20September 2021

Everything You Need to Know About Surgical Sutures

Skin, an epithelial tissue, is the outermost covering of our body. It is a waterproof barrier that prevents the direct entry of microbes into our bodies. Whenever there is a cut or a laceration in the skin, it impairs the skin integrity. This leads to many complications such as skin infection, inflammation, etc. So, after a large cut or a wound, it is necessary to repair the skin to close the wound. Special medical devices used to repair these cuts or close the wounds are known as surgical sutures. Surgical suture is named so because mostly these sutures are used to close the skin site after surgery. The surgical suture consists of a thread and a needle that joins the body tissues. There are numerous surgical suture manufacturer companies around the world. Due to the increasing surgical procedures, there is a rise in the growth of surgical suture companies.

Types of Surgical Suture

There are many types of surgical sutures. Surgical sutures are broadly classified into Absorbable and Non-Absorbable sutures. 

Absorbable sutures: Absorbable sutures are not removed by the doctor. This is because they are absorbed by the body and then broken down by the enzymes present in our body. The time of absorption depends upon various factors such as the material of the suture, its location, and it also depends on the patient. 

Some commonly used absorbable sutures are Vicryl Rapide, Monocryl, Vicryl, and Polyglycolic acid sutures.

USES OF ABSORBABLE SUTURES: These sutures are mainly used for deeper tissues that heal quickly. Absorbable sutures are used for suturing in the urinary or biliary tract, tying off small vessels near the skin, and in small bowel anastomosis. They should not be used in cardiovascular or neurological procedures.

Non-Absorbable sutures: Non-absorbable sutures are the sutures that are to be removed by the doctor after a required period. They provide long-term protection to the tissues. They remain separated from the inflammatory processes of the tissues until they are manually removed from the skin.

Some commonly used Non-absorbable sutures are Nylon, Prolene, and silk.

USES OF NON-ABSORBABLE SUTURES: These sutures are mainly used in tissues that take time to heal. These are used to suture tissues such as fascia, tendons, abdominal wall, or vascular anastomoses. 

Sutures Can Be Further Classified Into Natural and Synthetic

Natural: Natural sutures are the ones that are made up of natural fibres such as silk and catgut, which are derived from the skin of sheep. They are rarely used because they elicit a tissue response. Out of these, silk sutures are used in surgical drains.

Synthetic: Synthetic sutures are composed of man-made substances such as nylon and polydioxanone sutures. They tend to be stronger than natural sutures. Synthetic sutures are used in ophthalmic and plastic surgeries.

Surgical Sutures Are Then Sub-categorized Based On Their Structure

Monofilament suture: As the name suggests, these sutures consist of a single strand. The risk of infection is lesser in this case, but they provide poor knot security, and it is not easy to handle them. 

Multifilament suture: In these sutures, various sutures are twisted together, and that’s why they are known as multifilament sutures. They have good knot security, are easy to handle but have a risk for infection.

There is a wide range of surgical suture companies in India. Orion sutures are one of the best surgical suture manufacturers in India. The surgical suture market in India has experienced a quick growth rate due to the increasing application of surgeries over the years.

18September 2021

Repair Lacerations with Surgical Sutures

Have you heard about surgical sutures? Whenever you experience any injury, your tissues open apart. A suture is a medical device that is used to sew the tissues together and close the wound. The tissues are held together until the wound is properly closed and healed. The material that is used in suturing is gut, thread, or wire. Various types and thicknesses of sutures are present. The types of sutures are used depending on the type of surgery. A surgical suture must be strong enough to hold the tissues together in place. The sutures should not allow anybody’s fluids to pass through them due to the risk of causing infections. Sutures can be classified into a variety of ways.

Classification of sutures

1. Absorbable and non-absorbable sutures

Sutures can be classified into two types- absorbable that will break down on their own in the body after a while and non-absorbable that must be removed manually after some time. The type of suture that is used depends on the type of surgery.

  • Absorbable sutures: Polyglycolic Acid sutures, Polyglactin 910, Catgut, Poliglecaprone 25, and Polydioxanone sutures.
  • Non-absorbable sutures: Polypropylene sutures, nylon (polyamide), Polyester, PVDF, silk, and stainless steel sutures.

2. Monofilament, multifilament and barb sutures

Sutures can be classified based on material. Multifilament sutures are braided sutures and barb sutures are knotless monofilament sutures.

  • Monofilament sutures: Polypropylene sutures, Catgut, Nylon, PVDF, Stainless steel, Poliglecaprone, and Polydioxanone sutures.
  • Multifilament sutures: PGA sutures, Polyglactin 910, silk and polyester sutures.
  • Barb sutures: Polydioxanone, Poliglecaprone, and polypropylene suture materials.

3. Classification based on size

The surgical sutures are present in several sizes based on the diameter of the thread. The diameter of the suture affects its tensile strength and also its handling properties.

4. Natural and synthetic sutures

On the basis of raw material, surgical sutures can be natural or synthetic. Natural sutures are silk and catgut sutures, whereas all other types of sutures are synthetic sutures.

5. Coated and uncoated sutures

Surgical sutures are also classified based on the coatings. Some sutures are available with coatings on their surface to enhance their properties. The coating is usually applied on braided sutures. Various coating materials used are chromium salt, silicon, wax, PTFE, polycaprolactone, calcium stearate. For further protection, sutures are coated with antimicrobial or antibacterial coatings.

  • Coated sutures: PGA sutures, Catgut Chromic, Polyglactin 910, silk and polyester sutures, braided or twisted nylon, Poliglecaprone, and Polydioxanone sutures.
  • Un-coated sutures include Polypropylene sutures, Nylon, PVDF, Stainless steel, and PTFE sutures.

An ideal suture should allow the tissue to recover sufficiently. Surgeons should be familiar with and well aware of all the techniques and methods of suturing. The choice of material depends on various factors such as infection risk, type of tissue, and also, in some cases, personal preferences. Various suture companies in India are trusted and provide quality surgical sutures. These certified companies engage in the manufacturing and exporting of surgical sutures. You can also buy surgical sutures online through various websites at affordable prices but make sure that these companies are trusted and certified. Keep in mind to read reviews of that particular company.

17September 2021

Surgical Sutures – Wound Closure Accessories

Whenever we experience a cut or an injury, our tissues cut open. These tissues must be closed as soon as possible to prevent any infection and overflow of blood. A thread-like medical device is used for this purpose called a surgical suture. The sutures can be divided into two types absorbable and non-absorbable. The main difference between them is that absorbable sutures get absorbed naturally by the body after a while, but the non-absorbable sutures have to be removed manually. Absorbable sutures are made from easily dissolvable materials such as the intestine of animals, fibres, or artificially created polymers. The various types of absorbable sutures are Polyglycolic suture, Polyglactin 910, Catgut, Poliglecaprone 25, and Polydioxanone sutures. Polyglycolic acid sutures are braided multifilament surgical sutures.

Characteristics of polyglycolic acid sutures:

  • They are synthetic
  • They are well coated to allow easy passage through the tissues
  • They have a smooth tie down
  • PGA sutures have decreased tendency to irritate tissues
  • They have a higher tensile strength
  • Their absorption period is longer
  • They have predictable absorption
  • PGA surgical suture has outstanding handling properties
  • They are made up of 100% polymer of glycolide that is coated with polycaprolactone and calcium stearate
  • After two weeks, they lose 75% of their initial strength
  • These are found to be non-antigenic and non-pyrogenic
  • They are present in dyed (violet in colour) and un-dyed forms.
  • The absorption time of PGA sutures is approximately 60-90 days.
  • PGA sutures can be easily absorbed by hydrolysis

Advantages of using polyglycolic acid sutures:

  • PGA sutures are tightly braided enhance their strength and also improve their smoothness
  • PGA sutures have an outstanding knot security
  • PGA sutures have excellent tensile strength thus, they are preferred over other absorbable sutures
  • They are more flexible than non-absorbable sutures

Indications of polyglycolic acid sutures:

  • General surgery
  • Urology (disorders of Urinary system)
  • Skin closure
  • Eye surgery
  • Plastic surgery
  • Paediatrics (in infants)
  • GIT (Gastrointestinal tract) surgery
  • Gynaecology (deformities in female reproductive system)
  • Orthopaedics (deformities of bones or muscle)

Contraindications of polyglycolic acid sutures:

  • Cardiovascular surgery- as it can cause rupture and dilation during or after the absorption phase.
  • Neurosurgery-
  • PGA cannot be used in some cases where extended wound support is needed for more than seven days.
  • If there is any kind of inflammation or itching on the wound site of the patient, then usage of PGA suture must be stopped.

Storage of polyglycolic acid sutures:

It is recommended to store them away from moisture and direct heat. They are sterilized with ethylene oxide.

Disposal of polyglycolic acid suture:

The needles must be discarded in the bin that is meant for infectious waste.

The surgeons usually evaluate your wound site to decide about the best type of suture to be used. Vicryl (Polyglactin 910) was the second type of surgical sutures to become available. Surgeons from all over the world use these sutures for performing surgeries. The surgeon should be well aware of all the types of sutures and the purpose of each suture. The suture must not be used after the expiration date otherwise, it can cause adverse effects.

16September 2021

Non Absorbable Sutures For Long-Term Support

Sutures are medical devices that are used to repair cuts in the skin tissue. They hold the tissues together when there is a breakage in skin integrity after an injury or surgery. They are usually thread-like. They are of different shapes, sizes and are used according to the type of cuts. Suturing is crucial for the healthy recovery of patients. Sutures are classified into various types. They can be Monofilament or braided. They can be natural and synthetic. They can be absorbable and non-absorbable. Absorbable sutures are the ones that are not removed by the doctor. They are digested by the enzymes present in our body. There are many types of absorbable sutures such as Gut, Poliglecaprone, Polydioxanone, and polyglactin. Non-absorbable sutures are removed by the doctor after some time. There are many types of Non-absorbable sutures, such as polypropylene, polyethene, and polyamide sutures

Non-Absorbable sutures

Non-absorbable sutures are the sutures that are to be removed by the doctor after a required period. They provide long-term protection to the tissues. They remain separated from the inflammatory processes of the tissues until they are manually removed from the skin. Some commonly used Non-absorbable sutures are Nylon, Prolene, and silk. These sutures are mainly used in tissues that take time to heal. These are used to suture tissues such as fascia, tendons, abdominal wall, or vascular anastomoses. 

Types and their Advantages & Disadvantages:

Silk sutures

These sutures are being used for a very long time. Silk sutures are synthetic man-made sutures. Silk Sutures are best for use in Dental Surgery, It is also available in reels of 25meters or 10meter packing

Advantages: Silk sutures have excellent knot security. They are easy to be handled; therefore, they can also be used as a temporary suture during surgery. They rarely elicit a tissue reaction. They are soft and comfortable. 

Disadvantages: Silk tends to enter the tissues, which makes it painful to remove. It has low tensile strength, so it can break under high tension. 

Stainless steel wire sutures

These are the sterile non-absorbable sutures used widely in abdominal wound closure and orthopaedic procedures. 

Advantages: They are inexpensive, soft, and malleable. The main advantage of these sutures is that they do not promote infection. They are strong and flexible sutures.

Disadvantages: The stainless-steel wires are springy in nature.

Polypropylene sutures

They are synthetic non-absorbable monofilament sutures.

Advantages: These sutures provide long dermal support. They elicit less tissue reaction and are used in skin and percutaneous as well as subcuticular pull-out closures. 

Disadvantages: They have poor knot security. 

Polyethylene sutures

These sutures are non-absorbable surgical sutures. 

Advantages: These are soft and gentle, so they can be used on tissues easily. They have high knot security.

Polyamide sutures

Polyamide sutures are synthetic surgical sutures. It is composed of caprolactam.

Advantages: It has low tissue reactivity. It is widely used for general soft tissue approximation. It can also be used in cardiovascular and neurological procedures. 

Disadvantages: It is difficult to handle and to tie. 

Out of these non-absorbable sutures, polyamide nylon sutures in India, Black Braided Silk are soft and gentle and have minimal tissue response. Multifilament polyamide sutures are best for skin approximation. 

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