Thursday, November 10, 2011

Common Questions About Suture Types

What are the broad and general types of sutures?

There are several different types of sutures. The general categories include absorbable, which dissolve or degrade in the body, or nonabsorbable which require removal manually. Within these groups there are many different variations on manufacturing materials, coatings, treatments and styles of sutures. Two common styles include monofilament or single, continuous strands of sutures or braided sutures with are multifilament in design. Some suture types also include twisted, which is another multifilament option.
Choosing one type of suture over another is largely a function of the type of procedure, the potential stress on the wound during healing and the preference of the surgeon or physician within the options available.

What is the importance of tensile strength in selecting a suture types for different surgical procedures?

Tensile strength is the uniform strength that the suture provides in vivo over specific time periods. Wounds may require additional support or continuous support to ensure proper healing without tearing. High tensile strength is commonly seen in both absorbable and nonabsorbable sutures within specified time periods. With absorbable sutures the tensile strength begins to drop off as the protein in the suture is dissolved in the body through hydrolysis or enzyme activity. At this point the suture provides less and less support to the wound, eventually providing no support at all. This time period for decrease in tensile strength can range from a low of 7 to 10 days with full dissolving of the suture usually within a maximum of 70 days. Nonabsorbable suture types, with the exception of silk, tend to maintain their tensile strength indefinitely or until removed.

Why are some surgical suture types a different color than others is there a practical application for this variation in color?
Various surgical suture types have different color options. This is most common in the nonabsorbable varieties but some types of absorbable sutures are also designated by different colors. Generally the absorbable sutures tend to be natural colored or black, which simply makes the stitches easier to see in the wound if used on surface skin. Since these stitches will be dissolved in the body there is no need for specific coloring and it is largely irrelevant to both the physician and the patient, it is more of a personal choice for the surgeon or general practitioner.

Colored surgical sutures are used in nonabsorbable sutures so they can be easily located in the wound for removal after healing. Bright colors such as blue, green and violet that are not going to blend in with the wound or tissue colors ensure that all stitches are removed if they are going to be removed. If the stitches are left in the patient then, in the event of the need for additional surgery, there is still a highly visible record of the surgery and the incision. This allows the surgeon to check the existing surgical site as well as verify wound healing is not an issue with the current health condition. Colors also make different types of sutures very easy to distinguish on equipment trays and in equipment and materials preparation for surgical procedures.

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Presence of infection and contamination is an important factor that determine suture selection.

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