1. SUTURING
PRESENTED BY:
PROF.VIJAYREDDY VANDALI
PHD SCHOLAR, M.SC(N).PGCDE,MIPHA,.
DEPT OF MEDICAL-SURGICAL NURSING
INDIA,
Email: vijayvandali@yahoo.com

2. INTRODUCTION
• Suture means to sew or seam.
• Sutures are used to close wounds of skin or
other tissues. While sutures a wound, use a
needle attached to a length of “thread” to stitch
the wound shut.
• There are a variety of available materials that
can be used for suturing. doctor will choose a
material that’s appropriate for the wound or
procedure.

3. DEFINITIONS
1.Suture is a any strand of material utilized to
ligate blood vessels or approximate tissues.
Silverstein L H
2.Suture is a stitch or series of stitches made to
secure opposition of the edges of a surgical
/traumatic wound.
WILKINS

4. PURPOSES OF SUTURING
• Maintain hemostatsis
• Provide adequate tension
• Promote healing
• Provide support to tissues
• Reduce pain
• Permit proper flap position
• Prevent bone exposure
• Prevent infection

5. EQUIPMENT/ARTICLES
• Equipment required for suture closure of a
wound includes the following:
• Tray
• Suture material
• Needle
• Needle holder

6. SUTURE QUALITIES
• It is sterile
• It is suitable for all purposes (ie, is composed of
material that can be used in any surgical procedure)
• It causes minimal tissue injury or tissue reaction (ie,
is non-electrolytic, non-capillary, non-allergenic, and
non-carcinogenic)
• It is easy to handle
• It holds securely when knotted (ie, no fraying or
cutting)
• It has high tensile strength
• It possesses a favorable absorption profile
• It is resistant to infection

7. SUTURE CLASSIFICATION
Sutures may be classified in terms of their origin, their structure, and their
absorbability.
Natural vs synthetic: Natural sutures can be made of collagen from
mammal intestines or from synthetic collagen (polymers). Tissue
reaction and suture antigenicity lead to inflammatory reactions,
especially with natural materials. [26, 27] Synthetic sutures are made of
artificial polymers.
Monofilament vs multifilament: Monofilament suture material is made of
a single strand; this structure is relatively more resistant to harboring
microorganisms. It also exhibits less resistance to passage through tissue
than multifilament suture does. However, great care must be taken in
handling and tying a monofilament suture, because crushing or crimping
of the suture can nick or weaken it and lead to undesirable and
premature suture failure.
Absorbable vs non-absorbable: Absorbable sutures provide temporary
wound support until the wound heals well enough to withstand normal
stress. Absorption occurs by enzymatic degradation in natural materials
and by hydrolysis in synthetic materials. Hydrolysis causes less tissue
reaction than enzymatic degradation

9. TYPES OF SUTURES
The different types of sutures can be classified in
many ways.
• First, suture material can be classified as either
absorbable or non-absorbable.
• Absorbable sutures don’t require to remove
them. This is because enzymes found in the
tissues of your body naturally digest them.
• Non-absorbable sutures will need to be removed
but later date or in some cases left in permanently.

14. TYPES OF ABSORBABLE SUTURES
• Gut. This natural monofilament suture is used for repairing internal soft
tissue wounds or lacerations. Gut shouldn’t be used for cardiovascular or
neurological procedures. The body has the strongest reaction to this
suture and will often scar over. It’s not commonly used outside of
gynecological surgery.
• Polydioxanone (PDS). This synthetic monofilament suture can be used
for many types of soft tissue wound repair (such as abdominal closures)
as well as for pediatric cardiac procedures.
• Poliglecaprone (MONOCRYL). This synthetic monofilament suture is
used for general use in soft tissue repair. This material shouldn’t be used
for cardiovascular or neurological procedures. This suture is most
commonly used to close skin in an invisible manner.
• Polyglactin (Vicryl). This synthetic braided suture is good for repairing
hand or facial lacerations. It shouldn’t be used for cardiovascular or
neurological procedures.

15. TYPES OF NON-ABSORBABLE SUTURES
• Some examples of non-absorbable sutures can be
found below. These types of sutures can all be
used generally for soft tissue repair, including for
both cardiovascular and neurological procedures.
• Nylon. A natural monofilament suture.
• Polypropylene (Prolene). A synthetic
monofilament suture.
• Silk. A braided natural suture.
• Polyester (Ethibond). A braided synthetic suture.

16. THERE ARE MANY DIFFERENT SUTURE TECHNIQUES. SOME OF
THEM ARE:
Continuous sutures
This technique involves a series of stitches that use a single
strand of suture material. This type of suture can be placed
rapidly and is also strong, since tension is distributed evenly
throughout the continuous suture strand.
Interrupted sutures
• This suture technique uses several strands of suture material
to close the wound. After a stitch is made, the material is cut
and tied off. This technique leads to a securely closed
wound. If one of the stitches breaks, the remainder of the
stitches will still hold the wound together.
Deep sutures
This type of suture is placed under the layers of tissue below
(deep) to the skin. They may either be continuous or
interrupted. This stitch is often used to close facial layers.

17. Contd…
Buried sutures
• This type of suture is applied so that the suture knot is found inside
(that is, under or within the area that is to be closed off). This type of
suture is typically not removed and is useful when large sutures are
used deeper in the body.
Purse-string sutures
• This is a type of continuous suture that is placed around an area and
tightened much like the drawstring on a bag. For example, this type
of suture would be used in your intestines in order to secure an
intestinal stapling device.
Subcutaneous sutures
• These sutures are placed in your dermis, the layer of tissue that lies
below the upper layer of your skin. Short stitches are placed in a line
that is parallel to your wound. The stitches are then anchored at
either end of the wound.

18. SUTURE REMOVAL
• Sutures are removed will depend on where they
are on the body. According to American Family
Physician, some general guidelines are as follows:
• Scalp: 7 to 10 days
• Face: 3 to 5 days
• Chest or trunk: 10 to 14 days
• Arms: 7 to 10 days
• Legs: 10 to 14 days
• Hands or feet: 10 to 14 days
• Palms of hands or soles of feet: 14 to 21 days

19. REFERECES
1.www.healthline.com
2.www.slideshare.net

20. THANK YOU