Classification of suture materials used in OT.
Natural Absorbable Sutures - Surgical Catgut
-
Collagen manufactured from the submucosa
of sheep intestine or serosa of beef intestine.
-
Used in tissue that heals rapidly.
-
Digested by body enzymes and absorbed by
tissue so that no permanent foreign body remains.
-
The rate of absorption is influenced by
the following:
Ø Type
of tissue
Ø Type
of surgical catgut
Ø General
health status of the patient
Ø Condition
of tissue
Plain
Surgical Catgut
-
Lose tensile strength quickly, usually in
5 to 10 days
-
Used to ligate small vessels and to suture
subcutaneous fat
-
Not used to suture any layer of tissue
likely to be subjected to tension during healing.
-
Available in sizes 3 to 6-0.
-
Usually used in its natural yellow-tan
colour, it may be dyed blue or black
-
Fast absorbing plain surgical catgut is
specially treated to speed absorption and tensile strength loss.
-
May be used for epidermal suturing where
sutures are needed for no more than a week. These sutures are used only externally
on skin, not internally, particularly for facial cosmetic surgery.
Chromic
Surgical Catgut
-
Is treated in a chromium salt solution to
resist absorption by tissues
-
This treatment changes the color from the
yellow-tan shade of plain surgical catgut to a dark shade of brown
-
It is used for ligation of larger vessels
and for suture of tissues in which non-absorbable suture materials are not
recommended
-
Available in sizes 3 to 7-0
Synthetic Absorbable Sutures
-
These are absorbed by a slow hydrolysis process
in the presence of tissue fluids.
-
They are used for ligating and suturing.
-
They are extremely inert and have great
tensile strength
-
Can be used in nearly all tissues.
-
As a disadvantage, it tends to drag
through the tissue rather than passing smoothly.
The
sutures included in this group are:
Ø Polyglycolic
acid (Dexon) suture
Ø Polyglactin
910 (Vicryl) suture
Ø Polydioxanone
(PDS) Suture
Ø Polyglicaprone
(Monocryl) suture
Surgical
Silk
-
An animal product made from the fibre spun
by silkworm larvae in making their cocoons
-
Widely used non-absorbable suture that is
easy to handle and is both supple and strong.
-
Can be used in a wide variety of tissues,
ranging from ophthalmic to cardiovascular
-
Has a multifilament structure and is
treated with Teflon or a similar coating to prevent tissue drag and flaking.
Surgical
Cotton
-
Manufactured from the fibers of the cotton
plant
-
Supple and easy to handle
-
Has inferior strength and tendency to
flake
-
Can be strengthening by dipping it into saline
solution prior to use.
-
Its application is nearly identical to
that of silk.
Polyester
Suture
-
The strongest of all sutures except for
surgical steel
-
It is usually multifilament and may be
coated with Teflon
-
Used in a wide variety of tissues,
including facial, cardiovascular, and ophthalmic.
Nylon
Suture
-
Used primarily for skin closure,
ophthalmic procedures, and microsurgery.
-
Produces minimal tissue reaction
-
Has high tensile strength, and resists
capillary action
-
The major disadvantages of nylon are its
elasticity and stiffness, which necessitate the laying of many knots.
Polypropylene
(Prolene) Suture
-
Extruded into a monofilament strand
-
The most inert of the synthetic materials
and almost as inert as stainless steel
-
Easier to handle
-
Can be used in the presence of infections
-
The material of choice for many plastic
surgery and cardiovascular procedures because of its smooth passage through
tissues, as well as its strength and inertness
-
Frequently used for retention sutures
Surgical
Steel
-
Made of stainless steel and is the most
inert type of suture available
-
Used mainly in the orthopedic surgery to
approximate bone fragments
-
Not widely used because of major
disadvantages:
Ø Extremely
difficult to handle
Ø Kinks
easily and has a “sawing” effect on tissue
Ø Because
of its springiness it is easily contaminated at the field
Ø The
sharp ends of the strands can easily puncture a glove, causing contamination
and injury to the person handling it.
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