Choosing the Right Suture Thread

A suture thread is placed on a surgical needle for suturing or ligating various tissues. Suture thread is generally available in sterile packaging, and can come in different materials, diameters, lengths, and colors.

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  • Which suture threads should you choose for your application?

    The main criterion for choosing a suture thread is its intended use. There are threads for different types of surgery, including neurosurgery, general surgery, ophthalmology, oral surgery, etc. Your choice should take into account two characteristics of the tissue to be sutured or ligated:

    • The type of tissue
    • The thickness of the tissue

    Depending on the intended use, various characteristics of the thread and needle must be taken into account.

    • Mechanical characteristics of the thread: strength, coefficient of friction, elasticity, flexibility (see next section)
    • Structure and composition of the thread: monofilament or multifilament, absorbable or non-absorbable (see sections below on these distinctions)
    • Needle characteristics (see last section)
    B.Braun polypropylene and polyethylene monofilament suture thread

    B.Braun polypropylene and polyethylene monofilament suture thread

  • What mechanical characteristics should be taken into account?

    Four main mechanical characteristics must be considered when choosing a suture thread: strength, coefficient of friction, elasticity, and flexibility.

    • Strength: Refers to the tensile strength of the suture. It essentially depends on the diameter and material of the thread.
    • Coefficient of friction: This is the ability of the thread to slide through tissues without causing trauma.
    • Elasticity: Refers to the thread’s ability to stretch and return to its original shape.
    • Flexibility: This is the thread’s ability to bend. This influences the ease with which it can be handled, as well as the security of the knots.
  • What are the main differences between monofilament and multifilament sutures?

    Sutures can be divided into two categories: monofilament, made up of a single filament, and multifilament, made up of several fibers, which can be braided or twisted together. Here are the main advantages and disadvantages of each type:

    • Monofilament
      • Advantages:
        • High resistance
        • Good glide, which minimizes tissue drag and facilitates removal
        • Absence of capillarity, i.e. there is no possibility of fluids or microorganisms following along the suture, which reduces the risk of infection
      • Disadvantages:
        • Thread stiffness
        • Shape memory
    • Multifilament
      • Advantages:
        • High flexibility
        • Holds knots well
        • Low shape memory
      • Disadvantages:
        • Uneven surface of the thread, leading to capillarity
        • Less elastic than monofilaments
    Ethicon multifilament suture thread with curved needle

    Ethicon multifilament suture thread with curved needle

  • What materials are suture threads made of?

    While surgical needles are generally made of stainless steel, suture threads are available in a variety of materials, mostly synthetic, some absorbable, and others not. The most commonly used are listed below.

    The absorption time can range from 60 days to over 200 days, depending on the type of material, the thickness of the thread, etc.

    Nanjing Kaihong Healthcare absorbable PGA suture thread on a curved needle

    Nanjing Kaihong Healthcare absorbable PGA suture thread on a curved needle

  • What kind of needle should you use with the suture thread?

    The needle’s performance depends essentially on two criteria: its rigidity and penetration capacity.

    • Rigidity: This is the ability to resist bending under normal conditions of use.
    • Penetration: This is the needle’s ability to easily penetrate tissues without tearing them.

    In order to obtain the best possible result, it is important to pay attention to the following characteristics:

    • Needle curvature: Needles can be straight or curved. Different curves are required depending on access to the area to be sutured. Your choice depends on the depth of the area to be sutured.
    • Needle tip:
      • Round: Needles with a round tip reduce the risk of tissue trauma. They are therefore used for fragile and delicate tissues such as the heart, vessels, and gynecological tissues, as well as for the peritoneum and sutures in the digestive and urinary tracts.
      • Triangular: Needles with a triangular tip are sharp and are therefore classified as traumatic. They are the most commonly used because they easily penetrate tissues such as the skin, abdominal wall, ligaments, and fibrous tissues. They have good resistance to bending and therefore less risk of breakage.
      • Spatulated: This shape provides excellent penetration, good glide, and precise positioning. These needles are particularly suitable for use in the digestive and urinary tracts, in gynecology, and for the abdominal wall.
    • The shape of the needle body: Can be round, square, triangular, hexagonal, etc.
    Covidien (Medtronic) triangular tip suture needle

    Covidien (Medtronic) triangular tip suture needle

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