Surgical Suture is used to close the edges of a wound or incision and to repair damaged tissue. Physicians have used sutures for at least 4,000 years. Archaeological records from ancient Egypt show that Egyptians used linen and animal sinew to close wounds. In ancient India, physicians used the heads of beetles or ants to effectively staple wounds shut. Other natural materials doctors used in ancient times were hair, grass, cotton, silk, pig bristles, and animal gut.
In today's era, a range of suture materials are available, which includes natural absorbable and non absorbable sutures and synthetic absorbable and non absorbable sutures.
Natural sutures are made of catgut or reconstituted collagen, or from cotton, silk, or linen. Some sutures are also made of stainless steel. Because of the material, tissue reaction is often greater with natural sutures, especially those that are absorbable (e.g. Catgut). Coating agents are often used to help reduce tissue reactivity and to help reduce friction.
Silk was the next suture of choice in non-absorbable suture range and has become very popular because of its excellent handling properties. The Natural non-absorbable sutures had certain disadvantages and with technology advancements, Polyester and Polyamide were introduced and replaced previous non-absorbable sutures.
Synthetic sutures are made from synthetic collagen derived from polymers. Synthetic sutures are broken down by hydrolysis as opposite to enzymatic degradation (natural sutures), causing less tissue reaction. Synthetic absorbable sutures may be made of polyglycolic acid, a glycolide-lactide copolymer; or polydioxanone, a copolymer of glycolide and trimethylene carbonate. Synthetic non absorbable sutures may be made of polypropylene, polyester, polyethylene terephthalate, polybutylene terephthalate, polyamide, different proprietary nylons. Sutures are often coated, especially braided or twisted sutures. They may also be dyed to make them easy to see during surgery. Some allowable dyes are: chromium-cobalt-aluminum oxide, ferric ammonium citrate pyrogallol. The coatings used depend on whether the suture is absorbable or nonabsorbable. Absorbable coatings include calcium stearate with a glycolide-lactide copolymer. Nonabsorbable sutures may be coated with wax, silicone, fluorocarbon, or polytetramethylene adipate.
Suture needles are made of stainless or carbon steel. The needles may be nickel-plated or electroplated. Sutures needles of different types, size and curvature are available ranging from 4 mm to 60 mm in length and from 200 micron to as thick as size 6 of the suture in diameter. Packaging material includes water-resistant foil, such as aluminum foil, as well as cardboard and plastic.
Sutures are designed to meet many different needs. The needs depend on the type of surgery, the location where suture is intended to be used, the elasticity required in certain tissues, rate at which suture is degraded, knot security, and lastly on individual preference of the doctor.
Keeping all these factors in consideration, a range of sutures are manufactured using specially designed machines, and subjecting them to quality control tests for diameter, length, strength of the suture and how needle is secured to the suture.
The Manufacturing Technique:
The process of suture manufacturing involves polymerization of raw material and extruding it in to fiber, which is then stretched and braided on machines.
The principle for maximizing the patient benefit and comfort and maintaining the highest level of competency through ultramodern technology is used as a model here, the basic requirements being those applicable to quality management, personnel, premises and equipment, document, production, quality control, analysis, complaints and product recall, and self-inspection.
At Ishwari Healthcare, we have always been thriving to produce products that are technologically and clinically conforming to international standard.
|Sterile||Can be used in any surgical procedure|
|Inert (non reactive)||Easy to handle and ties down well|
|Uniform diameter and size||Knot is absolutely secure and is absorbed once the purpose is over|
|High tensile strength retention|