TYPES OF SUTURES

1) Surgical Sutures 2) Suture Types a. Absorbable Sutures o Polyglycolic Acid Sutures o Polyglactin 910 Sutures o Catgut Sutures o Poliglecaprone Sutures o Polydioxanone Sutures b. Non-absorbable Sutures o Polypropylene Sutures o Polyamide / Nylon Sutures o Polyester Sutures o Silk Sutures o Polyvinylidene fluoride / PVDF Sutures o Stainless Steel Sutures

Absorbable and non absorbable sutures Sutures can be divided into two types ± those which are absorbable and will break down harmlessly in the body over time without intervention, and those which are non-absorbable and must be manually removed if they are not left indefinitely. The type of suture used varies on the operation, with the major criteria being the demands of the location and environment and depends on the discretion and professional experience of the Surgeons.
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Sutures to be placed internally would require re-opening if they were to be removed. Sutures which lie on the exterior of the body can be removed within minutes, and without re-opening the wound. As a result, absorbable sutures are often used internally; non-absorbable externally. Sutures to be placed in a stressful environment, for example the heart (constant pressure and movement) or the bladder (adverse chemical presence) may require specialized or stronger materials to perform their role; usually such sutures are either specially treated, or made of special materials, and are often non-absorbable to reduce the risk of degradation.

Absorbable sutures include :- Polyglycolic Acid sutures, Polyglactin 910 , Catgut, Poliglecaprone 25 and Polydioxanone sutures. Non-Absorbable sutures include :- Polypropylene sutures, Nylon (poylamide), Polyester, PVDF, silk and stainless steel sutures.

In general. Monofilament sutures include :. Suture Techniques Running. Poliglecaprone and Polydioxanone sutures. The advantages of the running stitch are speed of execution. Continuous Stitch The "Running" stitch is made with one continuous length of suture material. Polyglactin 910. such as the peritoneum. natural and synthetic sutures. Interrupted Stitch . monofilament sutures and multifilament or braided sutures. silk and polyester sutures. Natural sutures include silk and catgut sutures whereas all other sutures are synthetic in nature. and accommodation of edema during or the wound healing process. However. Synthetic and Natural Sutures Surgical sutures can also be divided into two types on the basis of raw material origin i. Used to close tissue layers which require close approximation. More exact approximation of wound edges can be achieved with this technique than with the running stitch.Monofilament and Multifilament Sutures Sutures can also be divided into two types on the basis of material structure i. PVDF.Polypropylene sutures. Catgut. Monofilament sutures elicit lower tissue reaction compared to braided sutures.e. Each stitch is tied separately.e.PGA sutures. Braided sutures provide better knot security whereas monofilament sutures provide better passage through tissues. May also be used in skin or blood vessels. May be used in skin or underlying tissue layers. there is a greater potential for malapproximation of wound edges than with the interrupted stitch. Nylon. Stainless steel. Multifilament or braided sutures include :.

A continuous stitch paralleling the edges of a circular wound. Purse String A double loop technique alternating near and far stitches. Continuous Locking. The wound edges are inverted when tied. Commonly used to close circular wounds. SmeadJones/Far-andNear A self-locking running stitch used primarily for approximating skin edges. each stitch penetrates each side of the wound twice. and is inserted deep into the tissue.Mattress Suture A double stitch that is made parallel (horizontal mattress) or perpendicular (vertical mattress) to the wound edge. Chief advantage of this technique is strength of closure. Commonly used for approximating fascial edges. such as a hernia or an appendiceal stump. or Blanket Stitch .

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