Suture Materials

Question 1

How can suture materials be classified?

Answer 1

Origin: Natural/Synthetic
Persistance: Absorbable/Non-absorbable
Structure: Monofilament/Multifilament

Question 2

What are the advantages of synthetic over non-synthetic materials?

Answer 2

Synthetic fibres generally illicit less of an inflammatory response and have a predictable absorption time.

Question 3

When would one want to use a non-absorbable suture material?

Answer 3

When a long term strength is needed. I.e. > 60d strength needed.

Question 4

Why is a multifilament suture material good?

Answer 4

They are easier to handle and have better knot security than monofilament sutures, However monofilaments have less tissue drag but can weaken when crushed

Question 5

What are synthetic absorbable multifilament fibres used for and give examples of these.

Answer 5

Vessel ligation and soft tissue closure e.g. skin

Vicryl -
Dexon -
Polysorb -
Panacryl -

Question 6

What short duration synthetic absorbably monofilament fibres are there and what are they used for?

Answer 6

(90-120d absorbed)
Monocryl
Caprosyn

General soft tissue closure 
Visceral closure (monocryl)

Question 7

What options are there for soft tissue that need longer support i.e. muscles, fascia, fibrous tissue?

Answer 7

Synthetic absorbablemonofilament long duration (110-210d)

PDS 2
Maxon
Biosyn

Question 8

What are the following suture materials classified as and what is there use?

Prolene/Surgipro
Ethilon/Monosof
Flexon

Answer 8

Synthetic non-absorbable monofilament

These are inert so can be used for skin, stoma and vessels
Also for prolonged support e.g. hernia&tendon

Question 9

What are the following suture materials classified as and what is there use?

Mersiline/Ethibond
Novafil
Supramid

Answer 9

Synthetic non-absorbably multifilament

Ligament prosthesis
Skin closure possibly

Question 10

What are the natural absorbablemultifilaments available and what are they used for?

Answer 10

Catgut and collagen

Use in vessel ligation and possibly ophthalmic surgery

Question 11

What is silk used for?

Answer 11

Large vessel ligation outside of viscera.

Question 12

What is the rational basis behind suture material selection?

Answer 12

Tensile strength should match strength of the tissue
Rate of strength loss=gain in wound strength
Whether the suture material will alter biological healing

Question 13

What general rules about suture materials are there?

Answer 13

• Avoid multifilament in contaminated wounds
• Avoid non-absorbable materials in hollow organs
• Use inert material for skin
• Avoid reactive material for stoma creation
• Use slowly absorbable/non-absorbable material in muscle fascia etc.
• Avoid burying suture material from a multi-use cassette
• Avoid catgut in inflamed acidic or infected wounds.

Question 14

What is a consideration when thinking about the size of suture material to use?

Answer 14

Use the smallest size possible.

Question 15

What are the different shapes of needle?

Answer 15

• Straight
• Curved
• Curved on straight
• Compound curve
• J-Shape

Question 16

What are the different needle points?

Answer 16

Non-cutting - Round bodied
- Taper point

Cutting - Taper cut

         - Cutting
         - Reverse cutting
         - Spatula cutting

Question 17

What suture material(s) would one use for muscle repair?

Answer 17

ABS mono - PDS/Biosyn/Maxon

Question 18

What type of suture material is monocryl?

Answer 18

Synthetic absorbable monofilament short duration