Sutures can be made from absorbable materials like catgut or synthetic polymers, or non-absorbable materials like silk. Absorbable sutures degrade naturally in the body over time through hydrolysis or proteolysis, while non-absorbable sutures require removal. Common absorbable sutures include catgut, Vicryl, and Dexon, while common non-absorbable sutures are silk, nylon, and Prolene. Sutures vary in material, thickness, needle type and size to suit different surgical needs. Proper suturing technique involves grasping the needle correctly, perpendicular entry and exit of tissue, even spacing of sutures with knots on

1. SUTURES MATERIAL

2. SUTURING
• SUTURES:
– used for putting the tissue back in place
– usually use silk (non-resorbable)
• requires post-op visit to remove
– occasionally plain or chromic ―gut‖
(resorbable) when close to student break
time
• both made from sheep/cow , not ―cat‖
– Others (Dexon, nylon etc.) for special use

3. Different Types of Sutures
• There are different kinds of sutures.
• Most sutures are actually done the same
way but made out of different things.
• First we have to know there are two
different master types, absorbable and
nonabsorbable.
• Absorbable of course can be absorbed by
the body naturally, and non... can't. .

4. What are the types of resorbable
sutures? Nonresorbable sutures?
Resorbable
• Plain gut
• Chromic gut
• Synthetic
• Vicryl
• Dexon
Non resorbable
• Silk
• Synthetic
• Nylon
• Mersilene
• Prolene

5. Synthetic suture materials
• Absorbable
– Polyglycolic Acid (Dexon)
– Polyglactin (Vicryl)
– Polydioxone (PDS)
– Polyglyconate (Maxon)
• Non-Absorbable
– Polyamide (Nylon)
– Polyester (Dacron)
– Polypropylene (Prolene)

6. Natural suture materials
• Absorbable
– Catgut - Plain or chromic
• Non-Absorbable
– Silk
– Linen
– Stainless Steel Wire

7. Catgut
• Made from the submucosa of sheep
gastrointestinal tract
• Broken down within about a week
• Chromic acid delays hydrolysis
• Even so it is destroyed before many
wounds have healed

8. Silk
• Strong and handles well but induces
strong tissue reaction
• Capillarity encourages infection causing
suture sinuses and abscesses

9. Vicryl
• Tensile strength
– 65% @ 14 days
– 40% @ 21 days
– 10% @ 35 days
• Absorption complete by 70 days

10. Polydioxone
• Tensile strength
– 70% @ 14 days
– 50% @ 28 days
– 14% @ 56 days
• Absorption complete by 180 days

11. Absorbable suture are broken
down by either:
• Proteolysis (e.g. Catgut)
• Hydrolysis (e.g. Vicryl, Dexon)

12. SUTURING
• Info on front of package explains
– shape of needle
– Thickness of suture material (higher no. thinner
suture
– whether needle is ―cutting‖ or ―tapered‖

13. Ethicon Sutures

14. Polyglycolic acid PCA Chromic catgut CC

15. Polypropylene
Silk braided (SK)

16. • Thread length
45cm,,60cm ,75cm,100cm,125cm,150cm
• Thread diameter
8/0, 7/0,6/0, 5/0, 4/0, 3/0,2/0,1/0,1, 2, 3

17. • Needle length
6mm, 8mm, 12mm, 18mm, 22mm, 30mm,
35mm, 40mm, 50mm
• Needle curvature
Straight, 1/2 circle, 1/2 circle (double), 1/4
circle, 1/4 circle (double)
3/8 circle, 3/8 circle (double), 5/8
circle, loop round

18. • Cross section
Round bodied, round bodied
(heavy), curved cutting, curved
cutting(heavy)
Reverse cutting, reverse cutting
(heavy), tapercut, micro-point spatula
curved

19. needle identification

20. Needle shape

21. Suture materials

22. Rapid Absorbable Suture

23. DemeTech's Rapid Absorbable
Sutures
• DemeTech's Rapid Absorbable suture is a,
synthetic, absorbable sterile, surgical
suture composed of copolymers made
from 90% glycolide and 10% L-lactide.
• . The absorption time for Rapid
Absorbable is 42 to 56 days.DemeTech's
Rapid Absorbable sutures are available
violet and colorless.

24. • · DemeTech's Rapid Absorbable sutures
give the best characteristics of both
natural and synthetic sutures, allowing for
the low infection rate of a synthetic suture,
while providing the quick absorption and
high tensile strength of collagen sutures
(catguts).

25. MED EUROPE

26. What are the principles of suturing
technique?
• The suture should be grasped with the needle
holder three-fourths of the distance from the tip.
• The needle should be perpendicular when it
enters the tissue.
• The needle should be passed through the tissue
to coincide with the shape of the needle.
• Sutures should be placed at an equal distance
from the wound margin (2—3 mm) and at equal
depths.

27. What are the principles of suturing
technique?
• Sutures should be placed from mobile tissue to
fixed tissue.
• Sutures should be placed from thin tissue to
thick tissue.
• Sutures should not be overtightened.
• Tissues should not be closed under tension.
• Sutures should be 2—3 mm apart.
• The suture knot should be on the side of the
wound.

28. When should intraoral sutures
be removed?
• In uncomplicated cases, sutures generally
may be removed 5—7 days after
placement.