Sutures

Summary

Purpose: to hold healing tissues in apposition until such time that fibroblast and myofibroblast activity has restored natural tensile strength.

Ideal suture characteristics

1. ▪ Sterile and resistant to infection.

2. ▪ Causes minimal tissue reaction.

3. ▪ Easy to handle and atraumatic to tissues.

4. ▪ Holds knots securely.

5. ▪ Stays strong until its purpose is complete and absorbs completely thereafter.

No single suture material fits this description. Different materials are used depending on the situation.

Suture size

Classification of suture size refers to the diameter of the strand. This is measured by ‘zeroes’. The more ‘zeroes’ a strand has, the smaller it is i.e. 00 (2–0) is larger than 0000 (4–0). Strand diameter correlates to tensile strength.

Rough guide to general usage and days before removal (guide only.)

Needles

Ideal needle qualities:

Smallest diameter possible

Easily handled

Sterile and non-allergenic

Sharp enough to go through intended tissue with minimal tissue damage

Identical needle and thread size, thereby minimizing tissue trauma while filling the needle tract completely.

Point types

1. Cutting: designed to go through dense tough tissue with minimal trauma.

2. Taper point (round needle): passes through tissue by stretching it to breaking point and not cutting. These are associated with higher localized tissue trauma, but useful for elastic tissues (e.g. peritoneum).

3. Blunt point: for pushing tissue away from needle rather than cutting it (e.g. liver needle).