Suture Materials & Patterns

Question 1

Give some general pros and cons of monofilament vs multifilament suture materials

Answer 1

Monofilament suture: minimal tissue drag and a reduced risk of infection, but increased bending stiffness and memory are associated with poorer handling properties and reduced knot security

Multifilament suture: easier to handle (less memory) and less likely to break & greater initial breaking strength than monofilament suture. Does potentially incr infection risk through ‘wicking’ of bacteria

Question 2

Methods of absorbtion/degradation for natural vs synthetic absorbable suture

Answer 2

Natural - degraded by proteolytic enzymes

Synthetic - non-enzymatic hydrolysis of ester bonds, occurs independent of inflammation, then phagocytosis

Question 3

How many throws for surgeon or square knots are recommended to start and a continuous suture line in a linea alba closure

Answer 3

Greatest strength with at least 6 throws for a start knot & at least 7 throws for an end knot using large-gauge suture. Additional throws do make sutures larger which can incr tissue reaction