Whenever we experience an injury, our tissues tear apart. The skin integrity breaks. The tissues must be closed, or the skin integrity must be restored as early as possible. This is because if the tissues remain open for a long time, then it may lead to infection due to the entry of dust and microorganisms into the body. They get an inlet into our body which leads to skin complications. The tissues are closed with the help of thread-like medical devices known as sutures. Sutures are classified into two main types: Absorbable and Non-Absorbable sutures. 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. There are many types of Non-absorbable sutures such as polypropylene, polyethene, and polyamide sutures.
Definition: Non-absorbable sutures are man-made sutures that are manually removed by the doctor after a particular period of time. They provide protection to the tissues for a long period. These sutures are mainly used in the tissues which take a long time to heal such as fascia, tendons, abdominal wall, and vascular anastomoses. Some commonly used Non-absorbable sutures are Nylon sutures, Polypropylene, and silk sutures. The natural non-absorbable sutures are silk, linen, and cotton whereas the synthetic ones are Nylon and Polypropylene.
Types: Non-absorbable sutures come in the following ways:
•Polyamide: Polyamide nylon sutures are synthetic surgical sutures. It is composed of caprolactam.
•Polypropylene sutures: These sutures are non-absorbable surgical sutures. These are soft and gentle, so they can be used on tissues easily and have high knot security.
•Stainless steel wire sutures: These are the sterile non-absorbable sutures used widely in surgical procedures. Their main advantage is that it doesn’t promote infection.
•Black Braided Silk: Silk sutures are natural sutures of animal origin. Black braided silk sutures are formed of the silkworm.
Indications: Non-absorbable sutures are used in the following cases such as in abdominal wound closures, orthopaedic procedures, percutaneous as well as subcuticular pull-out closures, cardiovascular and neurological procedures.
Contraindications: Non-absorbable sutures should not be used in the mouth such as on the tongue, buccal mucosa, or gingiva.
Advantages of Non-Absorbable sutures:
•Minimal Tissue reaction: These sutures are inert, less reactive, and elicit less tissue response and hence they are effective as there won’t be any infection.
•High Tensile Strength: They have an excellent tensile strength that’s why they are preferred over absorbable sutures.
•High knot security: These sutures are tightly braided and increase the strength and security of the sutures.
Disadvantages of Non-absorbable sutures:
These sutures have the main disadvantage that sometimes they are difficult to handle (polyamide sutures), polypropylene sutures have poor knot security, and the cut ends of the suture material irritates the skin.
The sutures are used to heal and repair the lacerations. So, they must be sterilized using Ethylene oxide. Tensile strength is the quality that decides which sutures are to be used for specific surgery. Of all these Non-absorbable sutures, polypropylene sutures have the greatest tensile strength. They provide long dermal support to the tissues.