Suture Types

Absorbable Sutures
- the absorbable ones get dissolved in the body on their own and do not require removal. Micryl

The most widely used coated & braided synthetic absorbable suture coated with non Toxic and Biocompatable meterial called Polycaprolactone MSI-PGA Sutures are stronger than chromic catgut at implantation as the meterial is absorbed by Hydrolysis. Has excellent handling characteristics and its violet color is highly visible in the wound it is stonger less traumatic atlernative. Avialability From size 2(5) to 5-0(1) in 70cm, 90cm with different needles Application General closure, Urology, Gastrointestinal tract surgery, OB-Gyn, Orthopaedic, Opthalmic.

Other suture A. Polyglycolic Acid Sutures - PGA is an ideal and time tested synthetic absorbable suture, widely used by surgeons all over the world. PGA's superior features over catgut are predictable absorption, outstanding tensile strength, in-vivo inertness and excellent handling properties. Polyglycolic Acid Suture is a synthetic, absorbable, sterile, surgical suture composed of 100% glycolide, coated with polycaprolactone and calcium stearate. PGA suture retain approximately 75% of PGA initial strength after two weeks. Approximately 45% of the PGA sutures original tensile strength remains. Polyglycolic Acid Suture has been found to be non-antigenic, nonpyrogenic and elicit only mild tissue reactivity during the absorption process. The absorption time for Polyglycolic Acid (PGA) is 60 to 90 days. Absorption of bio-absorbable suture occurs by hydrolysis ; beginning with loss of tensile strength followed by loss of mass. PGA suture are available in dyed (violet colour suture) and also un-dyed versions from USP sizes 6-0 to USP size 2. PGA suture are indicated for use in general soft tissue approximation including ophthalmic surgery. Polyglycolic Acid Suture is not indicated for cardiovascular and neurological tissue approximation. PGA suture have first launched in India by us under the Brand name Petcryl which provided the first Synthetic Absorbable Suture to the Indian market apart from Vicryl suture by Ethicon. Vicryl, being a Polyglactin material is made from made from copolymer of 90% Glycolide and 10% L-lactide but Petcryl suture are 100% glycolide. B. Polyglactin 910 Sutures - Polyglactin 910 or PGLA suture is an absorbable, sterile, synthetic, braided suture. PGLA suture are indicated for soft tissue approximation and ligation. The sutures tensile strength remains for approximately three to four weeks in tissue. Polyglactin 910 Sutures are composed of copolymers made from 90% glycolide and 10% Llactide. Polyglactin 910 suture is an absorbable braided synthetic fibre. It is available as a plain (uncoated) and coated suture. The coating is equal parts of a copolymer of lactide and glactide with calcium stearate. Calcium sterate is a salt of calcium and stearic acid. This mixture forms an absorbable, adherent, non-flaking lubricant ideal for suture. All of these components are water repelling which slows tissue fluid penetration and absorption into the suture. Clinical trials have shown that after two weeks, approximately 70% of Polyglactin 910 sutures initial strength remained. Polyglactin suture are found to be non-antigenic and non-pyrogenic, eliciting only mild tissue reactivity during the absorption process. Polyglactin 910 suture are available violet and colourless.

C. Catgut Sutures - Catgut or gut suture is an absorbable suture usually manufactured from the intestine of sheep or goat. Catgut suture are composed of highly purified connective tissue derived from either beef or sheep intestines. The membrane is chemically treated and slender strands are woven together to form a suture. The grinding process creates a strand of uniform diameter. The suture strand is then further polished to achieve maximum smoothness, for reliability and strength. Catgut suture are available in the form of plain catgut or chromic catgut. Plain catgut is usually having shorter absorption periods and is absorbed more rapidly in infected areas. . The percentage of collagen in the catgut suture often determines the quality of the suture. Higher percentages of collagen allow for: superior tensile strength, longer absorption times, and lower reactions in vivo. Plain catgut is available in ivory colour. Chromic catgut is treated with chromium salt solution to resist body enzymes and slower the absorption process thus supporting the wound for longer periods. Chromic gut is chromicised before it is spun into strands. This allows control over the amount of chromic content for an even absorption rate. The chromic content not only increases the tensile strength, but also reduces tissue irritation.

D. Poliglecaprone Sutures - - Poliglecaprone suture is a fast absorbing suture made of a synthetic absorbable monofilament composed of glycolide and epsilon-caprolactone copolymer (usually called PGCL suture). It comes both dyed (violet) and un-dyed (clear), and is a monofilament suture. Ethicon are the original inventors of PGCL suture which are available under the brand name Monocryl suture. Poliglecaprone suture has a low tissue reactivity, maintains high tensile strength, but PGCL suture loses about 40% of its Tensile Strength within 7 to 14 days and loses about 50 to 60% tensile strength by 3 to 4 weeks, and the suture is completely hydrolyzed by 3 to 4 months. Progressive loss of tensile strength and eventual absorption of PGCL suture occurs by means of hydrolysis. Poliglecaprone 25 copolymer has been found to be non-antigenic, non-pyrogenic and elicits only a slight tissue reaction during absorption. Poliglecaprone suture are contraindicated for use in cardiovascular and neurologic tissues, and for usage in ophthalmic and microsurgery. Poliglecaprone suture are rarely used for percutaneous skin closure, and are not used in areas of high tension. . The use of Poliglecaprone suture may be inappropriate in elderly, malnourished, or debilitated patients, or in patients suffering from conditions that may delay wound healing.

E. Polydioxanone Sutures - Polydioxanone suture (PDO or PDS suture) or poly-p-dioxanone is a colourless, crystalline, biodegradable polymer. Polydioxanone suture is an absorbable, sterile, surgical suture composed of the polyester, poly (p-dioxanone). Polydioxanone suture has been found to be non-antigenic, non-pyrogenic, and elicits only minimal tissue reactivity during the absorption process. Polydioxanone is a poly (ether-ester) characterized by a glass transition temperature in the range of ?10 and 0 C and a crystallinity of about 55%. Because of the presence of an ether oxygen group into the backbone of the polymer chain, materials prepared with polydioxanone like suture are provided with a good flexibility. For the production of suture, polydioxanone is generally extruded into fibres, however care should be taken to process the polymer to the lowest possible temperature, in order to avoid its spontaneous de-polymerization back to the monomer. The suture prepared with this material typically lose half of their mechanical strength in about three weeks and complete degradation takes place in a time frame of around six months.

Non-absorbable Sutures
-The non absorbable ones have to be removed after specified time. The type of suture is decided again by the
location of the wound.

MSILK

Avialability From size 1(4) to 5-0(1) in 76cm, 90cm with different needles As Pre Cut Sutures 2 x 75cm, 10 x 35, 2 x 100cm Reels - Non Sterile Box of 6x25 Meters Also avialable as cassette in 50meter/100meter Application General Closure, Gastrointestinal Tract Surgery, Ob-Gyn, Orthopaedic, Cardio Vascular Surgeries.

A. Polypropylene Suture - Polypropylene suture is a non-absorbable, sterile surgical suture composed of an isotactic crystalline stereoisomer of polypropylene or synthetic linear polyolefin. Polypropylene suture is commonly used in both human and veterinary medicine for skin closure, Cardiovascular, Ophthalmic, General Closure, Orthopedics, Plastic and Microsurgeries, soft tissue approximation and, or ligation. As it is a monofilament suture, it does not support bacterial growth. It is not affected by blood, or weakened by tissue enzymes. It offers prolonged tensile strength even in infected areas as it is not degraded over time. This suture is known for low tissue drag, easy handling and good strength. Polypropylene suture are normally available in blue colour, allowing for easy identification and better visibility against skin when operating. B. Polyamide / Nylon Suture - DemeTech's Nylon suture is a non-absorbable, sterile surgical suture composed of the long chain aliphatic polymers Nylon 6 and Nylon 6.6. DemeTech's Nylon sutures are available in either black or blue, dyed with FDA listed dye(s). DemeTech's Nylon sutures elicit minimal inflammatory reaction in tissue. This process is usually followed by gradual encapsulation of the suture by fibrous connective tissue. While DemeTech's Nylon is not absorbed, progressive hydrolysis may cause a gradual loss of up to 20% in its tensile strength each year. DemeTech's Nylon sutures are indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic, and neurological procedures. C. Polyester Suture - DemeTech's Polyester suture is a non-absorbable, sterile, surgical suture composed of Poly (ethylene terephthalate). DemeTech uniformly coats its Polyester sutures, providing for an improvement in the physical properties of the suture. High quality materials, combined with precise braiding mechanisms, nearly eliminate the occurrence of post-operative suture fragments in the tissue. Unlike absorbable, and some non absorbable sutures, DemeTech's Polyester is not subject to degradation, or known to lose tensile strength in vivo D. Silk Suture - DemeTech's Silk suture is a non-absorbable, sterile, surgical suture composed of an organic protein called fibroin. DemeTech's silk sutures are processed to remove the natural waxes and gums from its origin. As Silk is a natural fiber, its does illicit an acute inflammatory reaction, which is followed by gradual encapsulation of the suture by fibrous connective tissue (occurring usually in 14-21 days). While DemeTech's silk sutures are not considered absorbable sutures, progressive degradation of its fibers results in the gradual loss of tensile strength within the first year. DemeTech's silk sutures are indicated for use in general soft tissue approximation and/or ligation.

E. Polyvinylidene fluoride / PVDF Suture

F. Stainless Steel Suture - DemeTech's Surgical Steel sutures are non-absorbable, sterile, surgical sutures composed of high quality stainless steel. Because of its high tensile strength, it exhibits very minimal loss over time and has low tissue reactivity. DemeTech's surgical steel is available as a monofilament. Surgical Steel is recommended for surgeries ranging from orthopedic surgery to sternal closure. Due to its rigidity, extreme care should be used when handling surgical steel to avoid fragmentation, which could pose harm to both the surgeon and patient.