Types of Suture material

varies types of suture material use surgical techniques

1. SUTURE MATERIAL Dr. HIREN PATOLIYA Seth Nandlal Dhoot Hospital Aurangabad

2. CONTENTS INTRODUCTION REQUISITES OF IDEAL SUTURE CLASSIFICATION SELECTION OF SUTURE MATERIAL ABSORPTION OF SUTURE MATERIAL BIOLOGICAL RESPONSE OF BODY TO SUTURE

3. INTRODUCTION SUTURE MEANS TO “SEW” OR “SEAM”. IN SURGERY SUTURE IS THE ACT OF SEWING OR BRINGING TISSUE TOGETHER AND HOLDING THEM IN APPOSITION UNTIL HEALING HAS TAKEN PLACE. SUTURE IS A STRAND OF MATERIAL USED TO LIGATE BLOOD VESSLES AND TYO APPROXIMNATE TISSUE TOGETHER.

4. GOALS OF SUTURING SUTURING IS PERFORMED TO PROVIDE ADEQUATE TENSION MAINTAIN HEMOSTASIS PROVIDE SUPPORT FOR TISSUE MARGINS REDUCE POST OP PAIN PREVENT BONE EXPOSURE PERMIT PROPER FLAP POSITION.

5. SUTURE MATERIALS

6. THE IDEAL SUTURE THREAD Universal applicability-only difference in diameter Limp- easy to handle, no kinks, coiling, twisting or levitating Inert-Minimal tissue strength Frictionless surface to glide through tissue- minimal trauma High friction for secure knotting Sterizable without composition changes Resist bacterial growth Capable of holding tissue layers throughout the wound healing Complete absorption, no residue, after healing is complete –no matter how long it takes. Nonelectrolytic,nonferromagnetic,noncapillary,nonallergenic,noncarcinogenic Cost effective.

7. CLASSIFICATION OF SUTURE MATERIALS ACCORDING TO SOURCE:- NATURAL SYNTHETIC METALLIC

8. ACCORDING TO STRUCTURE: MONOFILAMENT MULTIFILAMENT ACCORDING TO FATE:- ABSORBABLE(undergo degradation and lose tensile strength <60 days, it will eventtually dissolve, absorb into the tissue, and become unidentifiable ) NON ABSORBABLE( maintain tensile strength >60 days, permenent , fixture in the body and, when properly tied or secured, will remain intact indefinitely.) ACCORDING TO COATING COATED UNCOATED

9. NATURAL ABSORBABLE Catgut Chronic catgut Fascia lata Kangaroo tendon Beef tendon Cargile membrane NON ABSORBABLE Silk’ Silk worm gut Linen Cotton Ramie Horse hair

10. SYNTHETIC ABSORBABLE Poly g lycolic acid Poly g lactic acid Poly g lactin 910( vicryl ) Polydioxanone (PDS) Poly g lecaprone 25 NON ABSORBABLE Nylon/polyamide Polypropylene Polyesters Polyetelene Polybutester Polyvinylidene fluoride/PVDF sutures.

11. According to structure M onofilament Polyfilament

12. MONOFILAMENT Advantages Smooth surface Less tissue trauma No bacrteial harbours No capillarity More memory Provide more cosmetic result Disadvantages Handling and knoting Stretch. Any nick or crimp in the material leads to breakage. Required more knot to prevent slippage-5 to6 throws

13. MONOFILAMENT ABSORBABLE Surgical gut-plain/chromic Polydiaxanone polyglactin910 NON ABSORBABLE Polypropylene Polyester Nylon/polyamide Polyvinylidene fluoride/PVDF sutures

14. DIFFERENT BETWEEN MONO AND POLYFILAMENT MONOFILAMENT HANDLING DIFFICULT SMOOTH AND STRONG NO WICKING THINNER POLYFILAMENT HANDLING EASY LOW STRENGTH WICKING IS A PROBLEM THICKER

15. MULTI FILAMENT ADVANTAGES STRENGTH SOFT AND PLIABLE GOOD HANDLING GOOD KNOTTING ABSORBABLE POLYGLACTIN 910 POLYGLYCOLIC ACID DISADVANTAGES BACTERIAL HARBOURS CAPILLART ACTION TISSUE TRAUMA NON ABSORBABLE SILK COTTON LINEN

16. Plasticity:-ability to expand when stretched and don’t return to original length(loosen with edema) Elasticity:- ability to return to its origina;l length after stretching , high elasticity sutures should be used in oedematous tissue Fluid absorption and capillary action”:- the tendency for a suture to absorb water and wick infection

17. Breaking strength rate:- approximate days after placement when 50% of breaking strenth remains. Tensile strength:- force necessary to break a suture consider in areas of tension:linea alba) Knot strength:- force required for a knot to slip consider when ligating arteries Memory : tendency ti return to original shape(untied) tendency to stay in one position, leads to difficulty in tying sutures.

18. Shape of niddle Curved:- designed to be held with a needle holder used for most suturing Straight:- oftern hand held, used to secure percutaneously placed devices( central and arterial lines)