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    22.suture Materials

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    Shrestha Anjiv
    The document discusses different types of suture materials used in surgery. It describes 5 classifications of suture materials based on origin, structure, coating and thickness. Absorbable suture materials like catgut and Vicryl are used for tissues that do not require long-term support like skin and muscle. Non-absorbable materials like silk, polypropylene and steel are used for tissues like blood vessels or where long-term strength is needed. The ideal properties and appropriate uses of different suture materials are also outlined.

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    22.suture Materials

    Uploaded by

    Shrestha Anjiv
    307 views2 pages
    The document discusses different types of suture materials used in surgery. It describes 5 classifications of suture materials based on origin, structure, coating and thickness. Absorbable suture materials like catgut and Vicryl are used for tissues that do not require long-term support like skin and muscle. Non-absorbable materials like silk, polypropylene and steel are used for tissues like blood vessels or where long-term strength is needed. The ideal properties and appropriate uses of different suture materials are also outlined.

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    22.Suture Materials

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    The document discusses different types of suture materials used in surgery. It describes 5 classifications of suture materials based on origin, structure, coating and thickness. Absorbable suture materials like catgut and Vicryl are used for tissues that do not require long-term support like skin and muscle. Non-absorbable materials like silk, polypropylene and steel are used for tissues like blood vessels or where long-term strength is needed. The ideal properties and appropriate uses of different suture materials are also outlined.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    307 views2 pages

    22.suture Materials

    Uploaded by

    Shrestha Anjiv
    The document discusses different types of suture materials used in surgery. It describes 5 classifications of suture materials based on origin, structure, coating and thickness. Absorbable suture materials like catgut and Vicryl are used for tissues that do not require long-term support like skin and muscle. Non-absorbable materials like silk, polypropylene and steel are used for tissues like blood vessels or where long-term strength is needed. The ideal properties and appropriate uses of different suture materials are also outlined.

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    of 2

    1256 C.

    Suture Materials

    CHAPTER OUTLINE
    Classification I Classification IV
    Classification II Classification V
    Classification III

    Features of ideal suture material Uses of absorbable suture materials


     Adequate tensile strength  In bowel anastomosis like gastrojejunostomy, resection and
     Good knot holding property anastomosis. Vicryl is used
     Should be least reactive  In cholecystojejunostomy (CCJ), choledocho-jejunostomy
     Easy handling property (CDJ), pancreaticojejunostomy. Vicryl is used
     Should have less memory  In suturing muscle, fascia, peritoneum, subcutaneous tissue,
     Should be easily available and cost effective mucosa
     In ligating pedicles. 1-zero chromic catgut or vicryl are used,
    e.g. ligation of pedicles during hysterectomy
    CLASSIFICATION I  In circumcision, usually 3-zero plain or chromic catgut are used
    Absorbable Suture Materials Absorbable suture materials should not be used for suturing
    SRB's Manual of Surgery

    o Plain catgut is derived from submucosa of jejunum of tendon, nerves, vessels (vascular anastomosis).
    sheep.
     It is yellowish white in colour. Nonabsorbable Suture Materials
     It is absorbed by inflammatory reaction and phagocy- o Silk is natural, multifilament, braided, non-absorbable
    tosisabsorption time is 7 days. suture material derived from cocoon of silkworm larva.
     It is used for subcutaneous tissue, muscle, circumcision It is black in colour. It is coated suture material to reduce
    in children. capillary action.
    o Chromic catgut is catgut with chromic acid salt. o Polypropylene (Prolene) is synthetic, monofilament suture
     It is brown in colour. material. It is blue in colour. It has got high memory.
     Its absorption time is 21 days. (Memory of suture material is recoiling tendency after
     It is used for suturing muscle, fascia, external oblique removal from the packet. Ideally suture material should
    aponeurosis, ligating pedicles, etc. have low memory.) (Prolene mesh used for hernioplasty is
    o Vicryl (Polyglactic acid): white in colour).
     It is synthetic absorbable suture material. o Polyethylene (Ethylene) is synthetic monofilament nonab-
     It gets absorbed in 90 days. sorbable suture material. It is black in colour.
     Absorption is by hydrolysis. o Cotton is twisted multifilament natural nonabsorbable suture
     It is violet in colour (braided). material. It is white in colour.
     It is multifilament and braided. o Linen is derived from bark of cotton tree.
     It is very good suture material for bowel anastomosis, o Steel, polyester, polyamide, nylon are other nonabsorbable
    suturing muscles, closure of peritoneum. suture materials.
    o Dexon (Polyglycolic acid) is synthetic absorbable suture
    Uses of nonabsorbable suture materials
    material like vicryl. It is creamy yellow in colour (braided).
    o Maxon (Polyglyconate) monofilament.  In herniorrhaphy for repair
    o PDS (Poly Dioxanone Suture material) is absorbable suture  For closure of abdomen after laparotomy
    material. It is creamy in colour with properties like vicryl.  For vascular anastomosis (6-zero), nerve suturing, tendon
    It is costly but better suture material than vicryl. suturing
    o Monocryl (Polyglecaprone) monofilament.  For tension suturing in the abdomen
    o Biosyn (Glycomer) monofilament.  For suturing the skin
    CLASSIFICATION II Types of suturing 1257
    Natural  Continuous suturing
    o Catgut.  Interrupted simple suturing
    o Silk.  Interrupted mattress suturing
    o Cotton.  Subcuticular suturing
    o Linen.  Horizontal tension suturing
     Vertical tension suturing
    Synthetic
    o Vicryl, dexon, PDS, maxon.
    o Polypropylene, polyethylene, polyester, polyamide.

    CLASSIFICATION III
    o Braided: Polyester, polyamide, vicryl, dexon, silk.
    o Twisted: Cotton, linen.

    CLASSIFICATION IV
    o Monofilament: Polypropylene, polyethylene, PDS, catgut,
    steel.
    o Multifilament: Polyester, polyamide, vicryl, dexon, silk,
    cotton.

    CLASSIFICATION V

    Asepsis and Sterilisation


    o Coated.
    o Uncoated.

    Numbering of Suture Material


    2-Thick. For pedicle ligation.
    1-
    0-zero.
    1-zero.
    2-zero. For bowel suturing.
    3-zero. Fig. 32.45: Types of suturing.
    4-zero.
    5-zero. For vascular anastomosis.
    Types of knots
    6-zero.
    7-zero.  Reef knot
    8-zero.  Granny knot
    9-zero. For ophthalmic surgery. Requires operating  Surgeons knot
    microscope.

    Fig. 32.44: Photo showing different types of


    suture materials (with pack). Fig. 32.46: Types of knots.

    Sadness is a from of fatigue.

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