Tuesday, November 22, 2011

Common Questions about Silk Sutures

How are silk sutures made and what are the advantages in surgical procedures?

Silk sutures are made from a natural protein fiber that is harvested from the cocoons of a domesticated type of silkworm. This domestic variety is known as the Bombyx mori, which is sometimes know as the mulberry silkworm or incorrectly as the Chinese silkworm. Domestication of this specific type of silkworm allows for the larvae to produce very uniform strands of silk which is essential in use as a suture material. The same species also produces the silk that is woven into fabric or spun into thread and used in the textile industry.

Silk for medical use is sterilized, braided and graded to create different diameters of silk suture from 9-0, the very finest suture, up to the larger size 5 suture material. It can be used in a variety of different surgical procedures including general soft tissue repair as well as the more demanding surgical procedures. It can be used in some aspects of cardiovascular surgery and is also used commonly in dental and plastic surgery where fine, highly tensile sutures are required.

What types or styles of silk sutures are available and how are they packaged?

With the variety of uses of silk sutures there are many different options in styles and types of this type of suture material. Needled, sterilized packaging offers a wide range of needle options for both plastic surgery as well as general and specialized surgical procedures. This packaging option allows surgeons to choose needle size and style, silk suture diameter and length based on the specific surgical procedure.

Other options include purchasing the silk sutures on ligating reels for use with any appropriate needle. For specialized practices or surgical theatres this can be a good option since there will be a variety of different unique procedures. For general practice and emergency rooms the pre needled and sterilized packages can be very effective, highly practical and easy to store and access at any time.

Is it true that silk sutures will eventually breakdown in the body even though they are classified as a nonabsorbable suture? How does that impact tensile strength of the product?

As a natural protein fiber, specifically fibroin, there is a natural breakdown of the silk within the human body. It is important to recognize that this is a very slow process and is not the same type of enzymatic fast breakdown of the protein component as seen with catgut sutures of any type. The specific rate of breakdown or degradation of the silk protein also varies based on individual reactions within the human body. However, the chance of the tensile strength loss being problematic when the correct diameter of silk suture is selected is not considered to be a concern. Silk sutures are routinely used in plastic surgery, dental surgery, and cardiovascular surgery as well as for general wounds and surgical procedures. Silk may also be used in very delicate surgical procedures as with ophthalmic procedures and neurological repair.

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