Equis ISSN 2398-2977

Surgery: suture materials - types

Contributor(s): Stephen Adams, Debbie Archer, Graham Munroe

Absorbable

Catgut

Material

  • Ovine intestinal submucosa or bovine intestinal serosa treated with chromium salts.
  • Multifilament.

Biologic properties

  • Absorbed by cellular and tissue proteases over 90 days.
  • Tensile strength: 14-28 days.

Advantages

  • Easy to handle.
  • Used in rapidly healing tissues, eg subcutaneous tissues.
  • Can be used in infected wounds.

Disadvantages

  • Inflammatory breakdown   →   increased fibrosis.
  • Occasional sensitivity reaction   Granulomatous reaction: foreign body 02 - histopathology  .
  • Variability in absorption and loss of tensile strength.
  • Capillarity.

Polyglactin 910 (Vicryl)

Material

  • Copolymer of glycolic and lactic acids.
  • Multifilament, braided coated with calcium stearate.

Biologic properties

  • Absorbed by slow hydrolysis: 40-90 days.
  • Tensile strength: 14-21 days.

Advantages

  • Easy to handle.
  • Minimal tissue reaction.
  • Stable in contaminated wounds.
  • High tensile/knot strength.

Disadvantages

  • Non-coated has increased tissue drag.

Polyglycolic acid (Dexon)

Material

  • Polymer of glycolic acid.
  • Multifilament, braided.

Biologic properties

  • Absorbed by hydrolysis: 100-120 days.
  • Tensile strength: 7-14 days.
  • Degradation products antibacterial effect.

Advantages

  • Easy to handle.
  • Wide range of uses including in a contaminated environment.

Disadvantages

  • Increased drag and cutting in tissues.
  • Reduced knot security.
  • Premature absorption in urine.

Polydioxanone (PDS)

Material

  • Polymer of paradioxanone.
  • Monofilament.

Biologic properties

  • Degraded by hydrolysis and absorbed by 182 days.
  • Tensile strength: 28-56 days.

Advantages

  • Loses strength slower than other synthetic absorbables.
  • Strong.

Disadvantages

  • Slightly difficult to handle and knot.

Polyglyconate (Maxon)

Material

  • Copolymer of glycolic acid and trimethylene.
  • Monofilament.

Biologic properties

  • Absorbed by hydrolysis starting at 60 days and complete by 180 days.
  • Tensile strength: > 20 days.

Advantages

  • Strong.

Disadvantages

  • Slightly difficult to handle.

Non-absorbable

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Further Reading

Publications

Other sources of information

  • Blackford L W & Blackford J T (1999)Suture Materials and Patterns.In Equine Surgery.2nd edn. Eds: Auer J A & Stick J A. W B Saunders, Philadelphia. pp 91-103.


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