Refresh Suture

Instalasi Bedah Sentral RSU Cilacap 15 Mei 2009

Traditional Suture Classification

1. 2. 3.

Raw Material Thread Structure Absorption Properties

Thread Stucture & Apsobtion Properties

Monofilament Pseudomonofilament Multifilament Twisted and Braided Non-absorbable suture:

Remain in the body unless removed, no change in chemical or physical properties with time

Pseudo-non-absobable suture :
Loose part of physical properties over a long time, do not disappear completely

Absorbable suture :
Loose tensile strength and disappear as material degrades

Absorbable Suture

Suture Degradation : Enzymatic or Hydrolysis

Two Main Concepts : 50% Tensile Strength retention period : Short Term : < 7 days Middle Term : 15-21 days Long Term : 30-40 days Mass Absorption Time

Absorbable Suture
Natural

Catgut Chromic Catgut Plain

Synthetic

Braided Monofilament

Non Absorbable Suture

Natural Polyester Polypropylene Polyamide

How To Select a Needle

Type

of tissue Location and accessibility of tissue Size of suture material Surgeons personal preferences

Needle Point
Between the tip and the maximum cross section of the body
Specific to penetrate tissue type

Round Bodied (Taper) Blunt Point Spatula Reverse Cutting Trocar Point

Neddle (Curve & Straight)

F H

D V G

Needle Point & Body Shape Typical Application

Taper : Gastrointestinal,Fascia, Muscle, Nerve, Peritonium,Aponeurosis,Vesseles, etc Reverse Cutting : Fascia,Ligament,Skin,Tendon Nasal Cavity,etc Trocar & DRC : Broncus,Ovary,Pharynx,Trachea,etc Blunt Point : Kidney,Liver,Spleen,etc

CATGUT

Structure : Monofilament Material : Collagen from serosal layer Tensile Strength : Plain lost 7 to 10 days, Chromic lost 21 to 28 days Absorption : Enzymatic digestion Frequent uses : Ligatures,General,Urology, Gynaecology, Opthalmic

Natural (Silk)

Structure : Braided with wax coating Material : Natural Protein fibre from silkworm Tensile strength : Losses most or all in 1 year Degradation : Cannot be found > 2 years Frequent uses : Most body tissues for ligating and suturing,General Surgery,Skin & Plastic surgery

Polyglycolic Acid (PGA)

Structure : Braided Material : Polyglycolic Acid Tensile strength : Loss after 4 to 5 weeks Absobtion : Hydrolysis Frequent uses : General Surgery, Opthalmic Surgery, Gynaecology

POLYPROPYLENE (PPL)

Structure : Monofilament Material : Polymer of Propylene Absorbtion : Non absorbable Frequent uses : Cardiovascular Surgery, Vascular Surgery, Skin Closure, Plastic Surgery,General Surgery