Monday, December 12, 2011

Gut Sutures Q & A

How fast are gut sutures typically absorbed by the body and what factors make a difference in absorption rates?

Gut sutures are absorbed in the body at various rates. Most of the sutures will have full tensile strength for approximately 7 days after use but the tensile strength can begin to decrease slightly prior to that if infection, high levels of blood flow, taking specific medications or if the gut suture is not high quality collagen. In addition these sutures used in the mouth or in reproductive tract procedures will have a faster rate of loss of tensile strength due to faster breakdown of the collagen. High quality absorbable sutures are very uniform in size and are designed to have good flow through when suturing.

Most natural sutures will be completely absorbed by the body within 90 days. However, after day 7 the tensile strength decreases markedly and quickly, providing only limited support for the healing process.

What are the major features of gut sutures that make them a good option in a wide variety of types of procedures?

Gut sutures come pre-sterilized and packaged based on length and diameter of suture material as well as the type and size of needle required. This is a great option for a busy emergency or surgery unit or for a smaller clinic that typically is not going to complete a lot of emergency wound repairs or surgical procedures.

The nature of gut sutures also makes them very unlikely to cause reactions at the site of the suture. Plain gut is very neutral in the body and, unlike the chromic gut, there is rarely any reaction of the surrounding skin. Since the suture material is very uniform in diameter and smooth there is little if any tissue damage to the tissue during the suturing. Last but not least the suture is very easy to work with, flexible yet strong, resistant to fraying and is very effective at holding knots securely.

What options are available in absorbable sutures that will have slightly longer tensile strength in the body the standard gut sutures?

One option that many surgeons and medical practitioners prefer to plain gut is chromic gut. This is a natural suture that is treated with chromic salts prior to packaging. The chromic salts act as a barrier to the natural breakdown of the collagen in the suture. This slower ability of the body to break down the actual fibers in the sutures provides longer tensile strength. Different sizes of chromic gut and different preparations can extend the tensile strength and reduce absorption rates by days or weeks.

Although chromic gut is broken down less rapidly in the body than natural gut there are still multiple variables that can speed up or slow down the specific timeline for absorption. For this reason all types of absorbable sutures should be carefully considered before using in a specific surgical ligation or approximation. The absorption of the sutures is still a major benefit to consider in many types of procedures.

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