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Suture
is made of a variety of materials with a variety of properties.
It may be synthetic or biological, absorbable or non-absorbable
and constructed with a single or multiple filaments.
Nylon is an example of a synthetic suture. Biological suture,
such as gut, increases physiological response and is not good
for use in the skin. Silk is a braided biological suture, which
should not be used in dirty wounds. The multiple filaments create
space, allowing bacterial trapping, an silk is absorbed slowly.
Choice among these materials depends on:
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Availability |
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Individual
preference in handling |
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Security
of knots |
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Behaviour
of the material in the presence of infection |
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Cost. |
If you want a suture to last, for example when closing the abdominal
wall or ligating a major vessel, use one made of non-absorbable
material. Use absorbable material in the urinary tract to avoid
the encrustation and stone formation associated with non-absorbable
suture.
All varieties of suture material may be used in the skin, but
a reactive suture such as silk should be removed within a few
days. In skin wounds, remove sutures early to reduce visible
markings.
Because of the ease of tying, braided suture may be easier to
use for interrupted stitches. Absorbable and non-absorbable monofilament
suture is convenient for continuous running stitches.
The commercial suture package is marked with the needle shape
and size, the suture material and the suture thickness. Suture
is graded according to size. The most popular grading system
rates the suture material downward from a very heavy 2 to a very
fine ophthalmic suture of 10/0. Most common operations can be
completed with suture material between sizes 4/0 and 1.
Different materials have different strength characteristics.
The strength of all sutures increases with their size.
Suture can be purchased in reels and packaged and sterilized
on site as a less expensive alternative to packages from the
manufacturer.

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