SURGICAL SUTURES-10.ppt

8/10/2019 SURGICAL SUTURES-10.ppt

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Suture

The word "suture" describes anystrand of material used to ligate

(tie) blood vessels or approximate

(sew) tissues.


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History

In the10th century AD

ABUL QASIM AL ZAHRAVI in Baghdad

successfully Performed Thyroid Surgerywith the help of sutures.


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Ideal Suture

Sterile

Easy to handle

Minimal tissue reaction/trauma High tensile strength retention

Knot security

Absorbable Useful in all tissues


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Suture Classification

Absorbable / Nonabsorbable

Natural / Synthetic

Braided / Monofilament


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Absorbable Sutures

Definition- sutures that can be absorbed into the

body by either enzymatic or hydrolytic processes.


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Nonabsorbable

Definition- Sutures that are not absorbed

into the body.


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Natural

Definition- Sutures made of material that

can be found in nature.


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Definition- Sutures made from materials

created by man.

Synthetic


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Monofilament

Definition- A single strand of material

Properties-Less traumatic

- Resist Bacterial harboring


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Braided(multifilament)

Definition- Multifilament sutures that consist

of several filaments or strands, twisted or

braided together.

Properties

- Greater tensile strength

- Pliability and flexibility


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Example Suture Selection

Absorbable

Natural

Synthetic

Non AbsorbableNatural

SyntheticChromic gut

Plain Gut

VICRYL*

( polyglactin 910) suture

Stainless steel

Silk

PROLENE*

polyester

nylon

(polypropylene) suture


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AbsorbableNatural

Plain Gut Chromic Gut


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Plain Gut

Submucosal or serosal layer of sheepintestine

Packed wet to keep supple

resorbs quickly In oral cavity rarely lastinglonger than 3-5 days

absorption 60-90 days

Natural Absorbable

Monofilament


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Chromic

Submucosal or serosal layer of sheep intestine

Packed wet to keep supple

Chromicizing (chromic acid treated gut) processprolongs strength retention

chromic gut lasts longer upto 7-10days

absorption 90 days

Natural Absorbable

Monofilament


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Gut Sutures

Advantages

- no foreign body left

- minimal tissue trauma

- minimizes tissue reactions

- pliable, good handling & knotting

Natural Absorbable

Monofilament


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Chromic Gut

Absorption is by enzymatic action

Absorption is unpredictable

Tissue reactions occur

Natural Absorbable

Monofilament


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Example suture selection

Absorbable

Synthetic

VICRYL Rapide VICRYL


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VICRYL*(polyglactin 910) suture

Mass absorption 56-70 days

Synthetic

Absorbable Braided


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VICRYL*(polyglactin 910) suture

Advantages

Synthetic

Absorbable Braided

SYNTHETIC Predictable absorption less tissue reaction

ABSORBABLE No foreign body left

COATING Easier passage through tissue

Minimal trauma in tissue

Knots slide easily

Coating is not removed in presence of fluids


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Example suture Selection

Nonabsorbable

Natural

Stainless steelSilk


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SILK

Made from silkworm cocoons

Excellent handling & knot tying

characteristic

Standard for many years

Wicking action: because of multi-

filament carry bacteria along with saliva

Natural

Nonabsorbable

Braided


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Stainless Stell(stainless steel 316l) suture

Where extra strength is required

Sternum closure

Special packaging to minimize kinks

Pull out tendon sutures

Cardiac pacing wires

Natural Nonabsorbable

Monofilament


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Nonabsorbable

Synthetic

PROLENE


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PROLENE*(polypropylene) suture

Polypropylene

Most inert material

Stretching and handling properties

Knot security

Used in vascular surgery

Skin & subcuticular layer

Synthetic

Nonabsorbable

Monofilament


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Prolene*(Polypropylene) suture

Advantages

Synthetic

Nonabsorbable

Monofilament

MONOFILAMENT Easy to remove

SYNTHETIC Minimal tissue reactions even inthe presence of infection

Provides permanent woundsupport.

SURGICAL SUTURES-10.ppt

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