Surgical Suture

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Surgical suture is a medical device used to hold body tissues together after an injury or surgery. It generally consists of a needle with an attached length of thread. A number of different shapes, sizes, and thread materials have been developed over its millennia of history. The earliest reports of surgical suture date back to 3000 BC in ancient Egypt, and the oldest known suture is in a mummy from 1100 BC. The first detailed description of a wound suture and the suture materials used in it is by the Indian sage and physician Sushruta, written in 500 BCE. The Greek "father of medicine" Hippocrates described rudimentary suture techniques, as did the later Roman Aulus Cornelius Celsus. Traumatic needles are needles with holes or eyes which are supplied to the hospital separate from their suture thread. The suture must be threaded on site, as is done when sewing at home. Atraumatic needles with sutures comprise an eyeless needle attached to a specific length of suture thread. The suture manufacturer swages the suture thread to the eyeless atraumatic needle at the factory. There are several advantages to having the needle pre-mounted on the suture. The doctor or the nurse or odp does not have to spend time threading the suture on the needle. More importantly, the suture end of a swaged needle is smaller than the needle body. In traumatic needles with eyes, the thread comes out of the needle's hole on both sides. When passing through the tissues, this type of suture rips the tissue to a certain extent, thus the name traumatic. Nearly all modern sutures feature swaged atraumatic needles. Suture thread is made from numerous materials. The original sutures were made from biological materials, such as catgut suture and silk. Most modern sutures are synthetic, including the absorbables polyglycolic acid, polylactic acid, and polydioxanone as well as the non-absorbables nylon and polypropylene. Newer still is the idea of coating sutures with antimicrobial substances to reduce the chances of wound infection. Sutures come in very specific sizes and may be either absorbable (naturally biodegradable in the body) or non-absorbable. Sutures must be strong enough to hold tissue securely but flexible enough to be knotted. They must be hypoallergenic and avoid the "wick effect" that would allow fluids and thus infection to penetrate the body along the suture tract. [READ THE REST OF THIS ARTICLE]





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