Types of sutures -
Memorize atleast two from each
- Absorbable or non-absorbable (natural or synthetic)
- Monofilament or multifilament (braided)
- Dyed or undyed
- Sizes 3 to 12-0 (numbers alone indicate progressively larger sutures, whereas numbers followed by 0 indicate progressively smaller)
- New antibacterial sutures
| Non-Absorbable | Absorbable |
|---|---|
| Not biodegradable & Permanents -Prolene (Fixed position, least flex) -Silk (Natural, break down in yrs) -Nylon -Stainless steel | Degraded Via inflammatory response -Vicryl -Monocryl -Chromic -Cat gut (natural) but banned from market |
 |
| Neutral | Synthetic |
|---|---|
| Biological | Synthetic poLYMERS |
| Cause Inflammatory Reaction | Do not cause inflammatory response |
| -Catgut (C.T. from cow/sheep) -Silk (Silkworm fibers) -Chromic catgut | -Nylon -Vicryl -Monocryl -Prolene |
| Monofilament | Multifilament braided |
|---|---|
| Less reaction - minimal tissue truama Easier to tie - less infectious than multifilament Single strand of suture material Minimal tissue trauma Smooth tying but more knots needed Harder to handle Examples: nylon, monocryl, prolene, | More risk, due to highly braided filament, which may result in proliferation and growth bacteria on these sites Fibers are braided or twisted together More tissue resistance Easier to handle Fewer knots needed Examples: vicryl, silk, chromic |
Suture selectionZ
- Do not used dyedZ
- on the skin avoid multifilament and prefer Monofilaments
- Non-absorbable cause less scarring and allergic reactions- but must be removed
- Location and layer, patient factors, strength, healing, site and availability
- Absorbable for GI, urinary or biliary
- Non-absorbable or extended for up to 6 mos for skin, tendons, fascia
- Cosmetics = monofilament
Sizes of suture
- 1,2,3” large
- 2-0”, 3-0 e.g. Small