Kvet Forum
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Absorbable
1. Surgical Gut
‘Catgut’ is made from the submucosa of small intestine of sheep and the intestinal serosa of cattle. There are two types: plain gut, which has no coating, and chromic gut, which has been tanned with chromic salts to slow the rate of absorption and reduce tissue reaction.
- Absorbable
- Natural
- Monofilament/multifilament
- Absorbed by enzymatic degradation and phagocytosis
- Causes very little tissue reaction
- Absorbs fluids and swells
- Tensile strength 7–10 days (plain) and 17–21 days (chromic)
2. Polyglycolic acid – Dexon
- Absorbable
- Synthetic
- Multifilament
- Inert polyester
- Absorbed by hydrolysis
- Loses 80% strength by 14 days
- Absorbed in 40–60·days
- Braided
- Some chatter
- A lot of tissue drag
- Poor knot security
- Very little tissue reaction
3. Polyglactin – Vicryl
- Absorbable
- Synthetic
- Multifilament
- Absorbed by hydrolysis
- Loses 50% strength by 14 days
- Maintains wound support 28–35 days
- Absorbed by 60–90 days
- Braided and coated
- Some tissue drag
- Very little tissue reaction
- Moderate knot security
3. Polydioxanone – PDS II
- Absorbable
- Synthetic
- Monofilament
- Absorbed by hydrolysis
- Retains 50% strength by 28 days
- Totally absorbed at 180 days
- Monofilament therefore less tissue drag
- Very little tissue reaction
- Very ‘springy’ with high memory
- Good knot security as it ‘deforms’ when tied
Non-Absorbable
1. Silk – Mersilk
- Nonabsorbable
- Natural
- Multifilament
- Braided or twisted
- May be coated to minimize capillarity
- Loses 30% strength by 14 days
- Loses 60% strength by 30 days
- Excellent handling properties, knot security
- Main disadvantage is tissue reaction
2. Polypropylene – Prolene
- Nonabsorbable
- Synthetic
- Monofilament
- High tensile strength, but may stretch and fracture
- Poor handling qualities
- Reduced knot security
- High memory
- Virtually no tissue reaction
- Little tissue drag
3. Polyamide (nylon) – Ethilon and Supramid
- Nonabsorbable
- Synthetic
- Monofilament/multifilament
- High tensile strength
- Very little tissue reaction
- Impregnated with wax to reduce capillarity
- Average knot security
- Very little tissue drag
Metals – Stainless Steel or Tantalum
- Nonabsorbable
- Monofilament or multifilament
- High tensile strength
- Kinks easily
- No tissue reaction
- No tissue drag
- Difficult to knot
- Very good knot security
- Difficult to handle
Alternatives to Suture Materials
Staples
May be used for skin wound closure, for lung lobectomies, liver biopsies and bowel resection. They are expensive and need special equipment for the application of the staples. The main benefit is that they are extremely quick and provide good closure when used in internal organs.
Adhesive Tapes
Are available for wound closure but they are expensive and do not stick well to moist skin or skin with animal hair stubble.
Tissue Glue
Cyanoacrylate monomers are used to glue skin edges together, but they are toxic and have been shown to cause a granuloma reaction.