What is a Surgical Suture?

The suture is the material used to ensure the integrity of the tissue that is disrupted during the surgical procedure and to control the bleeding that occurs. In this article, we will talk about what you need to know about suture.

Appropriate suture selection varies according to the biological structure and anatomical localization of the wound. Suturing is a surgical procedure that has been practiced by humans for 4000 years. South American Indians used the heads of war ants like pincers to suture. The ancient Greeks made use of horsetail hairs attached to sharpened bones. This surgical material, which has been used for 4000 years from the past to the present, is still an indispensable element of medical surgical interventions. With the increase in technological possibilities, sutures have gained a much more ergonomic structure today.

Surgical incisions are best and most easily closed with sutures. The materials required for suture are simply needle, thread and surgical instruments. Portuges, scissors and forceps are sufficient tools for suture use. In this article, we will not talk about tools. You can reach our review article on the materials and tools required for suture usage tools here.

Selection of appropriate suture materials is the key to success in dermatological surgery. In this selection, the type of procedure to be performed, its localization and the experience of the dermatological surgeon are important factors. Thanks to the developing technology in recent years, the thread has been combined with the needle. Thus, the yarn is prevented from folding in half behind the needle, forming a bump and causing further tissue damage.

Suture Materials
I. Suture Needle
Surgical needles have three separate regions. These are the tip, body and stem. Needles are also classified according to their tips.

-Pointed Tip -Square Body
-Blank Tip
-Reverse Cut
-Diamond Tip
-Spatula Tip -Inner
Cut
-Scalpel Tip
-CC Needle -Pointed
Cutting
-Biopsy Needle
-Square Body Pointed

Sharp needles are generally used in dermatological surgery. Reverse sharp needles can be used more safely where the skin is thin and tearable. The body part of the needles (approximately the middle 1/3) is the part held by the porthole. It can be round, oval or triangular. The last 1/3 of the needles that continue with the thread is a soft and sensitive area. This area should not be held with a porthole.

The needles are in the form of an arc of a circle. They are named according to how much of the circle this spring part covers. For example, a half circle is called ½ (mostly used for internal sutures), a quarter of it is ¼, and if it covers an angle of 135 degrees, they are called 3/8.

-1/4 Circle
-3/8 Circle
-1/2 Circle
-5/8 Circle
-J Shape

II. Suture Thread
Threads are simply divided into two large groups;

-Absorbable Suture -Non
-absorbable Suture

Absorbable sutures, as the name suggests, are absorbed into the tissue. This absorption time varies according to the type of yarn. Those that are not absorbed cannot be absorbed by the tissue.

A second distinction for yarn is monofilament and multifilament. Monofilament yarns contain a single strand while multifilaments contain multiple strands and are braided. Knots made with multifilament yarns are stronger and not easily untied. However, the risks of tissue reactions and microbial colonization are higher.

The diameters and tensile strength of the ropes are standardized. Especially their diameters are calculated according to the number “0=zero”. The higher the number of zeros, the thinner the rope. There are two different measurement units when calculating suture thinness and thickness. One is the American Pharmacopoeia and the other is the European Pharmacopoeia.

Sutures have a wide range of uses. Sutures can be used in many areas such as gastrointestinal surgery, gynecology, urology, ophthalmic surgery, orthopedics, pediatric surgery, tissue closure intracutaneous, subcutaneous, abdominal wall closure, plastic surgery, pediatric cardiovascular tissues.