Suture

From ArticleWorld

Suture is any string-like material that is used in emergency repair of skin and soft tissue disruptions or in the process of surgical procedures. All body tissues can be “sewn” or “stitched together” using sutures. Almost all of the currently-used sutures in modern medicine today have the suture attached to the needle by the manufacturer and both come in the same package.

Types

There are absorbable or nonabsorbable sutures available. Historically, silk was used as a nonabsorbable fiber for sutures and substances like cat gut were used internally as absorbable sutures.

Nonabsorbable sutures are made from silk, natural or artificial fibers. The most common source of the artificial fibers in this type of suture is polypropylene, polyester or nylon. In heart surgery and in orthopedics, stainless steel wire sutures are used to close bony tissue together. Most of the artificial fibers tend to be stiffer than absorbable ones and are meant to be removed from the skin once the wound has sufficiently healed.

Absorbable sutures are usually used for the repair of internal structures and are supposed to absorb as the wound heals. The original cat gut sutures were made from the intestines of sheep. The natural fiber absorbable sutures can be untreated or can be coated with something that enhances the absorption rate. The problem with absorbable sutures made from natural materials is that an allergic or tissue reaction can cause the wound to open up or the suture itself to be expelled from the body.

Artificially-made fibers are less likely to cause a local tissue reaction and move through the tissue easier. (Cat gut sutures often harden unless the sutures are placed quickly). They may be braided fibers or a monofilament fiber. Various blends of polyglycolic acid, lactic acid or caprolactone are used to make these kinds of fibers.

“Liquid” sutures involve the closure of wounds using adhesive glues that both close the wound edge and provide a film-like barrier against microbes. This method works well for small wounds or wounds that do not involve much stretching and bending of the tissue in healing. Liquid adhesives tend to look very well connected when first placed but the wound falls apart more easily under stress than fibrous sutures.

Sizes

Sutures have developed into a variety of sizes that are used on different tissues for different purposes. Sizes in the range of #3/0 to #5/0 are used in routine stitching of common wounds with the larger number indicating the smaller diameter of suture material. The high number range, such as #11/0 monofilament sutures, is used in delicate ophthalmologic surgeries.