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A Brief History of Surgical Sutures

Surgical sutures or the ability to connect sides of a wound to enhance the chance of rapid healing is not a new concept. In fact there were many cultures including Egyptians, Greeks and Romans that routinely used stitches or sutures in their medical treatment of wounds and surgical procedures. The first types of needles were primitive and were made of fine shards of bone or metals. This meant that the suture material tended to be coarser and heavier and was most likely originally made from plant materials.

 

The first people to actually use surgical sutures are believed to the ancient Egyptians. The culture routinely used suturing in the preparation of mummies for burial and it was also used in medical practices of the time on living patients. Hippocrates used sutures, which were plant based, and would have been considered very crude by today's standards. It is very likely that individuals that received these types of sutures had considerable scaring and infection yet they were also likely to have been very effective in closing wounds in a more permanent way than binding the wounds with the material available at that time.

 

The specific transition of surgical sutures from plant based fibrous materials to animal products is not clearly known. It is reported that in the second century AD Galen of Pergamon, a Roman doctor that was very interested in human anatomy, is considered the first person to use catgut suture. Unlike the name suggests catgut sutures were and still are made from the intestines of sheep and cattle. Modern catgut sutures may also be made of synthetic products but, like their nature counterparts, dissolve in the body and do not require removal.

 

These early surgical sutures were not sterilized and the addition of animal products to the human body led to considerable problems with secondary infections and irritations of the skin. It was not until 1860 that Joseph Lister developed a method of sterilizing the suture material. This was done with carbolic acid, and later by chromic acid, and then in 1902, with iodine applied to the catgut.

 

Natural catgut surgical sutures were used very successfully for many years. The major problem that physicians noticed was the unpredictability with regards to the rate of dissolving of the stitches. Some patient's bodies dissolved the stitches early than others, allowing possible reopening of wounds in rare occasions. Scarring on the skin's surface was also possible with the catgut stitches.

 

In the late 1920's the production of synthetic types of threads in other industries allowed the medical field to take advantage of this evolving technology. By the first part of the 1930s there were both absorbable and non-absorbable surgical sutures available for doctors, providing the first real choice in materials to use. By the 1950s and 60s the modern polyesters and polyglycolic acids were available for use in all hospital and clinical settings. Polymer fibers are now the preferred choice for many types of surgical sutures and they come in a variety of types, styles and designs that are customize for different types of wounds and suture options.