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SUTURE MATERIALS

Suture Names and Material Type


SUTURE TYPES
 Monofilament or multifilament strands
 Absorbable or Non-Absorbable
 Absorbable loses strength in tissue and degrades within 60
days
 Non-absorbable greater than 60 days
SUTURE SIZE

 Size: Refers to the diameter of the suture


 The more “0’s” in the number, the smaller the suture
 Microsurgery/repair: 9-0 or 10-0 suture

 Facial skin closure: 5-0 or 6-0 suture

 Trunk or extremities: 4-0 or 5-0 suture

 Scalp: 3-0 suture

 Muscle, deep skin, intraoral mucosa: 3-0 or 4-0 suture


ABSORBABLE SUTURES
 Plain Gut
 Derived from submucosa of
sheep intestines
 Not a true monofilament
 Less than 10 day life span in
tissue
 Must be kept moist and rinsed
(packaged in alcohol)
 100 times the bacterial adhesion
than that of Nylon or
Polypropylene
ABSORBABLE SUTURES

• Chromic Gut
 Plain gut tanned with
chromium salts
 Improved strength and
duration
 Duration is 14-21 days
 Knot security greater than
plain gut
 Absorption by proteolytic
enzymes
ABSORBABLE SUTURES

• Dexon (polyglycolic or PGA)


 Monofilament which is braided
 Un-coated Dexon S and coated
Dexon Plus
 More durable than gut sutures
 Absorbed by hydrolysis of ester
bond
 Sutures lost orally is 16-20 days
ABSORBABLE SUTURES
• Vicryl
 Copolymer of glycolic and
lactic acid in a 9:1 ratio;
Polyglactin 910
 Nearly identical properties as
Dexon
 Strength loss after 16-20 days
 Absorbed by hydrolysis of
ester bond
 Braided suture like Dexon
NON-ABSORBABLE SUTURES

 Silk
 70% natural silk, silk worm
larvae
 Main advantage is favorable
handling
 Knot security is good
 Tissue response to silk is
severe
 Braided material, highest
potential for infection
NON-ABSORBABLE SUTURES

 Nylon
 Synthetic polyamide polymer
 Available in monofilament or
multifilament
 Poor knot security
 Among the best for minimizing
infection
 Mucosa/Lip: 5-0 or 6-0 Nylon
 Basic Extraction: 3-0 Nylon
NON-ABSORBABLE SUTURES

 Polypropylene (Prolene)
 Similar to Nylon, synthetic
monofilament polymers
 Breaking strength less than Nylon
 Knot security and ease of tying
greater than Nylon
 Absorption is non-existent, good
for contaminated wounds
NON-ABSORBABLE SUTURES

• Dacron (Mersilene)
 Polyester braided suture
 May be coated with Teflon to
improve handling
 Strongest non-metallic suture
 High coefficient of friction
 No absorption occurs
NEEDLES

 Most swaged onto the suture


strand Tapered

 Stainless steel, 2 basic


configurations;
 1. Tapered
 Pointed with circular cross-section Cutting

 2. Cutting
 Cutting & reverse cutting needles
 Pointed with triangular cross-
section Reversed Cutting

Adapted from: Contemporary Oral and Maxillofacial Surgery, Mosby


1988.
NEEDLES

 No universal needle labeling or coding


1/4 circle 3/8 circle
 Straight to as much as 5/8ths round in
shape
 For minor wound care, the 3/8
and 1/2 circle needles are used
1/2 circle
 Size corresponds with the 3/4 circle

outline on package
 Described on package (cutting) along
with manufacturer’s code
Curve-ended
straight Straight

Adapted from: Contemporary Oral and Maxillofacial Surgery, Mosby


1988.