Suture material & Selection

Question 1

How to pick the right suture?

Answer 1

o Smallest diameter suture that will adequately secure wound tissue
o Strong as the normal tissue
o Maintains strength until tissue adequately healed
o Handling & knot strength necessary

Question 2

What does capillarity mean?

Answer 2

process in which fluid wicked into multifilament fibers (important with hollow structures)
- ALL BRAIDED SUTURES HAVE SOME CAPILLARITY!

Question 3

Monofilament suture:

Answer 3

smooth, requires greater surface tension (worse knot security)
o Non capillary

Question 4

Multifilament suture:

Answer 4

rough, cause more tissue trauma & has coating to reduce drag “slippery sandpaper”
o Don’t use braided suture for intestinal closure, bladder, or c-section
o Avoid in contaminated or infected sites

Question 5

What is absorbable suture?

Answer 5

• Organic origin ( digested by tissue enzyme) or synthetics degraded via hydrolysis (non-inflammatory) and loses its tensile strength within 60 days!

Question 6

What is nonabsorbable suture?

Answer 6

• Encapsulated/wall off by fibrous tissue, that retains tensile strength >60 days (can fragment & lose strength in place)

Question 7

What suture to use in different tissues:

Answer 7

• Skin: monofilament nylon (avoid capillary)
• SQ: monofilament (absorbable & synthetic)
• Fascia: slow degrading syn.absorbable (PDS)
• GI: synthetic monofilament absorbable
• Bladder: absorbable monofilament