Evaluation Background: Surgical Sutures

Here is background for our Evaluations of surgical sutures, outlining the key considerations for making wise purchasing decisions. Learn how the technology is used and what factors we test for. Also review our latest product ratings and ECRI Institute's data describing hospitals' interest in each vendor.

Surgical sutures consist of medical-grade thread (natural, synthetic, or metallic) intended to join together the opposing edges of a wound or incision, perform a tissue anastomosis, or close a wound around prosthetic material. They are normally attached to curved, single-use needles, and are frequently colored for easy identification during surgery.

The key characteristics of sutures are:

1. Absorption—Manufacturers typically broadly categorize their suture offerings as absorbable and nonabsorbable

a) Absorbable—These are synthetic or natural (i.e., surgical gut sutures made from bovine or ovine collagen) sutures that are intended to provide tensile support to a wound for one to six weeks, and will be absorbed by the patient's body via either enzymatic degradation (natural sutures) or hydrolysis (synthetic sutures). These sutures may also have an antibacterial coating intended to reduce the incidence of surgical site infections.

b) Nonabsorbable—The body does not absorb these sutures; they are intended to provide tensile support for the duration of their implantation in procedures where permanent biomechanical support of the surgical repair is required, such as vascular anastomoses or hernia repair to secure a permanent prosthetic mesh. They can also close superficial wounds, but would be removed after the wound healing period. They are typically natural silk, synthetic polymer, or metallic.

2. Material—Sutures are made from a variety of materials, whether synthetic (e.g., polyester, nylon), natural (e.g., surgical gut, silk), or metallic (e.g., stainless steel). A patient's tissue reactivity varies with suture material; natural sutures tend to result in more foreign body inflammation than synthetic. In addition, some materials are more elastic than others, which can result in more forgiveness in the presence of edema, while still possessing comparable tensile strength when swelling recedes.

3. Configuration—Whether a suture is single- or multi-stranded:

a) Monofilament—These are single-stranded sutures that have a lower risk of...