What are three of the most important characteristics to consider in nonabsorbable sutures?

There are several different characteristics that are important to consider when choosing sutures. The first is the durability of the suture itself, some will eventually breakdown and stop providing wound support while others are a more permanent option. The second important characteristic is the ease of use of the suture material and the third is the resistance to infection and the minimal amount of tissue reaction that occurs when the sutures are used.

Can some types of nonabsorbable sutures be broken down by the body over time? Which options provide little or no risk for this to occur?

Not all nonabsorbable sutures will last indefinitely within the human body. Silk, which is considered a nonabsorbable, will typically be fully broken down in the body within approximately two years. This can vary based on the type of tissue the suture is in, blood flow to the area, infections and the reaction of the body to the presence of a foreign body.

The most permanent type of sutures are those made of stainless steel. These sutures will have a consistent tensile strength throughout their implantation in tissue in the human body. Polyblend fibers, which are synthetic, are another highly durable option. These nonabsorbable sutures, like stainless surgical steel, will not be absorbed by the body and there is no evidence that a significant change in tensile strength occurs after the procedure. It is considered to be up to 15 times stronger than steel on a weighted basis and highly resistant to abrasion.

What are the advantages of monofilament nonabsorbable sutures over multifilament options?

Monofilament nonabsorbable sutures are more uniform in shape and diameter and also have a smoother surface than the multifilament options which are braided or twisted. The variation is extremely small but may provide an increased risk of bacterial migration along the suture or in pulling instead of a smooth flow through the tissue during the suturing process. This is a minimal concern in most cases but for specific procedures it may be an important consideration.

What is the biggest difficulty in working with surgical stainless steel nonabsorbable sutures?

Stainless steel sutures are used in a variety of different surgical procedures. It is most commonly seen in areas where wound support is required for extended periods of time in very high stress areas of the body. Thoracic surgery, neurosurgery and for surgical procedures involving orthopedics it is considered the best possible suture.

The stiffness and lack of suppleness of stainless steel sutures make them difficult to work with, especially in limited spaces where the suture material can crimp or twist on itself during the suturing process. There is also the risk that this type of suture may have a reaction in some patients and cannot be used in areas of the body or in patients where there are other metals or alloys present. These can occasionally cause electrolyte reactions in the body when the metals or alloys are in close proximity to each other.

What has been the most important advancement in surgical sutures?

There are several advances in surgical sutures that have had a huge impact on wound healing and recovery after surgical procedures. The sterilization processes for the sutures as well the antibacterial coatings used on some products greatly reduce the chance for tissue inflammation or the possibility of infection at the surgical site. Nonabsorbable sutures also provide additional support for wounds that in areas that experience a lot of stress and movement such as the cardiovascular system, joint surgeries and abdominal surgeries. For patients undergoing these procedures the uniform tensile strength of the surgical sutures that provides continued and consistent wound support is a major advancement to promote effective healing without complications.

Why are there so many different types of surgical sutures and is there one product that is considered superior for all types of surgical applications?

While historically there have been few options in surgical sutures, typically plant based suture material gave way to the use of catgut, then silk and eventually synthetics. Each of these materials, with the exception of plant based fibers, are now routinely used in various medical procedures in most hospitals, clinics and medical settings. Typically the more specialized the facility is the greater the range of surgical sutures available. Often the simplest and most versatile types of suture materials are found in less advanced types of settings including hospitals and treatment facilities in lower income areas including developing countries.

Since sutures have been designed to enhance different features for specialized applications, there is really no one best product for all jobs. Typically for most practices a good choice is a suture material that is recommended for general soft tissue ligation and approximation which can include the nonabsorbable poly based sutures as well as the absorbable catguts and synthetics. Nonabsorbable sutures, including prolene, polyester, nylon and silk can be good options for wound closure that requires long term wound support for optimum healing.

Is there an advantage in buying needled surgical sutures over suture on the reel?

In many different practices there are advantages to both the needled surgical sutures that come sterilized and packaged and the option to buy suture on a ligating reel. The obvious benefit to needled and sterilized options is that there is no work required to prepare the equipment and surgical suture material prior to the procedure. The package is simply opened in a sterile environment and following sterile procedures. The surgeon is then able to select the needle style, size and type, the length of suture and the diameter of suture based on the specific protocols for the procedure.

For small surgeries or emergency rooms this is often an ideal time and labor saving options. For specialized surgeons and larger surgical units it may be more cost effective to consider the ligating reels for suture material. This will allow the use of specific amounts of suture material that can be customized for each procedure. Since there is constant use of the suture material there is less chance of issues with keeping the product sterile and using in sterile environments.