Sutures : Properties, Types and Uses

Sutures

What are sutures?

Sutures are the sterile threads, strings and strands, which are prepared specially for use in surgery. They are used for sewing tissues together.

Properties of sutures:

1. Sutures should be sterile
2. Sutures should not cause irritation
3. Sutures should have finest possible guage and adequate strength
4. Their time of absorption must be known for the absorbable sutures
5. Sutures should be used for one occasion only

Preparation of sutures:

Sutures may be prepared from

• Intestinal tissues and tendons of animals and birds
• Vegetable fibres
• Camel hair
• Human hair
• Synthetic threads
• Metallic wires

Depending on their absorption characteristics, i.e their digestion in the body tissues, they are known as

1. Absorbable sutures
2. Non-absorbable sutures

Sterilisation of sutures:

Various methods are available for sterilising the sutures. A few important methods for sterilising the sutures are

• Chemical sterilisation
• Sterilisation by irradiation
• Heat sterilisation

Heat sterilisation involves two processes and sutures are classified into two categories depending on their resistance to heat

• Boilable
• Non-boilable

Any sterilisation should not affect the properties of sutures or their utilisation. In irradiation method, the sterilisation is carried out by using electron particles or gamma rays from cobalt 60. The recognised dose of gamma rays treatment is 2.5 megarad.

Types of sutures:

(1) Absorbable sutures

• Sterile catgut (small intestine of sheep, ox and appendix of deer)
• Sterile reconstituted collagen suture

(2) Non-absorbable sutures

• Sterile non-absorbable sutures (silk and cotton)
• Sterile linen suture
• Sterile polyamide sutures (nylon)
• Sterile polyester sutures (terylene)
• Sterile braided sutures
• Sterile stainless and silver sutures

(3) Haemostatics

• Oxidised cellulose
• Absorbable gelatin sponge

Uses of Sutures:

• Based on the physical and chemical properties and also the desired effect, various sutures are used extensively under different conditions.
• Silk sutures are strong, smooth inactive and available in various diameters.
• The braided form is compact one and has a special advantage of not getting twisted when drawn through the tissues of the body.
• Nylon sutures are strong enough and are having their utility in skin and plastic surgeries.
• Cotton sutures are preferred more for their low tissue reactivity, but they have low tensile strength.
• Linen is much economical and quite effective, it does not have uniform diameter for practical purposes.
• Kangaroo tendons are used specially in hernia.
• Metallic sutures are used in general for surgeries.