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Views: 0 Author: Site Editor Publish Time: 2025-02-27 Origin: Site
Surgical sutures are special medical threads used to sew wounds. They maintain the apposition of wound edges by exerting tension until healing is complete and help reduce the risk of infection. Surgeons must precisely select the appropriate suture sizes, types, and surgical stitching techniques based on factors such as wound tension and tissue healing rate.
In everyday language, the terms “sutures” and “stitches” are often confused; however, the former specifically refers to the suture material, while the latter denotes the technique of closing a wound. Together, they form the key system for wound repair.
Different types of sutures are distinguished based on three aspects: material, absorbability, and structural design. Types of suture material can be classified as natural or synthetic; based on absorbability, they are divided into absorbable and non-absorbable sutures; and based on structure, they can be monofilament or multifilament.
The following primarily details the classification based on absorbability, with material and structure being mentioned within the descriptions.
Category | Product Name and Abbreviation | Material | Color | Characteristics and Applications | Image |
Absorbable surgical sutures | Polyglycolic acid (PGA) | Absorbable synthetic sutures | Violet, undyed (grayish white) | Characteristics: Minimal trauma, strong tension, smooth thread; provides more comfortable and short-term wound support, specifically designed for skin and mucosal suturing. Absorption cycle: Undergoes hydrolytic degradation, maintaining tensile strength for 60-90 days. Applications: Gastrointestinal anastomosis, fascial suturing (e.g., Dexon) |  |
Polyglycolic acid Rapid (PGAR) | Rapidly absorbing absorbable synthetic sutures | Violet, undyed (grayish white) | Same material as above, with a faster absorption rate. Absorption cycle: Approximately 42 days for complete hydrolytic absorption in the body (no residue) Applications: Suitable for short-term wound healing requirements |  | |
| Polyglactin 910 (PGLA910) | Absorbable synthetic sutures | Violet, undyed (grayish white) | Composition: Made of 90% PGA + 10% adhesive polymer; same material as Johnson Vicryl 910 Absorption cycle: 56-70 days Applications: Anti-infection design, suitable for laparoscopic surgery |  | |
| Rapid Polyglactin 910 (PGLAR 910) | Rapidly absorbing absorbable synthetic sutures | Violet, undyed (grayish white) | Same material as above, with a faster absorption rate. Characteristics: The fastest absorbing suture among chemically synthesized absorbable sutures Absorption cycle: Completely absorbed in 42 days Applications: Especially suitable for ophthalmic surgery and superficial wound closure; not recommended for cardiovascular and neural tissue suturing |  | |
Polydioxanone (PDO) | Monofilament absorbable synthetic sutures | Violet | Characteristics: Exhibits excellent flexibility and provides prolonged wound support as an absorbable monofilament suture Absorption cycle: Over 180 days Applications: Can be used for uterine and heart valve fixation, tendon repair (requires an extended support period) |  | |
| Poliglecaprone Poliglecaprone 25/ (PGCL) | Monofilament rapidly absorbing absorbable synthetic sutures | Violet, transparent | Composition: Copolymer of 75% glycolide and 25% caprolactone Characteristics: Smooth surface that reduces tissue friction and infection risk; offers superior flexibility compared to other monofilament sutures, making it more suitable for suturing in areas requiring bending. Absorption cycle: Retains approximately 50% of its initial tensile strength 7 days post-operation; completely absorbed over several weeks to months. Applications: Subcutaneous soft tissue suturing (e.g., cesarean section incisions, plastic surgery); scenarios requiring high flexibility (e.g., mobile areas or mucosal layer suturing) |  | |
Chromic catgut (CC) | Chromic catgut | Brown | Characteristics: Treated with chromic acid to slow tissue absorption, resulting in a milder inflammatory reaction compared to plain catgut. Absorption cycle: Retains tensile strength for approximately 2–3 weeks, with complete absorption in about 80–100 days. Applications: Commonly used in gynecological, renal, and urological surgeries |  | |
Plain catgut (CP) | Plain catgut | Light yellow | Characteristics: Catgut that has not been treated with chromic acid or similar agents; it is absorbed more quickly in tissue but elicits a slightly greater tissue reaction. Absorption cycle: Retains tensile strength for about 1 week, with complete absorption in approximately 70 days. Applications: Commonly used for tissues that heal rapidly or for ligating blood vessels and suturing infected wounds in subcutaneous tissue; frequently used in mucosal layers such as the uterus and bladder. |
| |
Non Absorable surgical Sutures | Silk braided (SK) | Silk surgical sutures | Black, white | Characteristics: A natural, non-absorbable suture made from silk protein, and currently one of the most widely used in clinical practice; easy to sterilize, high tensile strength, soft, minimal tissue reaction, secure knots, and low cost. However, long-term retention may lead to fragmentation and granuloma formation. Applications: Commonly used for epidermal suturing, ophthalmic microsurgery, or temporary vascular ligation |  |
Polyester braided (PB) | Polyester braided sutures Poly-cotton sutures | Green, white | Characteristics: Soft and smooth, with strong tensile strength but prone to slippage and breakage. Applications: Previously used in gynecology |  | |
Nylon monofilament (NL) | Nylon surgical sutures | Blue, black | Characteristics: Causes minimal tissue reaction and has higher tensile strength than silk; features a smooth surface, though knots tend to loosen after tying, necessitating 5–6 knots with the cut end 10 mm from the knot. Applications: Suitable for cardiovascular suturing; it remains stable in the body permanently without the need for removal. |  | |
| Polypropylene (PP) | Polypropylene sutures | Blue, black | Characteristics: Soft and smooth, with strong tensile strength but prone to slippage. Applications: Used in cardiovascular surgery (e.g., vascular anastomosis); for closure of surface wounds in patients requiring long-term fixation or who are sensitive to foreign body reactions; for internal soft tissue fixation (such as hernia repair), as the inert material can remain in the body for a long time. |  | |
Stainless steel | Stainless steel sutures | Metallic color | Characteristics: Metal sutures, usually made of stainless steel, copper, or silver; they exhibit high tensile strength and minimal tissue reaction, but their high rigidity can make them difficult to handle. Applications: Currently mostly used in orthopedic surgeries and for tension-reducing sutures in the chest and abdominal wall; suitable for abdominal wound closure, hernia repair, sternal closure, and orthopedic procedures including encircling and tendon repair. |  |
| Needle Shape | Point Type | Symbol | Application Scenario |
 | Round Bodied |  | For fragile soft tissues or mucous membranes (e.g., gastrointestinal tract, blood vessels, nerves), reducing the risk of tissue cutting. |
 | Curved Cutting |  | For suturing skin or fibrotic tissues (such as thick skin, scars, tendons), suitable for high-tension areas. |
 | Reverse Cutting |  | For epidermal or collagen-rich tissues (e.g., around joints, abdominal fascia), reducing the risk of the suture cutting through tissue. |
 | Taper Cutting |  | Commonly used in general surgical procedures (e.g., muscular layers, peritoneal suturing), balancing penetration with minimal trauma. |
 | Blunt Point |  | For suturing or puncturing fragile tissues (such as in liver or spleen surgery, blunt separation of adipose tissue), to avoid further tearing. |
 | Precision Point- Reverse Cutting |  | Mainly used in cosmetic or microsurgery (e.g., ophthalmology, plastic surgery) to ensure precise suturing. |
 | Micropoint Curved Spatula |  | For precise vascular anastomosis or microsurgery (such as in cardiovascular procedures), providing fine control. |
Gastrointestinal, Tendons, Skin General Surgery, Urology
Tissue Type and Healing Requirements
– For delicate tissues (e.g., mucous membranes, blood vessels, heart): Prefer monofilament absorbable sutures to minimize tissue friction and infection risk.
– For high-tension areas (e.g., fascia, ligaments): Choose high-strength non-absorbable sutures to provide long-term support.
– For the skin surface: Use multifilament absorbable sutures, which offer both flexibility and rapid absorption (tensile strength decreases by 50% within 5–6 days, providing effective support for about 14 days).
Matching Healing Cycle with Absorption Time
– For rapid closure needs (e.g., subcutaneous tissue): Use short-term absorbable sutures (e.g., PGLA, poly(lactic-co-glycolic acid)) with an absorption time of 14–35 days.
– For long-term support needs (e.g., hernia repair): Choose non-absorbable sutures that remain permanently to avoid wound dehiscence.
Surgical Site and Operability
– For deep or confined surgical areas (e.g., laparoscopy): Prefer monofilament sutures (smooth surface, easy passage through tissue).
– For mobile areas (e.g., near joints): Use sutures with high strength and good flexibility (e.g., Polydioxanone [PDO]) to reduce the risk of tissue cutting.
Suture Specifications (Thickness and Standards)
– Fine sutures (e.g., 6-0 to 8-0) are used in ophthalmology and microsurgery.
– Thick sutures (e.g., 0 to 1) are used for suturing thick tissues such as fascia and sternum.
Adjust the choice based on the suture material, size, and needle type, along with the surgeon’s personal technique and familiarity with the material (e.g., some special suturing methods may require high-elasticity sutures).
Continuous stitching is a single suture used continuously from one end of the incision to the other, with a final knot tied at the end.. This technique is suitable for closing long, straight incisions, offering speed and time savings; however, if one segment fails, the entire suture line may loosen.
Each stitch is knotted individually, allowing for independent tension adjustment. If one stitch loosens or breaks, the others maintain wound closure. This technique is commonly used for routine wound management or subcutaneous suturing, such as in superficial lacerations of the arm or leg.
Primarily used for closing deep tissues beneath the skin, such as the fascial layer or muscle. In abdominal surgery, it secures deep structures, ensuring even force distribution and reducing tension on the superficial skin. This technique typically requires thicker sutures for approximating deep tissues.
Knots are placed within the skin so they are not visible on the surface, and this method is primarily used in areas where cosmetic appearance is critical, such as facial or neck surgeries. Hiding the knots minimizes scar formation, though precise technique is required to avoid irritation of the underlying tissues.
A continuous suturing technique that encircles a circular area, commonly used in visceral surgeries to close small openings—for example, tightening around an intestinal stoma or securing a drainage tube. Uniform tightening of the suture ensures closure to prevent leakage of fluids or gases, requiring a well-sealed circular structure.
The suture is completely buried beneath the dermis with no visible marks on the surface. This technique is often used in plastic or cosmetic surgery, such as facial incisions, to ensure minimal scarring after healing. It is technically demanding and requires the use of fine, absorbable sutures.
