SUTURE NEEDLES AND

MATERIALS
Hardisiswo Soedjana

Suture needles

Points of needle: Taper

Smooth edges, very sharp
tip, atraumatic, especially for
internal organs

For aponeurosis, biliary tract,

blood vessel, dura fascia,
muscle, nere, peritoneum,
and other deeper tissue.

Points of needle: Cutting and

Reverse cutting
Sharp tip, sharp edges,
traumatic

For dermis, ligament,

nasal cavity, oral cavity,
pharynx, and skin

Points of needle: Tapercut

Very sharp tip, smooth edges

Bronchus, dermis, ligament,

nasal cavity, oral cavity, ovary,
perichondrium, periosteum,
pharynx, sclerotic vessel,
tendon, trachea, uterus

Needle shape
circle

3/8
circle

circle

5/8
circle

Compo
und
curved
and
straight

Suture materials

Suture materials

Absorbable

Synthetic

Monofilament

Non absorbable

Natural

Multifilament

Monofilament

Synthetic

Monofilament

Natural

Multifilament

Multifilament

Polydiaxone (PDS)

Polyglycolic acid
(Dexon)

Catgut

Polyamide (Ethilon)

Polyester

Silk

Polyglyconate
(Maxon)

Polyglatin 910
(Vicryl)

Collagen

Polyprolene (Prolene)

Polyamide

Linen

Polyglecaprone
(Monocryl)

Polybutester (Novafil)

Stainless steeel

Cotton

Polyglycolic acid
(Dexon)

Polyester

Stainless steel

Needle shape
A = fish-hook-shaped
D = 3/8 circle
F = 5/8 circle
G = straight
H = 1/2 circle
K = semi-curved
L = spoon-shaped
V = 1/4 circle
Special characteristics
A = asymptotic
F = slim needle
L = lancet point
M = micro point
N = blunt, round-bodied
S = slim
SP = spatula needle
T = trocar needle
X = extra strong
K = short inlying blade

Needle type
R = round-bodied
S = reverse cutting

Absorbable vs non absorbable

suture
Absorbable sutures
need not to be
removed, but the
tensile strength is
greatly reduced.

Non absorbable sutures

mostly used in skin
suturing.

Natural vs synthetic

Synthetic suture
materials is made from
biopolymerdegradable
materials.

Natural materials taken

from animal gut or other
natural materials.

Monofilament vs multifilament
Monofilament: single
strand processed by
polymer extrusion
method, low
resistance, high sterility,
poor knot security,
difficult to handle. This
suture is use mostly for
thinner threads,
smoother, and
unsurpassed in tissue.

Multifilament: several
strands either twisted
(silk, rough thread) or
braided (eight to
sixteen monofilament),
high elasticity, flexibility,
tensile strength, high
friction and traumatic

Non absorbable, synthetic

Polyamide(nylon): contained
amide group, thermal stability,
good chemical, and
mechanical properties.
Advantage is elastic, great
deal of memory, proclivity for
knot slippage. Nylon loses 1520% of tensile strength every
year by hydrolization.

Polypropylene(prolene):
monofilament thermoplastic
polymer made by
polymerization of propylene.
The advantage of this material
is it lose tensile strength over
time, good knot security, very
little tissue reaction.

Non absorbable, synthetic

Polybutester: coated with an
absorbable polytribolate
polymer that is composed of
glycolide, -caprolactone, and
poloxamer 188 to reduce its drag
forces. High knot security,
elongated under low loads, but
returned to its original length
when the load was removed

Polyester: nonabsorbable
synthetic braided, sterile, either
monofilament or multifilament
sutures composed of
polyethylene terephthalate
coating that improve the
physical properties. Advantage is
minimal tissue reactivity, high
tensile strength, good handling
and everlasting,

Non absorbable, natural

Silk: made of cocoon of silk
worm larvae, Bombyx mori,
coated with oil, wax or silicone
to reduce tissue friction and
capillarity. Strong tensile
strength, long knot security,
but high tissue reaction,
infection.

Linen: made from flax and

usually in twisted form,
sometimes treated with
silicone and polyvinyl solution.
Similar to silk, this material have
strong tensile strength and
knot security, while it gains 10%
tensile strength when it is wet.

Non absorbable, natural

Cotton: extracted from hairs of
seed of cotton plant. This is the best
knot security in natural non
absorbable suture with 50% loss of
tensile strength at 6 months, and
70% loss of tensile strength at 2
years. Disadvantages are
inferiorhandling ability due to
electrostatic properties and ability
to potentiate infection

Absorbable, natural,
monofilament
Catgut: purified connective tissue of the
small intestine of sheep or cattle. If suture
was twisted together and chromicisated,
it will yields chromic catgut. Longer tied,
but no longer to be used in UK for human
surgery

Absorbable, synthetic,
monofilament
Polydioxanone: ring-opening
polymerized thepdioxanone
monomer. Enhanced flexibility
due to the presence of an
ether oxygen within the
backbone of the polymer
chain. Minimal tissue reaction,
anti bacteria, less tissue grag,
But worse knot security

Polyglyconate:
copolymerization of glycolic
acid and trimethylene
carbonate. Good, handling
properties, lacks memory,
passes easily through tissues
and demonstrates superior
strength.

Absorbable, synthetic,
monofilament
PGA: biodegradable, tough thermoplastic fiber-forming polymer
(7 GPa), multifilament braided with N-laurin and N-lysine coated
(absorbable materials coated). Synthesis of PGA can be obtained
through azeotropic condensation polymerization of glycolic acid,
ring-opening polymerization of glycolide, and polycondensation
of halogenoacetates. Advantage are good knot stability,
outstanding suppleness, minimal saw effect. Unadvantage of this
material is instable and too sensitive to hydrogenolysis.

Absorbable, synthetic,
multifilament
Polyglactin 910: absorbable suture materials,
synthethic, either monofilament or braided
multifilament. The materials is heteropolymer
consisting of 90% glycolide and 10% lactide. It is
stronger than catgut with 3 strength, broken down
by enzymes not phagocytocis, and break down
products inhibit bacterial growth.

Suture material selections

THANK YOU