suture selection

Question 1

what suture should be used in the skin

Answer 1

monofilament sutures
synthetic monofilament nonabsorbable (e.g. Nylon, Polypropylene)

Question 2

what suture should be used in the subcutaneous

Answer 2

multi or monofilament absorbable

Question 3

what suture should be used for abdominal closure?

what pattern is preferred?

Answer 3

strong non-absorbable or standard absorbable monofilament (e.g. polypropylene, polybutester, polydioxanone “PDS” and polyglyconate “maxon”)

simple continuous pattern

Question 4

what suture should be used in muscles and tendons

Answer 4

muscle - absorbable or nonabsorbable
tendon - strong, nonabsorbable, minimally reactive

Question 5

what suture should be used in parenchymal organs (liver, kidney, spleen)?

Answer 5

absorbable monofilament

Question 6

what suture should be used in hollow viscus organs (trachea, GI tract, bladder)?

Answer 6

absorbable monofilament

Question 7

what suture should be used in infected or contaminated wounds?

Answer 7

none if possible
absorbable is preferred
synthetic monofilament non-absorbable nylon and polypropylene may elicit less infection than metallic

Question 8

what suture should NOT be used in infected or contaminated wounds?

Answer 8

monofilamentand multifilament nonabsorbable (silk or polyester) - can infect, fistulate
surgical gut - absorption in infected tissue unpredictable