Suture also known as stitches a piece of thread like material use to secure wound edges or body parts together after an injury or surgery. A variety of suture exists in size strength and durability.Stitches placed deep inside the wound always requires the use of dissolvable (absorbable) sutures, whereas stitches visible on the skin (placed superficially) may use dissolvable or non-dissolving (non-absorbable) sutures.
Surgical sutures as defined by the U.S.P. (United States Pharmacopoeia) are divided into two major classifications based on their reactions with body tissues
Description: capable of being absorbed by living mammalian tissue, yet may be treated to modify resistance to absorption source is both natural and synthetic.
Tissue interaction: absorbable sutures are digested by body enzymes by first losing their strength then gradually disappearing form the tissue.
2.Non Absorbable sutures
Description: material not affected by enzyme activity or absorption in living tissues and are natural and synthetic sources.
Tissue interaction: non absorbable sutures become encapsulated in fibrous tissue during the healing process and remains embedded in body tissues unless they are surgically removed.
- a.Class 1-silk or synthetic fibers of monofilament, twisted of branded construction.
- b.Class 2 –cotton or linen fibers or coated natural or synthetic fibers. The coating forms a thickness, yet does not contribute to its strength.
3 Monofilament suture is a single strand that is non capillary (Resistant to fluids soaking into the suture) it is designed by the U.S.P.
4 Multifilament suture on the other hand is multiple strands of suture held together by a process of twisting, braiding of spinning the material. All multifilament sutures have certain capacity to absorb body fluid(capillarity),which elicits a higher degree of tissue reaction and are classified by the U.S.P. as Type A.
Commonly Use Suture Materials
The size of suture material is measured by its width or diameter and is vital to proper wound closure. As a guide the following are specific areas of their usage:
- 1-0 and 2-0: Used for high stress areas requiring strong retention, i.e. – deep
- fascia repair
- 3-0: Used in areas requiring good retention, i.e. – scalp, torso, and hands
- 4-0: Used in areas requiring minimal retention, i.e. – extremities. Is the most common size utilized for superficial wound closure.
- 5-0: Used for areas involving the face, nose, ears, eyebrows, and eyelids.
- 6-0: Used on areas requiring little or no retention. Primarily used for cosmetic effects.
When suturing the edges of a wound together, it is important to evert the skin edges that is, to get the underlying dermis from both sides of the wound to touch. For the wound to heal, the dermal elements must meet and heal together. If the edges are inverted (the epidermis turns in and touches the epidermis of the other side), the wound will not heal as quickly or as well as you would like. The suture technique that you choose is important to achieve optimal wound healing.