The document discusses sutures and suturing materials. It defines sutures as stitches used to approximate wound edges to help healing. Suture materials are synthetic fibers that hold wounds closed until natural scar tissue forms. The goals of suturing are wound edge apposition, tension, hemostasis, and infection prevention to produce a good scar. Suture characteristics include physical structure (monofilament or multifilament), tensile strength, absorbability, and biological behavior. Common suturing tools are needle holders, needles of varying shapes and tips, and materials like polypropylene, silk, and vicryl which are selected based on wound and tissue factors.

1. SUTURE
MATERIAL

2. contents
o Definitions
o Goals of suturing
o Suture characteristics
o Armamentarium of suturing
o Suture materials
o Principles of suturing

3. DEFINITION
 what is suture?
• Suture is a stich or series of stiches made to
secure apposition of the edges of a surgical or
traumatic wound.
 What is suture material?
• Suture material is an artificial fibers used to
keep wound together until they hold themselves
by natural which is
synthesized & oven into a stronger scar.

4. GOALS OF
SUTURING
 Wound edge apposition.
 Provide adequate tension.
 Maintain hemostasis.
 Aid in wound healing.
 Avoid wound infection.
 Produce aesthetically pleasing scar by
approximating skin edges.

5. SUTURE
CHARACTERISTICS

6. PHYSICAL
STRUCTURE
MONOFILAMENT-
 This suture material is smooth &
tends to slide through tissues
easily.
 Difficult to knot.
 Can be damaged by gripping it with
needle holder or forceps.That can
lead to fracture of the suture materials.

7. PHYSICAL
STRUCTURE
MULTIFILAMENTS
 Easy to knot.
 Have a greater surface area
than monofilaments.
 Have a capillary actions where bacteria
may lodge & be responsible for
persistent infections.
 This material can be coated with silicone
in order to make it smooth.

10. TENSILE
STRENGTH
•It can be expressed as the force required to
break it when pulling the two ends apart.It
depends upon –
 Constituent of suture materials.
 Thickness of suture materials.
 How it is handled in the tissues.

11. ABSORBABILITY
• Suture materials may be absorbable or
non-absorbable.This property must be taken
into consideration when choosing suture
materials for specific wound closures. Oral
mucosa & Deep sturcture need to be
absorbable suture materials but vascular
anastomoses need non-absorbable suture
materials.
 Biological Behaviour:
• It depends upon the constituent of raw
materials.

12. BIOLOGICAL
BEHAVIOUR • It depends upon the constituent of raw
materials.

13. ARMAMENTARIUM
OF SUTURING
 Needle holder
 A suture needle
 Suture material

14. HOW TO HOLD
• The needle holder is held with
thumb & ring finger through the
rings & with the index finger
along the length of needle
holder to provide stability &
control.

15. A SUTURE NEEDLE
 Made up of either
SS(stainless
• steel) or carbon steel.
 Parts:
• 1.tip/point
• 2. body/shaft
3.eye/swaged
end

16. SHAPE OF NEEDLE

17.  According to Shape:
1. Straight 2.Curved
 According to eye:
1. Eyed needle/Traumatic
2. Eyeless needle/Atraumatic
Classification of needle

18.  According to cutting edge
1.Round body 2.Cutting
body-
• ▶Conventional
• ▶Reverse cutting
 According to its tip
1.T
riangular 2.Round
3.Blunt
Classification of needle

19. SUTURE MATERIAL

20. Ideal properties:
 Easy to handle.
 Predictable behaviour in tissues.
 Predictable tensile strength.
 Sterile.
 Secure knotting ability.
 Minimal tissue reaction.
 Non-alergenic,non-carcinogenic,non-
shrinkage.

21.  According to source:
1. Natural
2.Synthetic
3.Metallic
 According to structure:
1.Monofilament 2.Multifilament
CLASSIFICATIONS OF SUTURE MATERIALS

22.  According to fate:
1.Absorbable
2. Non-absorbable
 According to coating:
1.Coated 2.Uncoated
CLASSIFICATIONS OF SUTURE MATERIALS

23. NATURAL
Absorbable
• catgut
• Chromic catgut
• Collagen
• Fascia lata
• Beef tendon
ACCORDING TO SOURCE
Non- absorbable
• Silk
• Silk worm gut
• Linen
• Cotton
• Ramie

24. SYNTHETIC
Absorbable
▶ Polyglycolic acid
▶ Polyglactic acid
▶ Polyglactin(vicryl)
▶ Polydioxanone(PDS)
ACCORDING TO SOURCE
Non- absorbable
 nylone(polyamide)
▶ Polypropyline(Prolene)
▶ Polyesters
▶ polyethelene

25. • SS(stainless steel)
• Tantalum
• Silver
• Gold
• Aluminium
METALLIC

26. MONOFILAMENT
Absorbable
• Catgut
• Chromic catgut
• Vicryl
• PDS
ACCORDING TO STRUCTURE
Non-absorbable
• PolyPropylene
• Polyester
• Nylone
• Polyvenyleidene
fluoride/PVDF suture

27. MULTIFILAMENT
Absorbable
• Vicryl
• Polyglycolic acid
ACCORDING TO STRUCTURE
Non-absorbable
• Silk
• Cotton
• linen

28. MONOFILAMENT VS MULTIFILAMENT
MONOFILAMENT MULTIFILAMENT
 Has no capillary action
 Less infection risk
 Smooth tissue passage
 Higher tensile strength
 More throws required
 Has capillary action
 Increased infection risk
 Less smooth passage
 Less tensile strength
 Better knot security

29.  Condition of the wound.
 Tissues to be repaired.
 Tensile strength.
 Knot holding characteristics.
 Reaction of surrounding
tissues.
Selection of suture materials

30. COMMONLY USED
SUTURE MATERIALS

31.  It is synthetic ,non-absorbable monofilament suture materials.
 Polymer of propylene.
 Uses:
1.General surgery.
2.Plastic surgery.
3.Cardiovascular surgery.
4. Skin closure.
POLYPROPYLENE(prolene)

32.  Advantages:
1. Won’t loose tensile strength over time.
2.Good knot security. 3.Very little tissue reaction.
• 4.High plasticity.
 Disadvantage:
1.Stretch when pulled.
2.Loosens when edema subsides.
Polypropyelene

33.  It is natural, non-absorbable multifilament suture materials.
 Made from the filament spun by silkworm larva.
 Uses:
1. Ophthalmic surgery.
2.General surgery.
3.plastic surgery.
SILK

34.  Advantage:
1.Ease of handling.
2.Good knot security.
3.Cost effective.
 Disadvantage:
 1.Very reactive.
2.can’t be used in presence
of infection.
SILK

35.  It is synthetic & absorbable suture materials.
 Monofilament/multifilament & coated/uncoated.
 Available in purple color/undyed.
 Uses:
1. Intra oral suturing.
2. Gut anastomoses.
3.Vascular ligature.
4.Opthalmic surgery
5. Superficial soft tissue approximation of the skin and mucosa.
VICRYL

36. USES OF DIFFERENT SIZES OF NEEDLE

37.  The early response is a generalized acute aseptic
inflammation involving primarily polymorphonuclear
leucocytes.
 After few days mononuclear cells fibroblast &
histiocytes become evident.
 Capillary formation occurs at the end of this initial
phase.
BIOLOGICAL RESPONSE TO SUTURE MATERIALS

38.  Natural absorbable-
 Proteolytic degradation.
 Intense tissue response.
 Synthetic absorbable-
 Hydrolysis.
 Less intense response.
 Non-absorbable-
 Encapsulation.
 Acellular response.
BIOLOGICAL RESPONSE TO SUTURE MATERIALS

39. THANK YOU