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KRUUSEI KRUUSE Suture What is suture? Suture is a medical device or a thread used for the purpose of repositioning tissues after surgery or injury. By suturing the wound the tissue functioning is reestablished. To be able to know the difference of the various types of sutures, they are classified according to their properties, as follows: n Absorbable or non-absorbable Most absorbable sutures are broken down via hydrolysis. The suture loses its strength and vanishes over time. How long it takes depends on the type and the thickness of the suture. Non-absorbable suture is not absorbed by the body and thus requires manual removal. These kinds of sutures are typically used in skin or in tissues that require permanent tissue support. n Suture structure – monofilament or multifilament Monofilament suture is made of one fibre/strand. This suture type appears more rigid than the multifilament suture, thus the knot stability is less good, when you tie the knot. The advantage of the monofilament suture is that it does not absorb liquid and thus bacteria cannot be transferred from one place to another, through the suture. Multifilament suture is made of several braided fibres – made like a rope. Very smooth and flexible and has excellent knot stability. Contrary to the monofilament suture the multifilament can absorb liquid in between the fibers and thus bacteria can pass from one place to another. n Material Suture materials are either biological or synthetic. The synthetic sutures create much less tissue reactions than biological sutures. Further we describe the sutures by: n Thickness and Strength Sutures are available in many diameters classified in either size metric (EP) or USP. EP is short for European Pharmacopoeia and USP is short for United State Pharmacopoeia. The thicker the stronger. Remember to tie the knot properly, as the weakest part of a stitch always is the knot. n Knot firmness Multifilament suture has a very good knot quality, because of the individual fibres meshing together, making the knot more stable. n Coating Many of the multifilament/braided sutures are coated after manufacturing of the suture. The coating makes the surface of the suture smoother to ease passing through the tissue, thus providing less drag and less trauma, when the suture passes through the tissue. n Tissue reaction Suture is a foreign material in the body, the body tissues react to the suture. However, the body reacts differently to the individual suture materials (just like the thickness and time also can influence the tissue reaction). Suture techniques The suture material can be used in an interrupted or continuous pattern. Choice of suture, needle and technique are dependent on numerous factors: tissue type, patient and personal preferences. SSiimmple ipntelrreuptcedontinuous SimSimpplelecontiinnuotues rrupted www.kruuse.comPage 2