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.

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.

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