SURGICAL SUTURE CHARACTERISTICS’ TERMINOLOGY
Surgical sutures are sterilized at the end of manufacturing process. Sutures shall protect the sterile barrier system from sterilization to opening of the package in the operating room.
Minimum Tissue Reaction
Surgical sutures should not be allergenic, carcinogenic or harmful in any other way. Surgical sutures’ biocompatibility is proven by several biological tests.
Sutures should have the same diameter throughout the length.
These sutures are hydrolyzed by bodily fluids. During the absorption process, first suture wound support reduces and then suture begins to be absorbed. Suture material lose mass/volume as the time of progress.
Limit values of tensile strength at the time of suture breakage.
Absorbed fluid can be transferred through the suture along with many unwanted materials and organisms. This is an undesired situation and cause inflammation on the wound. Capillary effects of multifilament sutures are greater than monofilament sutures.
It is a term describing elongation of suture material by means of pulling method and then returning the suture to its original length when left free. Elasticity is a preferred characteristic in sutures. As a result, after implanting the suture to the wound, the suture is expected to
– Keep two parts of wound together in suitable position by elongating without stressing or cutting tissues due to edema developed in the wound,
– Return to original length upon retraction of wound after the re-absorption of edema.
Thereby, it provides maximum wound support.
Absorbable sutures are able to absorb fluid. This is an undesired situation and may cause spread of infection along the suture by capillarity effect.
It is defined as the force needed to break the suture. Tensile strength of suture reduces after implantation. Tensile strength is related with the diameter of suture and as the diameter of suture increases, the tensile strength increases as well.
Knot-pull Tensile Strength
The weakest point of a suture is knot. Therefore, tensile strength of sutures is measured in knotted form. A knotted suture has 2/3 strength of a straight suture of the same physical characteristics. Each applied knot reduces tensile strength of suture by 30% to 40%.
Straight-pull Tensile Strength
It is defined as the force needed to break the suture in linear form.
It is defined as the force that can cause the knot to slide. Coefficient of static friction and plasticity of suture material is related to the knot strength.
It is defined as the incapability of a suture to change form easily. Sutures with strong memory tend to return to their winding form, when they are removed from their packing, during and after implantation because of their rigidity. Implantation of sutures with strong memory is difficult and they have also weak knot safety.
Suture materials are which cannot be hydrolyzed by bodily fluids or enzymes. If used on epithelial tissue, they should be removed after tissue is healed.
It is defined as the capacity of a suture to retain strength and return to its original length after stretching. Sutures with high plasticity do not hinder circulation on the tissue by elongating without stressing or cutting tissues due to developing edema on the wound. However, elongated suture upon retraction of wound after re-absorption of edema cannot ensure correct approximation of wound edges.
The ease of use of the suture material; Ability to adjust knot tension and knot safety.
Wound breaking strength
Tensile strength limit of a healing wound where the wound dehiscence occurs.