June 29, 2011 by dailybolusoflr
Absorbable Suture material
The ideal suture material is: strong, easy to handle and tie, nonallergenic and minimally reactive to tissue.
In order to best choose a suture material, it is important to know the various properties of the choices.
The most commonly differentiating fact for us is generally ABSORBABLE vs. NON-ABSORBABLE
Gut sutures (cat gut or chromic cat gut) are moderately reactive sutures. Cat gut keeps its strength for about 5-7 days and chromic gut for up to 3 weeks. For the ED, the most common use of chromic gut is in the mouth, where the environment cuts the tensile strength duration down to about 2 weeks. Fast absorbing gut sutures can be used in the facial lacerations (they last about 5-7 days) or in children where removal will be more difficult. Note, on the face- they are moderately reactive to tissue and so have increased risk for more scar formation.
Monocryl and Vicryl are the two other commonly used absorbable sutures.
Monocryl is a monofilament suture (which has a single strand) and is less resistant (ie. easier to handle in tissue). It also has lower infection risk, as the monofilaments are known for. Monocryl has good strength and is good for deep subcutaneous use and high tension areas. It holds its strength about two weeks.
Vicryl is a multifilament suture (is braided) and has higher resistance (harder to handle and tie). It has a higher infection risk. It is longer acting and holds strength for up to 4 weeks. It is good for galeal repairs, subcutaneous sutures.
Ref: Ethicon Wound Manual