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suture needle. For the suture pictured above, a surgeon would say, "Give me a 4-0 Vicryl on a PS-2". 4-0 (pronounced 4-oh) refers to the size of the suture fiber. Vicryl is the type of suture. And finally a PS-2 is the type of needle the suture is attached to.
suture to break down in the body depends on a few factors such as suture type, size and the location it is placed. The list to follow includes the most common absorbable sutures in most operating rooms listed from shortest to longest break down time. *Complete breakdown of strength times of various Ethicon Sutures: Vicryl Rapide 2 weeks Undyed Monocryl 3 weeks Dyed Monocryl 4 weeks Coated Vicryl 4 weeks PDS 9 weeks Panacryl 70 weeks Note Suture absorption rates can increase in patients with fever, infection or protein deficiency. Also, the strength to a suture will decrease significantly prior to its complete breakdown time. Therefore a suture with higher tissue tension will have a greater chance of failure prior to the amount of time listed above
Suture Size
Smallest 10-0 Typically used in the most delicate surgeries. Common in both Ophthalmic (eye) 9-0 surgery and for repairing small damaged nerves often due to lacerations in the 8-0 hand. 7-0 Used for repairing small vessels and arteries or for delicate facial plastic surgery. 6-0 Common for use in vascular graft sewing such a carotid endarterectomy. 5-0 Used for larger vessel repair such as an Abdominal Aortic Aneurysm or 4-0 skin closure. 3-0 Skin closure when there is a lot of tension on the tissue, closure of muscle layers 2-0 or repair of bowel in general surgery. 0 For closing of the fascia layer in abdominal surgery, the joint capsule in knee and 1 hip surgery or deep layers in back surgery. 2 For repair of tendons or other high tension structures in large orthopedic 5 surgeries. Largest
Non-Absorbable Suture
Nylon (Ethilon), Gortex, Silk, Fiberwire, Ethibond, Prolene and Steel are all example of non absorbable suture. When used on the skin, these sutures will be removed however when used in the body they will be retained inside the tissue. Common uses for non absorbable suture: Interrupted skin suturing when sutures will be removed later, 4-0 Nylon Securing drains to skin, 2-0 Silk Repair stitches for blood vessels, 6-0 Prolene Vessel graft stitches for AAA, Fem-Pop or Carotid Artery grafts 5-0, 6-0 prolene or gortex Bowel repair stitch, 3-0 silk Achilles Tendon Repair, #5 Ethibond or Fiberwire
Suture Type
There are many different types of suture, the two most important properties are... Absorbable Vs Non-Absorbable and Braided Vs Non-Braided The Vicryl suture pictured above is an example of a braided absorbable suture.
Absorbable Suture
Absorbable suture breaks down over time in the body. Examples of absorbable suture include Monocryl, Vicryl, Chromic, and PDS. The amount of time it takes a
Suture Needles
Along with selecting the correct suture it is important as well to select an appropriate needle. The two factors in selecting a needle are size and if a cutting or tapered needle is needed. While there are exceptions, much of the time you will find tapered needles are used inside the body such as on bowel, fascia, or muscle where the tissue is more easily pierced. Cutting needles are used for skin and very tough tissue such as bone and tendon. Beyond choosing a cutting or tapered needle one only needs to select an appropriate size. There are hundreds of sizes and types of needles. Listed below are some of the most common used in most typical surgical procedures.