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Suture Material

Terms in this set (39)

Types of Suture Material
o Peel package
o Cassette (spool)
Type is chosen based on:
o Preference of the veterinarian
o Mechanical properties
o Biologic interactions
Characteristics to Consider:
o Monofilament - single thread/Multifilament - several threads braided together
o Tensile strength (How hard can the material be tugged before it breaks? Want good tensile strength)
o Absorbable - Suturing inner layer/Non-absorbable - Suturing skin or outer layer
o Capillary vs Non-capillary (Capillarity: how well the material will support the movement of fluid along that material - High capillarity in infection = more likely to harbor or keep that infection along the wick and in the wound. So if suturing wound, they choose suture material that has less capillarity.
o We would choose something that's high in capillarity because of its other characteristics. We don't want capillarity, but its characteristics will be beneficial)
o Stimulate minimal tissue reaction
o Knot security (How secure will the knots stay
What does the Package contain?
o Sizes
o Brand Names
o Mono or Multifilament
o Absorbable/Non absorbable
o Shape of suture needle and whether or not it's taper or sharp
o Type of needle
o Colour of material (some is dyed and some is not. To differentiate between suture material during surgery. Visibility against tissue.)
o Length of material
What are the two main categories of Suture material?
1. Absorbable
2. Non-Absorbable
1. Absorbable
• Digested by the body
• Does not require removal
• Used when sutures must be buried (i.e. within a body cavity)
• Animal and synthetic sources
• Absorption is sped up in the following scenarios:
o Highly vascularized tissue
o Infected wounds
o Acidic pepsin secretion from the stomach
A) Surgical Gut (multifilament)
• Natural material
• Produced from sheep or hog intestine
• Plain or chromic
• Chromic gut treated to prolong absorption time, increase tensile strength, and decrease tissue reaction
• Plain gut - absorbed in 3-5 days (generally not used due to rapid absorption and tissue reaction)
• Chromic gut - absorbed in 10-15 days
• Advantages
o Elastic, easy to handle, will not shrink and strangulate tissues
o Inexpensive
• Disadvantages
o Causes inflammatory tissue reactions
o Harbors bacterial growth
o Absorbs water & swells (loosens surgical knots
B) Collagen (multifilament)
• Natural material
• Produced from bovine flexor tendon
• Same absorption as surgical gut
• Prematurely absorbed and causes tissue reaction
• Expensive
• Used almost exclusively in ophthalmic surgery
C) Polyglycolic Acid (multifilament)
• Synthetic material
• May dissolve more quickly in presence of urine
• Brand Example - Dexon
• Advantages
o Less tissue reaction compared to gut
o Tolerated in clean and infected wounds
• Disadvantages
o Can drag the tissue
o Can cut friable tissue
o Initially poorer knot security than gut (requires more throws in each knot)
D) Polyglactin 910 (multifilament)
• Synthetic material
• Coated and non-coated (coated means decreased capillary action)
• Brand Example - Vicryl (dyed form is purple)
• Advantages
o Easy to handle
o Minimal tissue reaction
o Good knot security
o Stable in contaminated wound
• Uses
o Intestinal tissue, uterus, tying of vessels
o Muscle, thin fascia, fat
E) Polydioxanone (Monofilament)
• aka PDS
• Synthetic material
• Purple in colour
• Advantages
o Minimal tissue reaction
o Good tensile strength
• Uses
o Slow healing tissue
o Contaminated wounds
F) Poliglecaprone
• Brand name = Monocryl
• Synthetic
• Monofilament
• Absorbed more quickly than PDS
2. Non- Absorbable
• Not absorbed or digested by tissue
• Remain in tissue until removed
A) Silk (multifilament)
• Natural material
• Not commonly used
• Coated to decrease capillary action
• Advantages
o Inexpensive
o Readily available
o Retains tensile strength
• Disadvantages
o Supports bacterial growth
o More tissue inflammation than other sutures
• Uses: Ophthalmic, cardiovascular and gastrointestinal surgeries and for vessel ligation
B) Cotton (multifilament)
• Natural material
• Example: umbilical tape
• Advantages
o Reasonable cost
o Easy to sterilize
o Less tissue reaction than silk
• Disadvantages
o Supports bacterial growth
o Difficult to handle when wet - sticks to sx gloves
• Uses: Prolapsed rectum, vagina, uterus (used for purse string sutures)
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