Surgical Sutures

and Needles
SUTURES
The Ideal Suture
Moynihan 1912
Monofilament
Use for any procedure
Easy to handle
Minimal tissue reaction
High breaking strength
Hold knots securely
Absorbable
Predictable Absorption
Sterile
Classification of Sutures

CHARAC- Absorbable
Non-
TERISTIC absorbable

STRUCTURE Monofilament Multifilament

MATERIAL Synthetic Biological

Advantage

ABSORBABLE NONABSORBABLE
Broken down Permanent

by body Wound Support

No foreign

body left
Disadvantage

ABSORBABLE NONABSORBABLE
Time of wound Foreign body

support left
Suture sinus

Suture

extrusion
Advantage

MONOFILAMENT MULTIFILAMENT
Smooth surface Strength
Low friction
Soft & pliable

Less drag
Good handling

Less tissue
trauma
No bacterial
harbours
No capilarity
Disadvantage

MONOFILAMENT MULTIFILAMENT
Handling & Bacterial

Knotting harbours
Ends/knot Capillary action

burial Tissue trauma

Strecth
Drag

Cutting
Advantage

BIOLOGICAL SYNTHETICS
Handling & Resemble

Knotting natural
substances
Economical
Absorption by
hydrolysis
Predictable
absorption
Strong
Disadvantage

BIOLOGICAL SYNTHETICS
Absorption by Monofilament

enzymatic handling
action
Tissue reaction

Unpredictable

absorption
 Plain/F.A. Gut

Natural Chromic Gut

VICRYL*Rapide
VICRYL*
Absorbable Synthetic VICRYL* Plus

MONOCRYL*
PDS II*
PDS II

* Trademark
Absorption Terminology
ABSORBABLE SUTURES

LOSS OF ABSORPTION OF
TENSILE STRENGTH MASS
Wound support Elimination of
No loss of suture Suture
bulk Material removed
Strength reduced
Suture Handling
Absorbable Sutures
WOUND ABSORPTION
SUPPORT OF MASS
Catgut 7 10 60 90
VICRYL* 6 14 by 42
Rapide
Chromic 17 21 90 110
Catgut
MONOCRYL* 14 21 90 120
Coated
VICRYL* 28 35 56 70
PDS* II up to 56 by 182
Catgut Absorption

PLAIN CHROMIC
Wound
7-10 days 17 21 days
Support
Mass 90 110
60 90 days
absorption days

Absorption affected by many factors

Coated VICRYL*
Absorption
Synthetic Absorbable Hydrolysis
Predictable absorption

Minimal tissue reactions

Chromic Catgut at 14 days

Coated VICRYL* 2/0 at 14 days Extensive tissue reaction with
Minimal Tissue Reaction acute inflammatory response
around suture
 Silk
Biological
Biological

Non Absorbable ETHILON*

MERSILENE*
Synthetic
Synthetic ETHIBOND*

PROLENE*

Stainless Steel

* Trademark
MERSILK*

DRAWBACKS
Tissue reactions
Loss of strength
Ultimately
fragments
NUROLON* SILK
Foreign body
implanted long Greater reaction to biological material
term
PROLENE* Polypropylene

MINIMAL TISSUE REACTION

Enlarged photomicrograph
PROLENE* suture
Implanted 6 months
NEEDLES
Needle Selection
Minimal trauma to
tissue
Sharpness

Bend resistance

Corrosion

resistance
Sterility

Size, shape &

design
Use of Needle Holders
Eyed Needles
Double suture Eyed French / split eye
strand
Threading time
Resterilisation
Point
maintenance
Risk of corrosion
Risk of
unthreading
Suture Attachment

Channel
Drilled
Anatomy of a Surgical
Needle
Needle Shapes
 Needle Size Range
45 needle sizes from 3mm to 110mm
MICROSUTURES 3.75mm 8mm

OPHTHALMIC 5mm 16mm

CARDIOVASCUL 110mm
8mm 40mm 3mm
AR

SKIN RANGE 9mm 60mm

G.I. RANGE 13mm 40mm

CLOSURE 30mm 110mm

HAND HELD 55mm 110mm

Needle Types

Round Bodied
Cutting

Ophthalmic
Round Bodied Needles

Intestinal
JB Needle

VISIBLACK*

Blunt

ETHIGUARD*

CC
Cutting Needles

CONVENTIONAL CUTTING
Apex of edges on inside curvature
Cutting Needles

REVERSE CUTTING
Apex of edges on outside curvature
PACKAGING
 Packaging Foil Pack
Metric
USP Gauge
Gauge Code number

Manufacture Denotes Easy

& Expiry date Access packaging

Product description
& colour
Needle
description
Sterilisation Method
Length

IDENTIFICATION OF MARKINGS
Packaging Foil Pack
(Easy Access)
Tear in
direction of
arrow
Foil & card
open
together
revealing
needle
Arm needle
holder
Withdraw
suture
Packaging RELAY*
Single
overwrap
Remove
tray
Pull down
flap to
expose
Arm needle
holder
Withdraw
suture
KINK FREE SUTURE DISPENSED