Everything You Need to Know About Sutures

Overview

As time passes, surgeries begin to grow more complicated. Sutures help with various procedures by fastening the two tissues after a cut or surgery, which helps heal the laceration.

Cuts will not heal properly without the help of an instrument because there will be unequal spacing at different points in the cut.

Without proper suturing, infections can develop in or around the laceration, and these infections can even cause the death of a patient. Suturing helps seal wounds and guarantees a timely recovery for the patient. 

Veterinarians, physicians, surgeons, clinical pharmacists, eye doctors, dentists, and registered nurses can utilize suturing tools depending on the situation. Podiatrists, other trained nursing personnel, and medics also perform various procedures with the help of a suture. 

After surgery, doctors utilize suturing knots during the final stages of the operation. The instrument helps close all dead spaces in the laceration to create a tight seal in the wound that keeps out bacteria and heals at a faster rate with less pain.

Different types of bacteria can enter the laceration through dead spaces and cause potentially dangerous infections if the suture is not tight enough. 

There are different products for each laceration and area of injury, so the decision when choosing products depends on the location of the cut on the body.

History 

 

There is actually an extensive history in the field of medicine regarding this ancient practice. Bone and metals like copper, silver, aluminum, and bronze wire were all used to make needles in the past and perform these types of procedures.

Materials for making products were taken from plants (e.g., flax, hemp, etc.) and animals (e.g., hairs, tendons, arteries, muscle strips, nerves, silk, etc.).

According to some researchers, the first instrument dates back to Ancient Egypt in 3000 BC.

In 1600 BC, Galen of Pergamon in Greece used silk and catgut as a suture.

In 1100 BC, scientists tested the instruments on mummies. Later, Joseph Lister proposed the sterilization of the apparatus, and sterilization was essential because the bacteria on the equipment can cause infection.

 

Johnson and Johnson introduced their products 130 years ago. In 1887, they began bulk production and distribution.

Indications of use

Doctors use the apparatus in many different areas of medicine. There are many indications of use for the product, and the following are a few examples. 

 

Surgical Gut Suture 

It is an absorbable and entirely natural material used for repairing internal soft tissues. This material derived from the small intestine of sheep allows surgeons to stitch lacerations and lesions that often need great care. 

For surgical procedures related to neurology and the cardiovascular system, gut sutures are not adequate. Surgeons should not use this type of suture in these areas. 

The body will begin to scar over after using gut sutures as a reaction to the newly sewn cuts. Gut sutures are often used during gynecological surgeries.

Polydioxanone (PDS)

The demand for universal products for sutures has been increasing rapidly in recent years. There are several different types of cuts, therefore, doctors require different types of equipment, and PDS is handy for most situations because it is used on many types of soft tissues. 

Polydioxanone (PDS) is made of synthetic monofilament, and it is used for several suture procedures to solve various issues. The number of pediatric cardiac cases are increasing day by day, and during these procedures, this material makes for an effective and safe treatment. 

 

Poliglecaprone (MONOCRYL)

This medical supply is made of monofilament, which is synthetic and great for certain lacerations. Soft tissues are generally more challenging to heal, but with this suture, you can quickly repair them. 

Procedures related to neurology and the cardiovascular system, MONOCRYL is not the best solution, so surgeons should avoid using it for related procedures. 

A bonus to this type of suture is not medical, but it is favored by many patients because it often allows them to undergo a surgical procedure without a visible scar after it heals.


Polyglactin 910 (Vicryl)

This suture is made of synthetic braids and absorbed into the patient after roughly 2 to 2.5 months. The tensile strength of the suture is only present for about one-third of this time.

The suture is of excellent quality, and it is produced by Ethicon Inc. It can repair soft tissues, but it is still not recommended for surgeries related to the heart, vessels, or brain.

 

Buried sutures 

As the name implies, the knot can be buried inside the lacerations under the stitches. Buried sutures usually result in a light scar or the absence of one entirely. This technique is most effective in areas of the human body that experience moderate to light tension. It is often used for plastic surgery.

 

Complications of use

Numerous complications can occur, and they can be very dangerous for a patient.

If the equipment is not sterilized, the treated area can become infected. This complication can introduce many different diseases to the patient’s bloodstream, some more serious/critical than others. 

If any complications arise during the process and the sutures are not applied properly, the wounds will often reopen from small external forces. This obviously presents a critical issue because not only does this cause the patient pain and extend healing time, it also creates a large opening for infections. 

Keloid and hypertrophic scar

A keloid can form on the surface of the lesion as a complication of the product. A keloid is a scar that grows darker with time and causes irritation and itching for the patient. Doctors can use anti-inflammatory products in addition to employing proper techniques to avoid the development of keloids.

The doctors should place firm pressure while using the products; otherwise, a hypertrophic scar can grow around the joints. The scar will eventually fade away.

 

General specifications 

The general specifications for these types of supplies are as follows: 

  • Composition: 8-10% Nickel, 17-19% Chromium
  • Material: Stainless Steel 
  • Flexibility: rigid
  • Diameter for dental: 4-0
  • Circle: 5/8
  • Synthetic adorable diameter: 0.7
  • American wire gauge sizes: 0-34

How they work

Various types of surgeons use equipment like this to stitch the lesion after surgeries. During the process, doctors use a long thread to join the exposed soft tissues and create a seal that will begin to heal. After it heals, the stitches will either dissolve or be pulled out, depending on the type of product.

Prior to the procedure, a healthcare worker should apply a numbing gel on the laceration to numb the area to prevent pain.

The laceration is then cleaned to eliminate any bacteria on the surface of the wound. The patient will not feel any pain during this process because their skin will be numb, so the doctor will begin to stitch the wound tightly. The stitches should be tight enough to prevent the presence of exposed inner flesh, but loose enough not to cause any tears.

The following medical practitioners have the most experience:

Oral and maxillofacial surgeon

Oral and maxillofacial surgeons use the product to seal cuts in the mouth. After a small surgery or cut, they connect the soft tissues in the mouth to reconstruct different parts of the body like the mouth, face, or head. 

 

Otolaryngology surgeon

Otolaryngologists, or surgeons that focus on the ears, nose, and throat (ENT), often have some of the most challenging stitching jobs. During an ENT surgery, surgeons need to stitch together very delicate parts of the human body.

Oculoplastic surgeons

Eye surgery requires special care because the eyes are a sensitive part of the body. Oculoplastic surgeons use sutures to hold the soft tissue of the eyes together after a complicated surgery. One of the most common procedures in this situation is tumor removal.


Alternative Product

An alternative product available on the market is a glue for the wounds, but it is only useful when one needs to bond shallow cuts. Surgical glue should be placed on the wound by a healthcare professional. After some time, this process will allow the cut to heal quickly and effectively. The glue helps with recovery and acts as an alternative, pain-free method for sealing up cuts.

 

Market leaders 

There are a few major players around the world that hold the majority of the market share in the surgical suture market. Most of these corporations also manufacture and sell wound care management alternatives. The following organizations are heavily involved in this niche in the industry:

  • Ethicon, Inc. (United States)
  • Braun Melungeon AG (Germany)
  • Medtronic (Ireland)

 

Conclusion 

Techniques similar to modern-day suturing have been around for a long time, but the development of this universally proven and safe method has helped the medical industry greatly. It allows patients to stay infection free and for their wounds to heal quickly and properly. Whether the stitches must be pulled out or dissolved, it is vital to know the type of material or product needed by a particular surgeon in order to ensure their procedures are done properly. Some of these include PDS, Vicryl, and MONOCRYL.

You should now be able to identify the different types and uses of sutures and how they benefit patients and healthcare professionals on a daily basis.