and the strong knotting feature of the vicryl suture, provides 80% in the first two weeks, 60% in the first four weeks and full absorption in 6 months. It can be used in minimal tissue reactions.
Biosyn (Glycomer): In general, it is similar to monocryl suture and offers long-term durability as maxon suture. In some cases why should we use non-absorbable sutures is a irrelevant question beacuse sometimes doctor has to use absorbable sutures.
Caprosyn (Polygytone): A synthetic absorbable suture, cprosyn suture can stay in the body for up to 60 days. It can be used in many different areas with its durable polymer material, smooth passage through tissue and minimized infection potential. Patients may experience less discomfort and fewer wound complications during recovery. These are different than nonabsorbable suture material.
Knotting Techniques in Sutures
The correct knot directly affects the knot security of the suture, but knotting techniques are generally not well known. In a study, 25 gynecologists, most of whom were clinic chiefs, were asked to tie a square knot, but the majority of them tied a sliding knot instead of a square knot. Failure to tie the correct knot may cause serious complications such as incisional hernia and dehiscence. Non absorbable suture types are less important than different know types.
A knotted yarn has 2/3 the tensile strength of a knotless yarn. The weakest area of the seam is the knot. In terms of inflammation, the volume is important, not the number of nodes. The square knot has less volume than the floating knot, and the monofilament knot has less volume than the multifilament knot. In an unsuitable seam, the seam surface may be completely deformed during knotting. Diameter differences may occur along the seam, lint may occur, and surface integrity may be lost. So the most important quesiton is not why should we use non-absorbable sutures, but what kind of knot should we use for sutures.