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Suturing - Materials and Techniques

Published on Apr 20, 2022 and last reviewed on May 23, 2022   -  4 min read

Abstract

Suturing is a technique used to close opened wounds, secure and position the surgical flaps. This article discusses the techniques and materials used.

Contents

What Is a Suture?

Closing the wounds with a needle and thread is age-old. At present we have established several techniques to perform this procedure. A suture is an artificial material or thread used to ligate or approximate the wound tissues until they heal. This provides support for tissue margin and reduces postoperative pain.

Why Do We Need a Suture?

An adequately placed suture is required for the following reasons,

What Are the Requirements of Suture Material and How Do We Choose Them?

Suture materials are selected based on the physical and biological characteristics of the suture material, the healing properties of the tissue to be approximated, and the nature of the wound.

It should have the following requirements,

  1. It should be sterile.

  2. It should have enough tensile strength and hold the wound securely throughout the healing period.

  3. It should be easy to handle and limit bacterial adhesion.

  4. It should have a uniform diameter.

  5. It should be biologically inactive.

What Are the Types of Suture Materials?

Sutures are classified based on the following criteria:

  1. According to absorbability- Absorbable or nonabsorbable.

  2. According to the source- Natural or synthetic.

  3. According to structure- Monofilament or multifilament.

  4. According to tissue reaction- Reactive or non-reactive.

  5. According to handling- Easy or difficult to handle.

Natural Absorbable Sutures- They are monofilaments of highly purified collagen. They have mild to moderate strength. Also, they have a mild inflammatory reaction and should be avoided in some instances with high acidic environments like Nervosa bulosa, etc.

They are available in two types-

Synthetic Absorbable Sutures- They are braided filaments of polyglycolic acid. They inhibit bacterial growth and resorb within 21 days to 28 days.

They are available in two types-

Non Absorbable Sutures- They are resistant to resorption and are available as,

What Are the General Principles of Suturing?

What Are the Different Techniques in Suturing?

Here are some of the most commonly used suturing techniques discussed in detail:

This is the most commonly used suture inserted through one side of the wound and tied with a surgeon’s knot. These are used in areas of stress and are easy to clean.

It is a simple interrupted suture placed continuously. It distributes the tension uniformly, but the suture, if cut open at one point, slackens along the whole length.

It is similar to a continuous suture, but locking is provided by withdrawing the suture through its loop. It is used in long edentulous areas, tuberosity, or retromolar areas.

It is a variation of simple interrupted sutures used in wounds under tension. They provide excellent wound support and decrease the dead space.

They are useful in wounds that require distributing the tension across larger wounds, but they strangle the blood supply and cause the death of tissues in the end.

This technique involves penetrating the periodontal tissues and periosteum to the bone. The aim is to regenerate the lost alveolar structure for prosthetic purposes.

This procedure is used mainly for root coverage, gingiva esthetics, etc.

This technique is used for extraction socket closure and adapting the gingival papilla around the tooth.

Conclusion

Considering the requirements of modern surgery, there are many suturing techniques and methods that have been developed now. Proper knowledge about the suture, needle, instruments, and technique is necessary for a good surgeon. The difference in tissue reaction and bacterial adhesion should always be considered for selecting the suture material. Proper handling of the soft tissues and appropriate suturing techniques can achieve the desired effects of tissue healing.

Last reviewed at:
23 May 2022  -  4 min read

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