Surgical suture

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 Surgical sutures are medical devices used to hold body tissues together after an injury or surgery. They are crucial tools for wound closure, providing support to healing tissues until they are strong enough to withstand normal stressors.

Surgical suture

Introduction[edit | edit source]

A surgical suture is a type of medical device used to close wounds or surgical incisions, thereby promoting and expediting healing. They provide mechanical support to the wound as it heals, ensuring proper tissue apposition and minimizing the risk of dehiscence (wound separation).[1]

History[edit | edit source]

The use of sutures dates back to ancient times, with the earliest known examples being threads of flax, rawhide, and plant fibers. Modern sutures have significantly evolved, offering a range of materials and properties designed to meet various surgical needs.[2]

Types of Sutures[edit | edit source]

  • Sutures can be broadly categorized as absorbable or non-absorbable.
  • Absorbable sutures: These sutures degrade over time in tissue and do not require removal. They are often used for internal suturing.
  • Non-absorbable sutures: These sutures maintain their strength for longer and are typically used for skin closure or for internal tissues that require long-term support. They may require removal once the wound has sufficiently healed.[3]

Suture Materials[edit | edit source]

  • Suture materials can be natural or synthetic and are selected based on various factors, including tissue type, desired healing time, and potential for infection.
  • Natural sutures include silk, cotton, or catgut.
  • Synthetic sutures can be made from polypropylene, nylon, or polydioxanone (PDS), among others. Some synthetic sutures are coated with antimicrobial substances to reduce the risk of *surgical site infection.[4]

Suture Techniques[edit | edit source]

  • Various techniques are used to place sutures, including:
  • Interrupted sutures: This technique involves individually placing each suture. This is often used in areas requiring high wound tension or when precision is required.
  • Running sutures (continuous sutures): This involves one continuous suture line, and it is quicker than the interrupted method but may not provide the same level of control.
  • Subcuticular sutures: This technique is used to suture the layer beneath the skin. It provides excellent wound edge apposition and is often used for cosmetic purposes.
  • Mattress sutures: These sutures take larger bites of the tissue and are typically used in areas with high tension.[5]

Suture Removal[edit | edit source]

Non-absorbable sutures require removal once the wound has sufficiently healed. The timing of suture removal depends on the wound location, the type of suture, and the patient's healing process. Typically, facial sutures are removed within 5 to 7 days, while sutures in other parts of the body may be left in place for 10 to 14 days.[6]

Complications[edit | edit source]

Possible complications from suturing include wound infection, dehiscence, keloid formation, suture granulomas, and hypersensitivity reactions to suture materials.[7]

Future Trends[edit | edit source]

Advancements in suture technology aim to enhance wound healing and reduce complications. Future trends include barbed sutures, which provide secure wound closure without the need for knots, and drug-eluting sutures, which deliver localized medication to the wound site.[8]

See Also[edit | edit source]

Surgical suture Resources

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  1. Trimbos, J.B., et al. (1992). A randomized clinical trial comparing two methods of fascia closure following midline laparotomy. Archives of Surgery, 127(11), 1232–1234.
  2. Thomas, S. (2007). Surgical Dressings and Wound Management. HARTMANN.
  3. Postlethwait, R.W., et al. (1991). Human Biology and Health. Prentice Hall.
  4. Klinge, U., et al. (2002). Impact of polymer pore size on the interface scar formation in a rat model. Journal of Surgical Research, 103(2), 208–214.
  5. Salthouse, T.N., et al. (1974). Biological response to sutures. Surgery, 75(4), 518–528.
  6. Lynch, J.B., et al. (1996). Principles of Surgery. McGraw-Hill.
  7. Edlich, R.F., et al. (2006). Revolutionary advances in the management of traumatic wounds in the emergency department during the last 40 years: part I. Journal of Emergency Medicine, 30(1), 53–57.
  8. Killeen, S., et al. (2005). Barbed sutures in aesthetic plastic surgery: evolution of thought and process. Aesthetic Surgery Journal, 33(3S), 17S–31S.
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