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An Introduction To Suture Types
Choosing the right types of sutures for the specific incision or wound is an important consideration in any emergency or surgical procedure. The choice of absorbable suture or non-absorbable suture as well as selecting a braided or monofilament product will definitely have an impact on both the ease of applying the sutures as well as in the treatment of the wound during the healing process.
In general the major distinction between types of sutures is their ability to be absorbed by the body or the requirement for the suture to be removed. For internal layers of tissue an absorbable suture is important since this suture type does not require removal. Instead the body absorbs the material, the exact process is different based on the specific material of the suture, but there is no need to physically remove the stitches. The other category of suture types is the nonabsorbable. This suture will require removal after the wound has healed which can vary from a few days to weeks, depending on the specific location of the wound.
In general most people have fewer and less extreme types of reactions to the newer synthetic absorbable sutures and nonabsorbable suture types. Braided sutures may be more problematic for some patients than monofilament sutures that tend to be smoother and less irritating. However, braided sutures are often easier to secure and work with, so careful consideration as to the style and types of sutures is important to both the patient and the medical professional.
The longer the sutures need to stay in place the less options that the medical professional many have with regards to suture types. Absorbable sutures will begin to break down through one of two processes; enzymatic degradation or hydrolysis, within ten days to eight weeks after the suture is made. The time frame for degradation of the suture material is approximate as there are several factors that can speed up or delay the process.
Sutures on the skin's surface should be non-absorbable since there is less risk of scaring and a higher rate of tensile strength throughout the duration of the sutures in the skin. They are easy to remove and are less likely to cause as scar than absorbable sutures that are more likely to cause a reaction in the cells of the skin. Non-absorbable suture materials include propylene, polyester or nylon but can also be made of very fine stainless steel wires, particularly in very high stress areas of the body such as the tissue of the heart or incision closure on joints.
Suture types also vary by diameter of the thread itself. The smallest diameter is designated as 11-0 and is typically used in eye surgeries and procedures. As the initial number in the designation decreases from 11 the suture material becomes slightly thicker, but this is virtually undetectable to the average person without medical experience. The highest rating for non wire suture materials is 5, which has a diameter of 0.7 mm. Choosing which suture type and diameter to use is largely a factor of the size of the incision and wound as well as the specific type of surgical procedure.