Suture

Kim P. Suan
Common Sutures Common in the Philippines
The Ideal Suture Material
Can be used in any tissue
Easy to handle
Good knot security
Minimal tissue reaction
Unfriendly to bacteria
Strong yet small
Wont tear through tissues
Cheap
Suture Characteristics
Absorption
Absorbable- Absorbable suture breaks down
Tensile
over time in the body Strength

Non-absorbable- does not breakdown overtime

Tensile Strength - a measurement of the force Tissue Knot

Reactivity Quality Security
required to pull something

Tissue Reactivity Inflammatory reaction elicited by

the suture Ease of
Handling
Knot Security - knots untied, suture slipped from the
clamps
 The Suture Packaging

PRODUCT
CODE
STRAND
SIZE NEEDLE
CODE
MATERIAL WITH LIFE
SIZE
PICTURE
OF
STRAND NEEDLE
LENGTH

NEEDLE POINT NEEDLE

COLOUR CIRCLE TYPE LENGTH
Absorbable
Plain Gut Vicryl

Breakdown: 5 10 Days Breakdown: 4 weeks

Absorption: 70 days Absorption: 56-70 days
Chromic Gut PDS

Breakdown: 14 21 Days Breakdown: 30+ days

Absorption: 90 days Absorption: 180 -210 days
Absorbable
Dexon Monocryl

Breakdown: 7 days Breakdown: 30 days

Absorption: 60 90 days Absorption: 90 - 120 days
Non-absorbable Nylon
these sutures will be removed however
when used in the body they will be
retained inside the tissue.
Silk

Prolene
Polyester
Non Absorbable

Surgical Steel
 Tensile Strength
PDS Plain Gut

Absorbable

Surgical Steel Silk

Non-
Absorbable

Strongest Weakest
Tissue Reactivity
Non-braided sutures cause less reactivity in the body and are not as prone to
becoming infected because they lack the grooves and rough surface for things to
adhere. Plain Gut

Silk

Chromic Gut

Non-
Absorbable Absorbable
Knot Security
Non-braided sutures can have a greater tendency to loosen at the surgical knot
with the lack of grip

Monocryl
Silk

Most secure for Least secure for

non-braided Braided
Layers of Body Tissue
Skin - the external covering or integument
of an animal body
Subcutaneous fat - is the lowermost layer
of the integumentary system
Muscles - a tissue composed of cells or
fibers, the contraction of which
produces movement in the body
Fascia - A fascia is a band or sheet of
connective tissue, that attaches,
stabilizes, encloses, and separates
muscles and other internal organs
Peritoneum - is the serous membrane that
forms the lining of the abdominal
cavity
Type of Suture vs. Body Tissue
Type of Suture vs. Body Tissue
Type and Shape of Needle
How to load the needle holder and serve
Suture Sizes

5..4..3..2..1..0..2/0..3/0..4/0..5/0..6/0..7/0..8/0..9/0..10/0..11/0

General

Thickest to Thinness
Suture Sizes
Smallest
10-0 Typically used in the most delicate surgeries. Common in both
9-0 Ophthalmic (eye) surgery and for repairing small damaged nerves
8-0 often due to lacerations in the hand.

7-0 Used for repairing small vessels and arteries or for delicate facial
6-0 plastic surgery. Common in vascular graft sewing such as carotid
endarterectomy.

5-0 Used for larger vessel repair such as an Abdominal Aortic

4-0 Aneurysm or skin closure.
Suture Sizes
3-0 Skin closure when there is a lot of tension on the tissue, closure of
2-0 muscle layers or repair of bowel in general surgery.

0 For closing of the fascia layer in abdominal surgery, the joint capsule
1 in knee and hip surgery or deep layers in back surgery.

2 For repair of tendons or other high tension structures in large

5 orthopedic surgeries.

Largest
Suture techniques
Common suture stitching techniques include:
Simple Interrupted Stitch
Running Stitch
Mattress
Horizontal mattress
Vertical mattress
Subcuticular
Surgical techniques
Continuous

Running stitch
Surgical techniques
Simple interrupted

Subcuticular
Surgical techniques
Mattress