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Stainless Steel Sutures in Surgical Procedures
Stainless steel is actually a steel alloy that contains at least 11% chromium content when calculated by total overall mass. As the name implies it will not corrode, rust or stain easily, however over time stainless steel can and will become somewhat stained. When used in medical procedures surgical steel sutures must meet the requirements outlined by the United State Pharmacopeia to be used in the United States. Other countries may use different standards, often those developed by the European Pharmacopeia. Both standards allow for the maximum amount of tensile strength for the given diameters of the suture material. Depending on the specific type of stainless steel sutures the size can range from 6-0 through to a maximum diameter of 7.
Stainless steel sutures are used where high tensile strength is a major factor. This is often in orthopedic surgery where movement of the joint or limb in therapy and recovery can add additional pressure to the incision and surgical areas. Other uses of stainless steel material for sutures includes in heart surgery, most specifically in closing the chest after cardiac surgery. Hernia repair as well as repair of intestinal anastomosis and abdominal wounds and surgeries are all procedures where stainless steel stitches are routinely used. As can be imagined stainless steel has very little give or stretch even when put under tremendous pressure and movement from virtually any angle.
Nonabsorbable, surgical steel sutures are considered to be inert both inside and outside of the body. This means that their presence in the body does not trigger an immune reaction or increase the risk for inflammation of the area where the stitches are located. Since they do not degrade over time the stainless steel stitches may be removed after the wound has sufficiently closed or they may remain in the body without any risk to the patient. Stainless steel suture material is sterilized using a variety of methods that can include gamma irradiation or the use of ethylene oxide.
Stainless steel sutures are available as both monofilament and multifilament options. Monofilament means that the steel is a single filament. This allows a very smooth flow through the tissue and also provides strength and durability. Multifilament stainless steel has multiple filaments that are used to create the single thread and may be labeled as braided. Both options come in a variety of different diameters and lengths that are needled and sealed in sterile packaging. This is perfect for fast access in surgical theatres and emergency rooms. The size and type of needle will determine the options for size of the stainless steel thread; however some needle sizes and types will be available with two or more different diameters of thread to allow the optimum use by the physician.
Physicians may also elect to have the option to match needles and surgical steel sutures by choosing the option of ligating reels. This allows the professional to cut the suture to the desired length for each particular surgical application.