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The Case For Silk Sutures
Silk sutures were historically considered some of the best options for a variety of different types of wound closure, particularly in skin and tissue that was very soft in nature. This includes the tissue of the lips, eyes and around the facial area but it was also used in virtually all other types of wound closures prior to the invention of the nonabsorbable synthetic types of sutures now on the market. It is still the suture of choice for a number of would or surgical closures in neurological tissue, cardiovascular surgery or for any surgical procedures or wound repair of the eyes. Plastic surgeons favor the use of silk sutures for many of the very fine, detailed procedures used on the skin of the face, neck and around the hairline. With a variety of different diameters of thread there is little scaring or creation of suture tunnels, leaving virtually no visible record of the stitches within a very short period of time after removal.
Silk sutures are braided or twisted, but braided is often preferred. As a nonabsorbable suture they are ideal at maintaining their tensile strength initially after use. Long periods in the skin and tissue will result in a gradual decline in tensile strength as the protein within the suture is degraded by the enzymes in the body. This loss of tensile strength is usually very slow and does not produce concerns about the stitches giving way before healing is complete when used appropriately.
These silk sutures are sterile products that produce very little inflammation with proper wound care post surgery. The body will gradually produce fibrous connective tissue that will coat the suture, but the smooth surface allows for easy removal of the suture when wound healing is complete. The structure of the silk is perfect for easy movement through the tissue both for application and removal. It is also well known for holding the knots securely and preventing knot slippage over time.
There are a variety of different options with silk sutures ranging from the color of the suture, typically white or black, as well as if the suture material is silicone coated or natural. Silk sutures are available already threaded onto a variety of different needles with the diameter of the suture thread ranging from 9-0 or fine through medium in diameter. For those that prefer it is also available on ligating reels that allow easy spooling and measuring of the suture material to allow the physician to customize the length of the thread and the specific type of needle used.
The silk in silk sutures is actually an organic protein that comes from the Bombyx mori, more commonly known as the silkworm. It is a domesticated species which means that it has specifically been developed for its silk production which is considered to be perfect for both thread and suture material. The uniformity of the protein content and the silk thread from this specific species makes it an ideal option for the nonabsorbable sutures that are used in such a wide range of wound closures.