Absorbable sutures dissolve over time, while non-absorbable sutures stay in place permanently. Absorbable sutures are usually used for internal sutures, while non-absorbable sutures are usually used for external sutures. Absorbable sutures are commonly used in surgery, while non-absorbable sutures are commonly used in dermatology and ophthalmology.

Understanding Absorbable Sutures

A surgical suture, consisting of a piece of wire, stitches tissue or skin together during surgery. Typically, it is made from materials like polyester and polypropylene, whether absorbable or non-absorbable. Absorbable surgical sutures undergo absorption into the body tissue gradually, obviating the need for surgical removal.  Non-absorbable surgical sutures must be removed again after surgery. The choice of surgical sutures depends on the nature of the surgery, the need for postoperative healing, and individual factors.

What Is a Surgical Suture?

Nylon is a non-absorbable surgical suture composed of long-chain aliphatic polymers such as polyamide nylon and polyamide nylon. This indicates that it will stay within the body for a predetermined amount of time, typically a few weeks or months.

What is a Absorbable Sutures?

Absorbable sutures are materials the body can break down and absorb over time. Non-absorbable sutures, however, consist of materials that exhibit greater durability and resistance to breaking down and soaking into the body.

What is a Non-Absorbable Sutures?

Non-absorbable sutures are made from materials such as nylon, polyester, or polypropylene. These materials are more resistant to breaking down and absorbing into the body, so they can stay in place for a longer period of time.

Absorbable vs Non-absorbable

You do not need a doctor to remove absorbable stitches. However, your doctor may need to remove non-absorbable stitches in the days or weeks following your procedure, or they may choose to leave them in place permanently.

Characteristics and applications of sutures:

Because sutures are foreign bodies to the human body, they can cause an inflammatory reaction in the skin. The inflammatory response peaked from day 2 to day 7 after suturing. When suturing a wound or incision, the surgeon must ensure that there is no dead space in the subcutaneous tissue. The sutures should not be too tight to avoid affecting the blood supply and causing tissue necrosis. The tension on the wound should be as low as possible.

A medical surgeon’s sutures should have the following characteristics:

1. Non-allergenic

2. Sufficient tensile strength

3. Easy to control

4. Knotted firmly to provide sufficient support for tissue edges until complete healing

5. It is not easy to hide bacteria or Pathogenic microorganisms

6. Will not cause damage to tissues

Suture Material

• Silk: Typically braided and naturally made, silk sutures
• Nylon: Nylon creates a type of natural monofilament suture
• Polypropylene: This material creates a monofilament suture.
• Polyester: This form is synthetic and braided
• Cotton: Cotton thread serves as an excellent suture material; specifically, it is highly effective when employed in clean wounds

Natural sutures and chemically synthesized sutures

Natural sutures, typically represented by silk, flat gut, and chrome gut, are derived from raw materials.

The body absorbs it through protease degradation in the intestine. Due to the multiple fibers in these sutures, they maintain solidity during the initial days of wound healing. However, over the next few weeks, their intensity will decrease rapidly. The use of gut for suturing muscles is due to the rapid healing of muscles, but the early stages of healing require high-strength sutures.

With the advent of high-strength chemically synthesized threads, the use of gut has decreased. The chemical synthesis line comprises polyglycolic acid (PGA), polyesters (POLYESTERS), polydioxanone (PDO), and other polymers.

Hydrolysis, not the action of enzymes, accomplishes the degradation of chemically synthesized threads.

Because of this, unlike the gut, synthetic threads do not cause a robust inflammatory response and only a mild tissue reaction. Absorbable sutures and non-absorbable sutures constitute the two main categories for dividing sutures. 

Body tissues can degrade or completely absorb absorbable sutures. The time required for complete absorption varies depending on the material, size, local environment, wound location, and overall patient health.

Final Thoughts

The choice between absorbable and non-absorbable sutures involves a nuanced understanding of the patient’s condition and the specifics of the wound. Healthcare practitioners must weigh the advantages of each type to ensure optimal wound healing and patient comfort. With this knowledge, the medical community can continue to enhance the art and science of suturing to improve patient outcomes.

FAQs: Absorbable and non-absorbable sutures

What is the difference between absorbable and non-absorbable sutures?

Absorbable sutures, crafted from materials like catgut or synthetic polymers, naturally dissolve within the body over time, thus eliminating the need for removal. On the other hand, non-absorbable sutures maintain their structural integrity for an extended period of time and require manual removal after the wound has sufficiently healed. Common materials for non-absorbable sutures include silk, nylon, and polyester.

Which is an example of a non-absorbable suture?

Silk is a classic example of a non-absorbable suture material. Its durability and resistance to breakdown make it suitable for external wounds or situations where extended support is necessary. 

What is an example of an absorbable suture material?

Vicryl is an example of an absorbable suture material. Vicryl is a synthetic, braided suture made from polyglactin, gradually breaking down within the body. This makes it an excellent choice for internal tissues or areas that are challenging to access, as it eliminates the need for a second intervention to remove the sutures.

Is Vicryl non-absorbable?

No, Vicryl is an absorbable suture. Designed to dissolve within the body, it provides support during the crucial initial stages of wound healing. The gradual absorption of Vicryl aligns with the natural tissue healing process, making it a suitable choice for various medical applications.