Suture materials

Content  in suture packet

Toothed forceps
Non toothed forceps
Scissor
Swabs
Drapes
Lignocane
10 ml  syringe
suture



Needle  types


Based  on  edge


Cutting  needle

Cutting edge on inside of circle. Ue to  suture skin & aponeurosis


Reverse Cutting



Cutting edge on outside of circle. Use  to suture  muco periosteum


Round body needle



Used in  soft  tissues like peritoneum , muscle, vessels, nerves & bowel

Based on curvature

Straight needle














Curved needle













Curved Shapes of Needles



•          3/8 circle
•          1/2 circle
•          Straight
•          Specialty


Based  on existence  of the eye

A traumatic  needle


Here  suture  martial  is  attached  to  the  needle  by  swaging.  Size of  suture  material  and that  of  the  needle is  same  & tissue  trauma  less. Not  reusable.




Traumatic  needle
It  is eyed  needle. Needle  in the  eye  area is  wider than the  body of  the  needle &  so tissue  trauma  is more . reusable

         Suture  materials

Absorbable Sutures
•          Internal
•          Intradermal/ subcuticular

Natural


Gut/ Chromic Gut


•          Made of submucosa of small intestines
•          Multifilament
•          Breaks down by phagocytosis: inflammatory reaction common

Chromic: tanned, lasts longer, less reactive
•          Easy handling
•          Plain: 3-5 days
•          Chromic: 10-15 days

Synthatic

Vicryl (Polyglactin 910)


•          Braided, synthetic, absorbable
•          Stronger than gut: retains strength 3 weeks
•          Broken down by enzymes, not phagocytosis
•          Break-down products inhibit bacterial growth
–      Can use in contaminated wounds, unlike other multifilaments

Dexon and PGA


•          Polymer of glycolic acids
•          Braided, synthetic, absorbable
•          Broken down by enzymes
•          Both PGA and dexon have increased tissue drag, good knot security
•          Both are stronger than gut

PDS (polydioxine)


•          Monofilament (less drag, worse knot security – lots of “memory”)
•          Synthetic, absorbable

•          Very good tensile strength (better than gut, vicryl, dexon) which lasts
•          Absorbed completely by 182 days





Maxon (polyglyconate)


•          Monofilament- memory
•          Synthetic Absorbable
•          Very little tissue drag
•          Poor knot security
Very strong Non-absorbable Suture




Non absorbable

•          Primarily Skin
–      Needs to be removed later
–      Stainless steel = exception
–      Can be used internally
•          Ligature
•          Orthopedics

•          Can be left in place for long periods

Synthatic


Nylon
•          Synthetic
•          Mono or Multifilament
•          Memory
•          Very little tissue reaction
•          Poor knot security



Polypropylene


•          Prolene, Surgilene
•          Monofilament, Synthetic
•          Won’t lose tensile strength over time
•          Good knot security
•          Very little tissue reaction




Stainless Steel

•          Monofilament
•          Strongest !
•          Great knot security
•          Difficult handling
•          Can cut through tissues
•          Very little tissue reaction, won’t harbor bacteria

Natural

Collagen and  silk
           Natural sutures
•          Very  reactive, absorbable
•          Use in ophthalmic surgery