SUTURES

The purpose of a suture

to hold a wound together in good apposition until such time as the natural healing process is sufficiently well established to make the support from the suture material unnecessary and redundant.

Suture Materials

Surgical suture materials are typical medical devices used for repairing tissues. Even today, most wound closures are performed with sutures. The mechanical properties of the materials employed to replace the temporary loss of tissue strength are therefore of great importance.
Absorbable suture materials, such as PGA Resorba®, support the natural repair processes until form and function have been restored. These materials are then broken down within the body.
Non-absorbable suture materials (e.g., Mopylen®) guarantee lasting support and optimal bioavailability, as is necessary in particular in connection with long-term implants.

Choice of a suture

Choice of suture depends on:

 Properties of suture material
Absorption rate
 Handling characteristics and knotting properties
 Size of suture
 Type of needle

Common errors of suture use

 Too many throws. Increases foreign body size. Causes stitch abscesses
 Intra-cuticular rather than subcuticular sutures causing hypertrophic scars
Holding monofilament sutures with instruments reduces tensile strength by over 50%
 Holding butt of needle causes needle and suture breakage.

Collagen
 

Collagen is present in connective tissue such as skin, bone, cartilage and tendons, and is responsible for the tensile strength of body structures; collagen is the main structural protein of these tissues, and is synthesised by fibroblasts and osteoblasts, and even by chondrocytes. It is a component of the extracellular matrix and plays an essential part in cell interactions.
Reconstituted collagen materials are produced in the form of sponges or films and are used in particular for haemostasis and for covering skin defects; collagen is also applied as an suitable carrier for drugs and medicinal products.
In the realm of Tissue Engineering, Resorba collagen products have proved to be an ideal matrix for the growth and propagation of cells that are difficult to cultivate. This has provided regenerative medicine with a potent tool by which cells and tissues can be cultured and successfully employed for treating surgical defects.