CLASSIFICATION OF SUTURES
The sutures are generally classified according to whether the material is natural or synthetic, the material in the body is absorbable or non-absorbable and the suture structure is monofilament or multifilament. Since surgical sutures are classified as medical devices, suture production is under regulatory control of the health ministry of the country that manufacturing takes place. Production guidelines and tests for industry are provided by a non-governmental organization called the United States Pharmacopoeia (USP) and the European Council of the European Pharmacopoeia (EP). The USP system was established in 1937 to standardize and compare suture materials corresponding to metric measurements; The European Pharmacopoeia was first published in 1969.
Suture types are collagen, synthetic absorbable and non-absorbable. These are as follows:
- Type I- Monofilament, twisted or braided silk or synthetic fibers.
- Type II – Cotton or linen fibers or coated natural or synthetic fibers in which the coating contributes to suture diameter without adding strength
- Type III – Metal sutures in monofilament or multifilament construction.
The diameter of the suture strand is indicated by zeros and denotes the size of the suture. The suture diameter decreases as the zeros expressing the suture size increase (For example, 3-0 is lesser than 2-0). Suture size significantly affects the tensile strength of the wire. As the suture diameter increases, the tensile strength of the wire increases. This is one of the reasons why different suture diameters are preferred for different operations.
Different types of sutures have different advantages and disadvantages compared to each other. When choosing sutures, sutures should be selected according to these advantages and disadvantages.