Sutures
ABSORBABLE VS.
NONABSORBABLE SUTURES
Sutures are classified according to
their degradation properties.
Sutures that undergo rapid degradation
in tissues, losing their tensile
strength within 60 days, are
considered absorbable sutures.
Sutures that generally maintain
their tensile strength for longer than
60 days are nonabsorbable sutures.
Absorbable sutures may be used to
hold wound edges in approximation
temporarily, until they have healed
sufficiently to withstand normal
stress. These sutures are prepared
either from the collagen of healthy
mammals or from synthetic
polymers. Some are absorbed
rapidly, while others are treated or
chemically structured to lengthen
absorption time. They may also be
impregnated or coated with agents
that improve their handling
properties, and colored with an
FDA-approved dye to increase
visibility in tissue. Natural
absorbable sutures are digested by
body enzymes which attack and
break down the suture strand.
Synthetic absorbable sutures are
hydrolyzed—a process by which
water gradually penetrates the
suture filaments, causing the
breakdown of the suture's polymer
chain. Compared to the enzymatic
action of natural absorbables,
hydrolyzation results in a lesser
degree of tissue reaction following
implantation.
During the first stage of the
absorption process, tensile strength
diminishes in a gradual, almost
linear fashion. This occurs over the
first several weeks postimplantation.
The second stage often follows with
considerable overlap, characterized
by loss of suture mass. Both stages
exhibit leukocytic cellular responses
which serve to remove cellular
debris and suture material from...
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