Different kinds of sutures for you

 A suture is a filament of material, natural or synthetic, used to tie blood vessels together and to tie tissues together. Suture materials are the earliest and most frequent application of textile materials for closing surgical wounds.

Linen was used as a suture material more than 4,000 years ago. Since then, numerous materials such as ligatures and sutures have been used. It includes: steel wire, gold, silver, dried gut, horse hair, leather straps, bark fibers, silk, linen and tendon.

This property allows sutures to minimize chronic reactions from undesirable tissues after the sutures have lost most of their mechanical properties like bone wax.

The last feature introduced in the sutures is multi functionality. A typical example is Vicryl coated with Triclosa. The polypropylene suture which has antimicrobial capacity to reduce the possibility of wound infection. Today, surgeons can choose from a large number of suture materials with various chemical, physical, mechanical, and biological properties.

The suture threads are classified as non-absorbable and absorbable.

The nonabsorbables must be removed and are used for superficial wound closure (superficial suture). Absorbables do not need to be removed and are used in the dermis or subcutaneous to approximate the wound edges and decrease tension (subcutaneous or hypodermic suture).

Nylon or polyamide: Low coefficient of friction, high tensile strength and plasticity, and minimal inflammatory reaction. This avoids leaving suture marks but favors cutting the edges of the wound.

Polypropylene: Synthetic monofilament suture with characteristics similar to nylon. It is widely used, especially in continuous intradermal sutures due to its low coefficient of friction,

ABSORBABLE

They are those that maintain the approximation of the tissue temporarily and end up being digested by enzymes or hydrolyzed by tissue fluids. They can be of the monofilament type, when they consist of a single thread or multifilament, when they have several twisted or braided threads. Some are:

Dry Gut: its use is currently prohibited because it is composed of 95% animal collagen.

polyglycolic acid suture: It is composed of glycolic and lactic acid polymers that are degraded by chemical hydrolysis which causes minimal tissue reaction. It has great tensile strength and knot security.

polydioxanone suture: It is a polymer of polydioxanone that is degraded by non-enzymatic hydrolysis. It is presented as a monofilament that takes longer to absorb than the previous ones, making it useful in high tension wounds and infected wounds. Its absorption is complete at 180 days and maintains 75% of the tensile strength at 2 weeks and 25% at 6 weeks. It is more flexible and less cuts the edges of the wound.

polyglactin suture: Monofilament that is absorbed by hydrolysis. It combines the high tensile strength of polydioxane with less stiffness, making it easier to handle. Complete absorption at 180 days and maintains 50% of the tensile strength at 2 weeks.

PoliglecaproneSuture: It is a monofilament that is used in intradermal and hypodermic sutures. It induces fewer hypertrophic scars than fast absorbing polyglycan. Lower tension force since at week it loses 50% and at 2 weeks it only maintains 25% of the tension force of the first day.