01_07-B&L27_Pt1_Ch07.

indd 92

92
PART 1 | BASIC PRINCIPLES
CHAPTER 7 Basic surgical skills and anastomoses
TABLE 7.2 Non-absorbable suture materials.
Suture Types Raw material Tensile strength Absorption rate Tissue reaction Contraindications Frequent uses How supplied
Silk Braided Natural protein Loses 20% when Fibrous Moderate to Not for use with vascular Ligation and suturing 10/0–2 with
or twisted Raw silk from wet; 80–100% encapsulation in high prostheses or in tissues when long-term tissue needles, 4/0–1
multifilament. silkworm lost by 6 months. body at 2–3 weeks Not requiring prolonged support is necessary without needles
Dyed or undyed. Because Absorbed slowly recommended approximation under For securing drains
Coated (with of tissue over 1–2 years Consider stress externally
wax or silicone) reactions and suitable Risk of infection and
or uncoated unpredictability, absorbable or tissue reaction makes
silk is non-absorbable silk unsuitable for
increasingly not routine skin closure
recommended
Linen Twisted Long staple flax Stronger when Non-absorbable Moderate Not advised for use with Ligation and suturing 3/0–1 with needles,
fibres wet Remains vascular prostheses in gastrointestinal 3/0–1 without
Loses 50% at encapsulated in surgery. No longer in needles
6 months; 30% body tissues common use in most
remains at 2 centres
years
Surgical steel Monofilament or An alloy of Infinite (>1 year) Non-absorbable Minimal Should not be used Closure of sternotomy Monofilament:
multifilament iron, nickel and Remains in conjunction with wounds 5/0–5 with needles;
chromium encapsulated in prosthesis of different Previously found favour multifilament: 5/0–
body tissues metal for tendon and hernia 3/0 with needles
repairs
Nylon Monofilament Polyamide polymer Loses 15–20% Degrades at Low None General surgical Monofilament:
or braided per year approximately use, e.g. skin 11/0–2 with
multifilament 15–20% per year closure, abdominal needles (including
Dyed or undyed wall mass closure, loops in some
hernia repair, plastic sizes), 4/0–2
surgery, neurosurgery, without needles;
microsurgery, multifilament:
ophthalmic surgery 6/0–2 with needles,
3/0–1 without
needles
Polyester Monofilament Polyester Infinite (>1 year) Non-absorbable: Low None Cardiovascular, Monofilament:
or braided (polyethylene remains ophthalmic, plastic and (ophthalmic) 11/10;
multifilament terephthalate) encapsulated in general surgery 10/0 with needles;
Dyed or undyed body tissues multifilament:
Coated 5/0–1 with needles
(polybutylate
or silicone) or
uncoated
Polybutester Monofilament. Polybutylene Infinite (>1 year) Non-absorbable: Low None Exhibits a degree of 7/0–1 with needles
Dyed or undyed terephthalate and remains elasticity. Particularly
polytetramethylene encapsulated in favoured for use in
ether glycol body tissues plastic surgery
Polypropylene Monofilament. Polymer of Infinite (>1 year) Non-absorbable: Low None Cardiovascular surgery, 10/0–1 with
Dyed or undyed propylene remains plastic surgery, needles
encapsulated in ophthalmic surgery,
body tissues general surgical
subcuticular skin
25/10/2017 07:47

closure