Types of suture material and uses pdf

For sutures, doctors use a thread or strand of material to perform wound closure. Plain is an absorbable suture made by twisting together strands of purified collagen taken from bovine intestines. The term stitches refers to the surgical procedure or process of closing a wound with sutures. To fully appreciate the uses, characteristics, and limitations of barbed suture, a rudimentary understanding of their production is helpful. The natural plain thread is precision ground in order to achieve a monofilament character and treated with a glycerol containing solution. The suture should be placed closer than 3mm only in areas of tension so it helps in holding the suture in place while movements. Stitching, or suturing, is the most common form of repairing a wound. Suture materials can also be subclassified by their structure. If cutting suture or nontissue material, avoid using fine. Selection of appropriate suture material is important for successful healing. Suturing techniques different types of suture with videos. Meyle suture materials and suture techniques figs 10a and 10b approximation of the wound edges after tooth extraction by overlying, crossedover mattress stitch.

Multifilament suture made of several filaments that are twisted together e. Make sure the needle exits and enters the tissue at the same depth on both sides of the incisionlaceration green suture. This webinar will cover the jargon surrounding the material science of sutures, properties of suture materials and needle types and shapes helping you to understand what is required of the material in a variety of situations. Polyglactin 910 sutures are absorbed more rapidly than polyglycolic acid suture. The smallest sutures, 100, you will likely never use as a nurse practitioner. Surgical needles are designed to lead suture material through tissue with minimal injury. Their useful strength in tissue varies from a few days with plain catgut to several months for silk, and can vary with the individual. Knot security is also an important factor to consider when choosing suture materials. The needle should be grasped in the tip of the needle holder about 23 of the way back from the point. Most sutures come as a single piece, with the suture material swaged onto the base of the needle. After a stitch is made, the material is cut and tied off. The ideal properties of a suture material have yet to be. Residents ssutures and suturing techniques in skin.

There are both natural and synthetic absorbable sutures. May 01, 2020 the different types of sutures have their advantages as well as disadvantages, and usage of a specific type depends on the kind of wound that warrants the sutures in the first place. Knot tensile strength is measured by the force, in pounds, which the suture strand can withstand before it breaks when knotted. Absorbable suture materials suture is considered to be absorbable if it loses its tensile strength by 60 days after implantation. Common suture materials and suggested indications for their. This would be for skin edges, vascular anastomosis, etc. There are many circumstances in which sutures are used to repair tissue and facilitate healing. Besides using the right size and type of material, it is essential to use the right instruments needle and needle holder and the right suturing technique to minimize tension and scarring. A variety of suture materials may be used for a particular.

As with any suture material, adequate knot security requires the accepted surgical technique of flat and square ties. A number of different shapes, sizes, and thread materials have been developed over its millennia of history. The most commonly used suture patterns and knots are described and illustrated, along with information on suture materials and surgical needles used for sutures and knots it is our hope that this handbook will be useful to medical students and residents as a quick. Monofilament polypropylene sutures, monofilament nylon. Nonabsorbable surgical suture material that is relatively unaffected by the biological activities of the body tissues and is therefore permanent unless removed plasticity measure of the ability to deform without breaking and to maintain a new form after relief of the deforming force pliability. Sutures are also classified into various types based on the usage or application. Usually best to select smallest suture that provides adequate tensile strength as more material increases tissue reaction. Sutures are surgical threads that are used for closing or stitching surgical incisions and wounds, so as to speed up the healing process. Preface his manual has been prepared for the medical professional who would like to learn more about the practice of surgerythe dynamics of tissue healing, the principles of wound closure, and the. Pga sutures, catgut chromic, polyglactin 910, silk and polyester sutures, braided or twisted nylon, poliglecaprone and polydioxanone sutures. Common suture materials and suggested indications for their use table of when to use different types of sutures examples synthetic or natural suggested indications absorbable monofilament catgutchromic catgut natural rarely used pds polydioxanonemonocryl polycaprone glycolide maxon polyglyconate synthetic buried dermal sutures or continuous subcuticular suture absorbable braided. Single strand absorbable sutures are called monofilament while multiple strand types are called multifilament absorbable sutures.

Knot security tends to improve as the diameter of the suture material decreases. Suture selection should be based on knowledge of the physical and biological properties of suture materials, an assessment of the healing rate of a particular tissue and local conditions in the wound. What suture material, size and needle type for bowel anastomosis. Suture materials suture materials can be classified into two broad categories. Different types of suture patterns that might be used for wound closure include simple. Monofilament polypropylene sutures, monofilament nylon, pvdf, stainless steel. The most commonly used suture patterns and knots are described and illustrated, along with information on suture materials and surgical needles used for sutures and knots it is our hope that this handbook will be useful to medical students and residents as a quick guide to basic suture patterns and methods of knot tying. It follows on, therefore, that a tissue reaction within the host should be expected, and can be either an advantage or a disadvantage. This suture material will maintain sufficient tension over the first 2 weeks 75%, 50% after 3 weeks, and 25% after 2 weeks. Absorbable sutures will naturally break down in the body over time while nonabsorbable sutures are made of synthetic material that is removed after a. They have a lower infection risk but also have a poor knot security and ease of handling.

This suture technique uses several strands of suture material to close the wound. It is generally accepted that if one uses sutures to repair an uncomplicated laceration, the best choice is a monofilament nonabsorbable suture. Use of needle holders loading needle needle passing through skin. The final knot is made by taking a bite of the second to last pass though the tissue and tied in the usual fashion. Sutures are used either for apposing tissues or for ligation, and a variety of different types of suture material is currently available. The largest sutures, 00, are as large as fishing line and are used. Overview of biomaterials and their use in medical devices. Suture contains irgacare mp, the purist form of the broad spectrum antibacterial agent triclosan. These include tensile strength required for wound closure, site anatomic location of the wound closure, and ability to return for follow up.

Sutures can be divided into two types those which are. There are two types of sutures, absorbable and nonabsorbable. Monofilament sutures are made of a single strand of material. Ophthalmic suturing 101 american academy of ophthalmology. Needles can be straight git or curved swaged or eyed made up of either ss or carbon steel. They can be further subclassified into synthetic or natural sutures, and monofilament or multifilament sutures the ideal suture is the smallest possible to produce uniform tensile strength, securely hold the wound for the required time for healing, then be absorbed. Sutures are little stitches that hold the edges of a wound together while the skin heals. Suture materials are the substances that make up those stitches. The pds suture knots must be properly placed to be secure. We take a look at what you need to know about sutures and provide a framework with which you can explain the topic to any examiner or surgeon. This synthetic monofilament suture is used for general use in soft tissue repair. There are many factors that go into selecting a suture type. Absorbable suture an overview sciencedirect topics. Monofilament suture a single stranded filament suture e.

To learn the basics of suturing prior to trying these out click here. Sutures, stitches and staples are used for the same purpose to close wounds or surgical incisions but they are not the same. Sutures are used to close wounds suture components a thread b needle types of thread surgical suture material can be classified on the basis of the characteristics absorbability. Throughout antiquity many materials have been used to approximate wounds. This healthhearty writeup provides information on the types of sutures and their uses. The choice of suture material plays an important role in wound care. Both natural and synthetic materials are used to make these surgical threads. Each type is further classified into whether the strands making the suture are single or multiple. Types of suture materials absorbable catgut, polydioxanone, polyglycolic acid used. The first suture is made in the same manner as the simple interrupted, but subsequent sutures are placed without cutting the suture material.

Surgical suture is a medical device used to hold body tissues together after an injury or surgery. Surgical sutures are for holding body tissues together after surgery or injury. Simple interrupted suture most simple suture to use and suitable for almost all situations needle is inserted in one side of the wound and out through the wound itself suture should extend through. In the first edition of williams obstetrics, the authors opined that silkworm gut accompanied by plain catgut was the ideal suture choice. The needle enters the outer layer of the skin as well as the layer beneath it on one side of the wound and exits on the other. Strength of suture proportional to square of the diameter of the thread. The suture material is inert and has a relatively low tissue reaction. Uses include for tissues that heal slowly, such as fascia or tendons, closure of abdominal wall, or vascular anastomoses. Apr 05, 2018 this suture technique uses several strands of suture material to close the wound. When we use a suture material in the human body we are implanting a foreign tissue into a host.

The different types of sutures have their advantages as well as disadvantages, and usage of a specific type depends on the kind of wound that warrants the sutures in the first place. Types of wound healing6 healing by primary intention6 healing by second intention. The residual tensile strength of a polyglactin 9104 suture is consistently greater than that of polyglycolic acid suture. Jan 08, 2016 surgical needles are designed to lead suture material through tissue with minimal injury. Technological advances mean there are more suture materials available for perineum repair. Pdf suture materials and suture techniques researchgate. Sutures are normally classified into general sutures, cardiovascular sutures, valve sutures, orthopedic sutures, dental sutures, gynaec, veterinary sutures, cosmetic surgery sutures, ophthalmic sutures etc. This material shouldnt be used for cardiovascular or neurological. We will focus on the common commercially available suture materials and discover what situation each is best suited for. Conjunctival and vaginal mucosal sutures remaining in place for extended periods may be associated with localized irritation. Suture materials lose strength during implantation due to manipulation and knotting and after implantation due to tissue degradation while it is healing. The condition of the wound, the tissues to be repaired, the tensile strength of the suture material, knotholding characteristics of the suture material, and the reaction of surrounding tissues to the suture materials 12.

Suturing techniques used in dentistry junior dentist. When choosing sutures veterinary surgeons should always consider which is the appropriate suture material, surgical needle and suture size for a given tissue and be familiar with suture characteristics and tissue requirements. Each suture should be placed with a distance of 34mm. These tiny sutures, as fine as human hair, are used for microvascular procedures. Vicryl or maxon or pds or monocryl, 0 or 20 with tapered needle. Jan 19, 2014 nonabsorbable surgical suture material that is relatively unaffected by the biological activities of the body tissues and is therefore permanent unless removed plasticity measure of the ability to deform without breaking and to maintain a new form after relief of the deforming force pliability. The word suture describes any strand of material used to ligate tie blood vessels or approximate bring close together tissues. Polyglactic acid suture or polyglactin910 vicryl, dexon, surgicryl, polysorb vicryl is most commonly used for the deep layer, unless risk of infection in which case use monofilament nonbraided monofilament polyglecaprone 25 monocryl indicated for the deep layer, when wounds are higher risk of infection, and vicryl is contraindicated. Aug 01, 2009 non absorbable suture obviously does not go away. Suture material size refers to the diameter of material the more zeroes in the number, the smaller the diameter i. What suture material, size and needle type for uterine closure as in csection in small animal. The techniques that you use, the suture material you use, and the specific type of needle you use will vary depending on whether you are closing a simple laceration on the foot, a complex laceration on the face, a gastrointestinal anastomosis, a vascular anastomosis, or closing a median sternotomy.

Surgical suture, types of sutures, sizes, how to suture. Although the tissues and structures of the body perform for an extended period of time in most people, they do suffer from a variety. Suture material frequent uses caprosyn glycolide, caprolactone, tremethlyene carbonate, lactide most procedures in which fast absorption of the suture is required, e. There are many different types of suture materials, including both natural and synthetic materials, those that can or cannot be absorbed by the body, and those that are braided or consist of a single strand. Even today, there is a search for ideal suture material. The material may not be completely absorbed at this point, but it will have lost the majority of its initial tensile strength. Suture classification as per the united states pharmacopeia usp is based on the diameter of any given suture material necessary to produce a certain tensile strength. Synthetic suture material sutures can be made from synthesizing a wide variety of polymers. Common suture materials and suggested indications for their use.

Learn vocabulary, terms, and more with flashcards, games, and other study tools. In general, the higher suture number indicates a lower crosssectional diameter of the suture, however because the usp grading system is based on suture strength, as opposed to. Common suture materials and suggested indications for. Pearls on the best suture for episiotomy mdedge obgyn. Do not use same injection set on more than one patient.

Suture sizing is just like the sizing for ivs and injection needles the smaller the suture, the larger the number. Suture needles surgical needles are designed to lead suture material through. Uses for biomaterials ref 3 one of the primary reasons that biomaterials are used is to physically replace hard or soft tissues that have become damaged or destroyed through some pathological process ref 3. This is particularly important with deep skin closures and when suturing cornea during penetrating keratoplasties.