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Surgical suture

life science Maturity 5-7 Next article →

A surgical suture is a medical device used to hold body tissues together. These devices are often called stitches. They work by approximating the edges of a wound after an injury or surgery. This close placement allows the body to heal more effectively. Choosing the right suture is a complex decision for medical providers. They must match the tool to the specific location and type of tissue.

A Surgeon Applying a Suture
A Surgeon Applying a Suture

To select a suture, a provider must consider several mechanical properties. First, they look at tensile strength. This is the ability of the thread to hold tissues together without breaking. The provider must account for the mechanical and shear forces acting on the wound. They also evaluate elasticity, which is how well the material adapts to changing tissues. For example, tissues may swell due to edema. The provider also considers tissue reactivity. This is the inflammatory response of the surrounding area to the suture material.

Suture, before and after, RMO
Suture, before and after, RMO

Needle design is a critical part of the suturing process. Historically, surgeons used reusable needles with eyes, much like sewing fabric. Today, many use swaged or atraumatic needles. In a swaged suture, the thread is already attached to the needle. This method is faster and reduces drag when passing through tissue. It also protects friable, or easily crumbled, tissue from damage.

Suture micrograph
Suture micrograph

Needles come in many shapes, such as straight or various circular curves. Some are 1/4 circle, while others are 5/8 circle. Special designs like "ski" or "canoe" needles are used in laparoscopic surgery. These allow curved needles to function through narrow cannulas in the abdominal cavity.

Needles are also classified by their point geometry. A taper needle has a round body that ends in a smooth point. A cutting needle has a triangular body with a sharpened edge. There are also reverse cutting needles, where the edge is on the outside curve. Other types include trocar points and spatula points. Spatula points are flat on the top and bottom. These are specifically used during eye surgery.

Surgical suture
Surgical suture

Suture materials are divided into absorbable and non-absorbable categories. Absorbable sutures are broken down by the body through proteolysis or hydrolysis. These are often used for internal tissues to avoid extra procedures for removal. Natural absorbable materials include catgut, which is made from bovine intestines. Plain catgut maintains strength for 7 to 10 days. Chromic catgut is coated in salt to decrease tissue reactivity. Fast catgut is treated with heat to allow for even quicker absorption.

Surgical thread supplier 1
Surgical thread supplier 1

Synthetic absorbable sutures offer different advantages. For example, polyglactin 910, also known as Vicryl, is a polyfilament suture. It loses all tensile strength within 28 days. Another example is polydioxanone, or PDS, which is a monofilament. PDS can maintain its strength for 36 to 53 days. Non-absorbable sutures are used when high force is present, such as in tendons. These include materials like nylon, polypropylene, and surgical steel.

C. Stromayr; Sewing wound after herniotomy. 1559 Wellcome M0010186
C. Stromayr; Sewing wound after herniotomy. 1559 Wellcome M0010186

Sutures can also be categorized by their fiber structure. Monofilament sutures consist of a single fiber. These create less tissue trauma and are good for delicate blood vessels. Polyfilament, or braided, sutures are made of multiple fibers. These generally have greater tensile strength and better knot security. However, they may have a higher propensity to harbor bacteria. The choice between these types depends on the balance of strength and the need to minimize tissue reaction.

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🖼️ Images & Media (7)
File:A Surgeon Applying a Suture.jpg
A Surgeon Applying a Suture.jpg
File:Suture micrograph.jpg
Suture micrograph.jpg
File:Surgical suture.jpg
Surgical suture.jpg
File:Suture, before and after, RMO.jpg
Suture, before and after, RMO.jpg
ASC Leiden - Coutinho Collection - A 37 -...
File:C. Stromayr; Sewing wound after herniotomy. 1559 Wellcome M0010186.jpg
C. Stromayr; Sewing wound after...
File:Surgical thread supplier 1.jpg
Surgical thread supplier 1.jpg
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