What is sutures? types of Sutures i:e Absorbable sutures and nonabsorbable sutures.

Sutures: 

Sutures bind tissues together Sutures are used to hold skin, internal organs, blood vessels, and all other tissues after they have been severed by injury or surgery. Sutures are designed to help the healing of the body by closely opposing the two sides of a wound to minimize scar formation or to prevent leaking blood, like in vessels. They have to comply with several requirements to be effective. They must be strong (so they do not break), non-toxic and hypoallergenic (to avoid adverse reactions in the body), and flexible (so they can be tied and knotted easily). Also, they must lack the so-called "wick effect", which means that sutures must not allow fluids to penetrate the body through them from outside, which could easily cause infections.

Sizes of Sutures: 

Sizes of Sutures are sized according to the USP scale. Sizes and diameters are available on a scale from 6 to 0, which is 0.07 mm in diameter, to 2, which is 0.5 mm: 6-0 = 0.07 mm 5-0 = 0.10 mm 4-0 = 0.15 mm 3-0 = 0.20 mm 2-0 = 0.30 mm 0 = 0.35 mm 1 = 0.40 mm 2 = 0.5 mm 

Types of Sutures:

There are two types of sutures 1) absorbable sutures 2) non-absorbable sutures
A) Based on origin animal- catgut, silk vegetable- cotton, linen synthetic - nylon, metal- stainless steel B) Whether the material is absorbable or not Absorbable or Non-absorbable 

1) Absorbable Sutures: 

 Absorbable Sutures Absorbable sutures are made of materials that are broken down in tissue after a given period, which depending on the suture can be from ten days to four weeks. They are used therefore in many of the inner tissues of the body. In most cases, three weeks is sufficient for the wound to close firmly. The suture is not needed anymore, and the fact that it disappears is an advantage, as there is no foreign material left inside the body and no need for the patient to have the sutures removed. 

Absorbable sutures were originally made of the intestines of sheep, the so-called catgut. The inventor, a 10th-century surgeon named al- Zahrawi reportedly discovered the dissolving nature of catgut when his lute's strings were eaten by a monkey. Today, gut sutures are made of specially prepared beef and sheep intestine and may be untreated (plain gut), tanned with chromium salts to increase their persistence in the body (chromic gut). 

However, the major part of the absorbable sutures used are now made of synthetic polymer fibers, which may be braided or monofilament; these offer numerous advantages over gut sutures, notably ease of handling, low cost, low tissue reaction, consistent performance and guaranteed non-toxicity. 

Examples of Absorbable Sutures:  

      Absorbable Sutures Name Brand Name Plain Catgut --- Chromic Catgut ---Poliglecaprone 25 Monocryl Polyglactin 910 Vicryl Polyglycolic acid Dexon Polydioxanone PDS II 

2) Nonabsorbable sutures: 

Nonabsorbable sutures are made of materials that are not metabolized by the body, and are used therefore either on skin wound closure, where the sutures can be removed after a few weeks, or in some inner tissues in which absorbable sutures are not adequate. This is the case, for example, in the heart and in blood vessels, whose rhythmic movement requires a suture that stays longer than three weeks, to give the wound enough time to close. or tendons that take a long time to heal because of their poor blood supply.

There are several materials used for no absorbable sutures. The most common is a natural fiber, silk, which undergoes a special manufacturing process to make it adequate for its use in surgery. Other nonabsorbable sutures are made of artificial fibers, like polypropylene, polyester or nylon; these may or may not have coatings to enhance their performance characteristics. Finally, stainless steel wires are used in orthopedic surgery and for sternal closure in cardiac surgery. 

 

Example of nonabsorbable sutures: 

Nonabsorbable sutures Name Brand Name Silk Braided Polyester Ethibond, Tyvek Stainless Steel Wire --- Polypropylene Prolene Nylon --- Ethibond