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What is Suture?

Suture is a strand used to ligate the blood vessels and approximate the tissues.

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THE IDEAL SUTURE


An ideal suture must have following properties: Use for any procedure Easy to Handle Minimal Tissue Reaction High Breaking Strength Holds Knot Securely Absorbable Predictable Absorption Sterile

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Characteristics of Sutures
Absorbable Breaking strength Limit of tensile strength at which suture breaks Capillarity Extent to which body fluid absorbed in the body Elasticity- Measure of the ability of the material to gain its original form after deformation (Silk) Knot strength Amount of force necessary to cause a knot to slip Memory Inherent capability of suture to return to or to maintain its original gross shape
Polypropylene

Plasticity Measure of the ability to deform without breaking and to maintain a new form after
relief of the deforming force - polypropylene

Pliability Ease of Handling Tensile strength Amount of tension or pull the suture can withstand before it breaks Wound breaking strength Limit of tensile strength of healing wound at which separation
wound edge occurs.

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Suture size
Size refers to the diameter of the suture strand.

The more zeroes characterizing a suture size, the smaller the


resultant strand diameter (eg, 4-0 or 0000 is larger than 5-0 or

00000). The smaller the suture, the less tensile strength of the
strand.

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CLASSIFICATION OF SUTURES
ABSORBABLE NONABSORBABLE

MONOFILAMENT

MULTIFILAMENT (BRAIDED)

SYNTHETIC

NATURAL

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ABSORPTION TERMINOLOGY (Absorbable Sutures)


LOSS OF TENSILE STRENGTH
ABSORPTION OF MASS

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Loss of Tensile Strength Definition


Tensile Strength retention refers to the amount of strength INVIVO that a suture material has retained.

This can be measured in days and as a percentage of original strength Loss of Tensile strength can take place without any visible loss of suture bulk

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Absorbable PGA Polyglactin 910 Polydiaxonone

Polyglecaprolactone
Catgut Non Absorbable Nylon Silk Polypropelene

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Factors that determine suture selection


Surgeons familiarity with the suture Physical & biological characteristics of the suture

Healing characteristics of the tissue in which it is placed


Presence of infection or contamination

Patients age, weight and status of health and expected postoperative course of the patient
Cosmetic results

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