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Types of Suture material
This document discusses suture materials used in surgery. It begins by defining sutures and their purpose in surgery. It then lists the goals of suturing and the ideal properties of suture materials. The document categorizes suture materials based on source (natural, synthetic, metallic), structure (monofilament, multifilament), absorption rate (absorbable, non-absorbable), and coating. Common examples are provided for each category. Key differences between monofilament and multifilament sutures are outlined. Properties like strength, memory, and knot security are discussed in selecting the appropriate suture material.
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Types of Suture material
- 1. SUTURE MATERIAL Dr. HIRENPATOLIYA Seth Nandlal Dhoot Hospital Aurangabad
- 2. CONTENTS • INTRODUCTION • REQUISITESOF IDEAL SUTURE • CLASSIFICATION • SELECTION OF SUTURE MATERIAL • ABSORPTION OF SUTURE MATERIAL • BIOLOGICAL RESPONSE OF BODY TO SUTURE
- 3. INTRODUCTION • SUTURE MEANSTO “SEW” OR “SEAM”. IN SURGERY SUTURE IS THE ACT OF SEWING OR BRINGING TISSUE TOGETHER AND HOLDING THEM IN APPOSITION UNTIL HEALING HAS TAKEN PLACE. • SUTURE IS A STRAND OF MATERIAL USED TO LIGATE BLOOD VESSLES AND TYO APPROXIMNATE TISSUE TOGETHER.
- 4. GOALS OF SUTURING SUTURINGIS PERFORMED TO • PROVIDE ADEQUATE TENSION • MAINTAIN HEMOSTASIS • PROVIDE SUPPORT FOR TISSUE MARGINS • REDUCE POST OP PAIN • PREVENT BONE EXPOSURE • PERMIT PROPER FLAP POSITION.
- 5.
- 7. THE IDEAL SUTURETHREAD 1. Universal applicability-only difference in diameter 2. Limp- easy to handle, no kinks, coiling, twisting or levitating 3. Inert-Minimal tissue strength 4. Frictionless surface to glide through tissue- minimal trauma 5. High friction for secure knotting 6. Sterizable without composition changes 7. Resist bacterial growth 8. Capable of holding tissue layers throughout the wound healing 9. Complete absorption, no residue, after healing is complete –no matter how long it takes. 10. Nonelectrolytic,nonferromagnetic,noncapillary,nonallergenic,no ncarcinogenic 11. Cost effective.
- 8. CLASSIFICATION OF SUTURE MATERIALS •ACCORDING TO SOURCE:- • NATURAL • SYNTHETIC • METALLIC
- 9. ACCORDING TO STRUCTURE: MONOFILAMENT MULTIFILAMENT ACCORDINGTO FATE:- 1. ABSORBABLE(undergo degradation and lose tensile strength <60 days, it will eventtually dissolve, absorb into the tissue, and become unidentifiable) 2. NON ABSORBABLE(maintain tensile strength >60 days, permenent, fixture in the body and, when properly tied or secured, will remain intact indefinitely.) ACCORDING TO COATING 1. COATED 2. UNCOATED
- 10. NATURAL ABSORBABLE • Catgut • Chroniccatgut • Fascia lata • Kangaroo tendon • Beef tendon • Cargile membrane NON ABSORBABLE • Silk’ • Silk worm gut • Linen • Cotton • Ramie • Horse hair
- 11. SYNTHETIC ABSORBABLE • Polyglycolic acid •Polyglactic acid • Polyglactin 910(vicryl) • Polydioxanone (PDS) • Polyglecaprone 25 NON ABSORBABLE • Nylon/polyamide • Polypropylene • Polyesters • Polyetelene • Polybutester • Polyvinylidene fluoride/PVDF sutures.
- 12. According to structure •Monofilament • Polyfilament
- 13. MONOFILAMENT Advantages • Smooth surface •Less tissue trauma • No bacrteial harbours • No capillarity • More memory • Provide more cosmetic result Disadvantages • Handling and knoting • Stretch. • Any nick or crimp in the material leads to breakage. • Required more knot to prevent slippage-5 to6 throws
- 14. MONOFILAMENT ABSORBABLE • Surgical gut-plain/chromic •Polydiaxanone • polyglactin910 NON ABSORBABLE • Polypropylene • Polyester • Nylon/polyamide • Polyvinylidene fluoride/PVDF sutures
- 15. DIFFERENT BETWEEN MONOAND POLYFILAMENT MONOFILAMENT • HANDLING DIFFICULT • SMOOTH AND STRONG • NO WICKING • THINNER POLYFILAMENT • HANDLING EASY • LOW STRENGTH • WICKING IS A PROBLEM • THICKER
- 16. MULTI FILAMENT ADVANTAGES • STRENGTH •SOFT AND PLIABLE • GOOD HANDLING • GOOD KNOTTING ABSORBABLE POLYGLACTIN 910 POLYGLYCOLIC ACID DISADVANTAGES • BACTERIAL HARBOURS • CAPILLART ACTION • TISSUE TRAUMA NON ABSORBABLE SILK COTTON LINEN
- 19. •Plasticity:-ability to expandwhen stretched and don’t return to original length(loosen with edema) • Elasticity:- ability to return to its origina;l length after stretching , high elasticity sutures should be used in oedematous tissue • Fluid absorption and capillary action”:- the tendency for a suture to absorb water and wick infection
- 20. Breaking strength rate:-approximate days after placement when 50% of breaking strenth remains. • Tensile strength:- force necessary to break a suture consider in areas of tension:linea alba) • Knot strength:- force required for a knot to slip consider when ligating arteries • Memory : tendency ti return to original shape(untied) tendency to stay in one position, leads to difficulty in tying sutures.
- 23. Shape of niddle •Curved:- designed to be held with a needle holder used for most suturing • Straight:- oftern hand held, used to secure percutaneously placed devices( central and arterial lines)