Sutures: Types, Stitches, Techniques and Removal

Medical professionals including surgeons and physicians use sutures to seal wounds. A doctor will close a cut or laceration using the appropriate suture method and material, depending on your condition.

Your doctor will use stitches to seal any wounds to your skin or other tissues. When your doctor sutures a wound, they will close it with a needle connected to a piece of "thread."

Suturing may be accomplished with a wide range of materials. The substance that your doctor chooses will depend on the operation or wound.

Types Of Sutures

Numerous categories exist for the various kinds of sutures.

Suture materials can be categorized as absorbable or nonabsorbable first.

• Your doctor doesn't need to remove absorbable sutures. This is because your body's tissues naturally break them down through enzymes.
• Your doctor will need to take out non-absorbable sutures eventually, or in certain situations, leave them in permanently.

Second, the suture material may be categorized based on its true structure.

•  A single thread makes up monofilament sutures. As a result, the suture can go through tissues more readily. 
• Multiple tiny threads are braided together to form braided sutures. Improved security may result from this, but the risk of infection may also rise.

Thirdly, sutures can be categorized as either synthetic or natural materials. This distinction is not very helpful, though, because all suture material is sterilized.

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Absorbable suture types

• Abdomen: For the treatment of anterior soft tissue wounds or abrasions, utilize this natural monofilament suture. Cardiovascular and neurological treatments should not be performed on the gut. The body responds to this stitch strongly, frequently leaving scars behind. Other than gynecological surgery, it is rarely frequently used.
• Polydioxanone PDS: In addition to pediatric cardiac surgeries, this synthetic monofilament suture may be utilized for a variety of soft tissue wound healing applications, including abdominal closures.
• Vicryl, or polyglactin: This synthetic braided suture works well for dressing cuts on the hands and face. It is not recommended for use in neurological or cardiovascular operations.

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Nonabsorbable suture types

The following is a list of nonabsorbable suture examples. All of these sutures are typically suitable for soft tissue repair, including operations involving the nervous system and the cardiovascular system.

• Nylon- An organic monofilament stitch.
• Prolene- A monofilament artificial suture.
• Silk- A naturally braided suture.
• Polyester-synthetic suture that is braided.

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Stitches versus sutures

The terms sutures and stitches are frequently used interchangeably. It's crucial to remember that the actual medical equipment utilized to heal the wound is referred to as a "suture." The method your doctor uses to seal the wound is called stitching.

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Techniques and choosing of sutures

The diameter of the suture strand determines the grade of the suture material. The material diameter is indicated by the grading system using the letter "O" followed by a number. The suture strand's diameter decreases with increasing number.

A needle also has suture material connected to it. There are several qualities that the needle might have. It can have a cutting or non cutting edge, and it can come in different sizes. Smaller needles are more likely to lessen scarring, while larger needles can close more tissue with each stitch.

Similar to the wide variety of sutures available, there are also several suture procedures. Among them are:

• Continuous sutures: With this method, a single strand of suture material is used for several sutures. This kind of suture is robust and fast to apply since the tension is evenly spread over the whole continuous suture strand.
• Interrupted sutures: To seal the incision, this suture method employs many strands of suture material. The cloth is cut and knotted off once a stitch has been created. This method results in a wound that is firmly closed. The remaining stitches will continue to seal the wound together even if one breaks.
• Deep sutures: This kind of suture is inserted well under the layers of tissue that cover the skin. They might be interrupted or ongoing. Closing fascial layers is a common usage for this stitch.
• Buried stitches: With this kind of suture, the knot is positioned within, either underneath or inside the region that has to be sealed off. This kind of stitch is helpful when big sutures are used deeper into the body since it is usually left in place.
• String-purse sutures: This kind of continuous suture is wrapped around the affected region and pulled taut, akin to a bag's drawstring. To anchor an intestinal stapling device, for instance, this kind of stitch would be utilized in your intestines.
• Subcutaneous sutures: The layer of tissue underneath the outermost layer of skin, known as the dermis, is where these sutures are inserted. Short stitches are positioned parallel to your incision in a line. After that, the stitches are secured at both ends of the incision.

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Removal of sutures

The location of your sutures on your body will determine when they are taken out. American Family Physician lists the following as some basic recommendations:

• Scalp: ten to seven days
• Face: 3–5 daYS
• Arms: 7–10 days
• Legs: 10–14 days
• Hands or feet 10–14 days
• Chest or trunk: 10–14 days
• Hands' palms or feet's soles: 14–21 days

First, your doctor will sterilize the area before taking out your sutures. In an attempt to cut your suture as near to your skin as possible, they will pick up one end of it. After that, they will carefully remove the suture strand.

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