Suture material

Suture materials, Types of suturing, Types of knots

1. Suture Material
M. Jude NilshanFernando

2. Classifications
•Absorbabalevsnon-absorbable
•Natural vssynthetic
•Monofilament vspolyfilament

3. Absorbable
Absorbable
Natural
Monofilament Braided
Synthetic
Monofilament Braided
JMJ 3
Plain Catgut
Chromic catgut
Polydiaxanone-
PDS
Polyglycolicacid-
Dexon
Polyglactin-Vicryl

4. Non -Absorbable
Non-Absorbable
Natural
Monofilament Braided
Synthetic
Monofilament Braided
JMJ 4
Silk
Linen
Wire –steel
Nylone–Ethilon
Polypropylene -
prolene
Expanded polytetrafluoroethylene(ePTFE) –expanded monofilament

5. Absorbable vsNon-absorbable
•Strength of absorbable sutures are less
•Non-absorbable sutures
•retain strength indefinitely and are used
•where strength is needed until repair is completed naturally
(abdominal incision and hernia repair)
JMJ 5

6. Natural vsSynthetic
Natural
•Catgut
•Silk
•Linen (strong inflammatory
reaction)
Synthetic
•Dexon
•Vicryl
•PDS
•Nylon
•Polypropylene
•ePTFE
JMJ 6

7. Monofilament vsBraided
Monofilament
•Catgut
•Polydiaxanone
•Wire
•Polypropylene
•Nylon
Braided
•Polyglycolicacid
•Polyglactil
•Silk
•Nylon
•Linen
JMJ 7
They are smooth
Pass easily through
tissue
Cause less tissue
reaction
Handle well
More risk of
infection

8. Features of a ideal suture material
•Adequate tensile strength
•Good knot holding property
•Should be least reactive
•Easy handling property
•Should have less memory
•Should be easily available and costeffective
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9. JMJ 9

10. JMJ 10

11. JMJ 11

12. Absorbable
Suture Materials
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13. Plain catgut
•Absorbed by inflammatory reaction and phagocytosis
•Absorption time –7 days
•Used for
•Subcutaneous tissue
•Muscle
•Circumcision in children
JMJ 13

14. Chromic catgut
•Catgut with chromic acid salt
•Brown in colour
•Absorption time 21 days
•Used for
•Suturing muscles
•Fascia
•External oblique aponeurosis
•Ligating pedicles
JMJ 14

15. Vicryl–Polyglacticacid
•Absorbed in 90 days
•Absorption is by hydrolysis
•Violet in colour(braided)
•Polyfilamentand braided
•Used for
•Bowel anastomosis
•Suturing muscles
•Closure of peritoneum
JMJ 15

16. Dexon–Polyglycolicacid
•Creamy yellow in colour
JMJ 16
PDS-Poly DioxanoneSuture
Material
•Costly
•But better than vicryl

17. Uses in absorbable suture materials
•Bowel anastomosis (gastrojejunostomy, resection &
anastomosis)
•Vicryl
•In cholecystojejunostomy, choledechojejunostomy
•Vicryl
•In suturing muscle, fascia, peritoneum, sub cutaneous
tissue, mucosa
JMJ 17

18. Uses of absorbable suture materials
•Ligation of pedicles during hysterectomy
•1-zero chromic catgut
•Vicryl
•In circumcision
•3-zero plain or chromic catgut
•Absorbable suture materials should not be used for
•Suturing tendons
•Nerves
•Vessels (vascular anastomosis)
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19. Non-Absorbable
Suture Materials
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20. Silk
•Black colour
•Coated material to reduce capillary action
JMJ 20

21. Polypropelene
•Blue in colour
•Got high memory
JMJ 21
MEMORY –is recoiling tendency after
removal from the packet. Ideally
suture material should have low
memory

22. Uses of non-absorbable suture
materials
•In herniorraphyfor repair
•For closure of abdomen after laparotomy
•For vascular anastomosis (6-zero), nerve suturing,
tendon suturing
•For tension suturing in the abdomen
•For suturing of skin
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23. TYPES OF SUTURING
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24. Simple continuous suture

25. Interrupted simple suturing
Increase risk of infection
Easy when need of draining

26. Interrupted mattress suturing

27. Subcuticularsuturing
Good cosmetic results

28. Suture Removal
•Face and neck 3-4 days
•Scalp 5-7 days
•Limbs 5-7 days
•Hands and feet10-14 days
•Abdomen 8-10 days
JMJ 28

29. TYPES OF KNOTS
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31. NEEDLES
JMJ 31

33. Needles
Cutting edge
•Triangular in cross section
•Skin
•Tendon
•Breast tissue
Round body
•Oval or round in cross
section
•GI tract
•Vascular anastamosis
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34. THANK YOU!
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