There is no such thing as the “perfect” suture so the surgeon has to make an educated choice in what suture material is best to be used. The ability of the suture to hold a knot is imperative. Some suture will hold knots better than others; braided material has less knot slippage than monofilament suture. Other characteristics the suture should have is strength, cause no tissue reactivity, and be easy to handle.
When selecting a suture the surgeon needs to take the following into consideration:
- Patient size
- Tissue to be sutured: skin versus hollow organ
- Strength required
- Healing potential of the tissue
- Importance of cosmetic appearance
- Knot security
There are two basic types of suture: multifilament and monofilament.
- Multifilament suture, which is also called braided suture, has two or more strands braided together to form a single strand of suture.
- Monofilament suture is a single, solid strand of suture material.
Origin of suture material is classified as Natural, Synthetic or Metallic
- Natural suture material is made from fibers found in nature. This would include cotton, silk and catgut.
- Synthetic suture material is produced with the use of man-made products. This would include Nylon, Polyester, Polyglactin 910, Polypropylene and Polidioxanone.
- Metallic suture would be stainless steel such as wire, external staples and internal staples.
The size of suture material is classified as ought. When reading the size of suture the numerical “0” represents ought. The more zeros in a size, the smaller the suture material. 4-0 or “0000” are both four ought suture. Suture material with only whole numbers increase in size as the number increased, No.1 would be smaller than No.5. Suture comes in a range of 11-0 to No. 5; this would be smallest to largest. Smaller sizes of suture are often used in ophthalmology and cardiovascular procedures while the larger sizes are often used in large animal surgery.
Suture needle are chosen on the basis of tissue type to be sutured, the size of the wound, suture pattern and choice of suture material. They may be either separated from the suture material or fused to the suture material. They also come in different shapes: straight, half-curved and part-circle. The type of the point of the needle comes in several choices: non-cutting, taper point, cutting, and reverse cutting.
|List of some of the common suture material:|
|Generic Name||Brand Name||Absorbability|
|Chromic Gut||Chromic Gut||Absorbable (10-15 days)|
|Polidioxanone||PDS||Absorbable (180 days)|
|Polyglactin 910||Vicryl||Absorbable (60 days)|
|Polyglactin 910||Vicryl Rapide||Absorbable (42 days)|
|Stainless steel||Stainless steel||Nonabsorbable|
Minor Veterinary Surgery – Julian Hoad
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