Surgical sutures are some of the most useful medical devices in the world today. They’re used for joining and securing pieces of bodily tissue together, such as stitching up an open wound or closing a patient’s body after surgery. They save lives, prevent bleeding and infection, and make many medical operations and interventions possible.

In addition, sutures come in many forms, with lots of different materials used to make them. They can be made of synthetic materials and natural materials, including everything from catgut to nylon, silk, and even steel. Each type of suture has its own advantages and uses, and in this guide, we’ll take a look at the various types of sutures in use today.

What Are the Two Categories of Sutures?

As stated above, there are many different types of sutures, and there are lots of ways in which we can divide them into different groups and categories. In general, however, sutures can all be placed into one of two main groups: absorbable and non-absorbable. Here’s a quick explainer about absorbable vs non-absorbable sutures.

Absorbable Sutures

As the name suggests, absorbable sutures are those that can be absorbed naturally by the body. Such sutures degrade over time through processes like hydrolysis or proteolysis. The time it takes for such sutures to break down in the body varies, depending on the material and the location in which they are used; it can be anywhere from a matter of days to several months.

In terms of usage and benefits, absorbable sutures are usually used to stitch together deep tissues or tissues that are able to heal rapidly. This removes the need for the patient to undergo another operation later on for the suture removal, as the sutures will naturally break down and fade away on their own.

Common examples of absorbable sutures include chromic gut sutures, polyglycolic acid sutures, plain gut sutures, and vicryl sutures.

Non-Absorbable Sutures

Next, we have non-absorbable sutures. Again, the name here is relatively self-explanatory; non-absorbable sutures are those that will not break down and be absorbed by the body over time. Instead, these kinds of sutures will resist the body’s inflammatory responses and remain intact, which means that they have to be removed manually.

Why and how are non-absorbable sutures used? In general, these kinds of sutures are useful for providing long-term support for bodily tissue. They’re used in situations when the body might need more time to heal, such as tendon wounds or closure of the abdominal wall. These sutures are great for long-term use and may be left indefinitely or eventually removed.

Common examples of non-absorbable sutures include polyester sutures, steel sutures, nylon sutures, and silk sutures.

What Are the Different Types of Sutures?

Next, let’s take a look at some of the different types of sutures. The list below is by no means exhaustive, as there are lots of different kinds of sutures and medical companies are always experimenting with new materials and concepts. However, this list covers many of the most commonly-used kinds of sutures in both absorbable and non-absorbable categories.

Absorbable Suture Types

Absorbable sutures are made of materials that break down naturally in the body and are helpful for deep tissue repairs or minimizing the need for patients to undergo multiple operations. Here are some of the most common varieties of absorbable sutures.

1. Chromic Gut Sutures

Chromic gut sutures are some of the most-used kinds of absorbable sutures. They’re also sometimes known as catgut sutures or just gut sutures, and they’re actually made from collagen which has been extracted from bovine intestines. 

This makes them an example of natural sutures, as opposed to synthetic sutures.Chromic gut sutures also fall into the category of polyfilament sutures, and they stand out for their high levels of elasticity and low risks of trauma, but are quite poor in terms of handling and general tensile strength.

How are chromic gut sutures used? In general, these kinds of sutures, along with other sorts of gut sutures, like fast gut and plain gut, are useful for skin closure in the facial region. They’re also helpful for closing wounds or surgical sites around the genitals.

2. Plain Gut Sutures 

Plain gut is another kind of natural suture that is made from biological material. Specifically, plain gut or plain catgut sutures are made from purified collagen that is typically extracted from bovines. The collagen is twisted into strands to form the plain gut.

Plain gut sutures are strong enough to retain their strength for around a week before they start to break down and weaken. They’re an example of multifilament sutures that have relatively low levels of tissue reaction and decent elasticity to deal with any swelling or inflammation.

In terms of their main uses, plain gut polyfilament sutures are helpful for closing up wounds or surgical sites in areas that have fast-healing bodily tissue. For example, areas of mucosal tissue tend to heal quickly, so are often stitched up with the aid of plain gut sutures.

3. Polyglycolic Acid Sutures 

Polyglycolic acid sutures are a type of synthetic absorbable suture. This means that they are made from synthetic materials, rather than natural ones. They’re made up of polyglycolic acid and usually coated with magnesium stearate, forming a braided structure.

Polyglycolic acid sutures may also be known under the brand name Dexon. They’re available in undyed or dyed (green) variants, and they usually retain their strength for up to 25 days before breaking down. They have low levels of tissue reaction and decent handling, but low levels of knot security.

When it comes to their main uses and applications, polyglycolic acid sutures or Dexon sutures are mainly used for stitching subcutaneous tissue, which is tissue located under the skin. They help to hold tissue together while it heals before breaking down and fading away naturally.

4. Polydioxanone Sutures 

Next, we have polydioxanone sutures, which are also sometimes referred to as polydioxanone closures or PDS sutures. These are monofilament sutures that are made from polydioxanone. Polydioxanone is a polyester that is used in various medical devices, first created in the 1980s.

Polydioxanone sutures are quite long-lasting. They can keep their tensile strength at high levels for the first couple of weeks, retaining around 40-50% of their strength by eight weeks and being completely absorbed into the body within 200 days.

These kinds of sutures have low levels of tissue reaction and decent tensile strength, but can be difficult to work with. They’re a good choice for stitching and joining bodily tissue at a subcutaneous level, especially for slower-healing tissue that needs extra tensile strength, like abdominal incisions.

5. Polysorb Sutures

Polysorb sutures are absorbable, synthetic sutures that are used in many hospitals around the world. They’re made from a copolymer called lactomer, which is made by combining glycolide and lactide. These sutures are made exclusively by Covidien/Medtronic.

Polysorb sutures have several unique advantages. They’ve got great levels of tensile strength in the early stages of the healing period, for example, before breaking down later on. They’re also excellent to handle and offer good knot security.

In terms of the best uses of Polysorb sutures, the main time to use these sutures is for sealing surgical sites after operations. They’re effective for stitching together soft pieces of bodily tissue after ophthalmic surgery, for instance, or in other situations that require high levels of precision and care. 

6. Vicryl Sutures

Another type of absorbable, synthetic suture that you might see commonly used in many hospitals and clinics is Vicryl. Also known as polyglactin 910, Vicryl is a brand name used by the Ethicon company, which is a subsidiary of Johnson & Johnson.

Vicryl sutures offer good levels of tensile strength and can retain that strength for around two to three weeks, before breaking down via hydrolysis. They break down completely within 70 days. There are also other varieties, like Vicryl Rapide, which break down faster.

Highly popular and used very frequently in medical establishments across the world, Vicryl sutures have lots of uses. They’re ideal for general soft tissue approximation, as well as ligation, and they’re specifically used at a subcutaneous level to help deep tissue heal without the need for additional interventions or manual removal.

Non-Absorbable Suture Types

Non-absorbable sutures are made of materials that will not break down inside the body and are useful for long-term tissue support and repair of tissues that need lots of time to heal. Here are some of the most common varieties of non-absorbable sutures.

1. Polyester Sutures 

Polyester sutures are some of the most commonly-used types of non-absorbable sutures. As the name implies, they’re made from polyester, usually in a braided form, and there are various brand names of polyester sutures, like Ethibond, Dagrofil, and PremiCron. 

Often coated in silicone and dyed to aid in visibility, polyester sutures offer decent levels of handling and knot security. They also have low tissue reactivity but are more costly when compared to other kinds of sutures.

Polyester sutures are often used for pediatric surgery, especially for operations that involve the heart and cardiovascular system in general. They can also be beneficial for use during orthopedic surgery, thanks to their good levels of handling.

2. Polypropylene Sutures 

Polypropylene or PP sutures are another example of non-absorbable sutures. They’re made from polypropylene, which is a thermoplastic polymer that has a huge number of applications in the medical world and beyond. These kinds of sutures are excellent for long-term or permanent tissue support.

It’s usually quite easy to identify polypropylene sutures due to their distinctive blue color, which makes them easier to see and work with for surgeons. They’re also famed for their high levels of tensile strength and general versatility, with a lot of potential uses.

Some of the most common uses of polypropylene sutures include closing surgical openings and joining tissue after orthopedic, plastic and micro surgeries. They’re also used in a lot of operations on the cardiovascular system.

3. Polydek Sutures 

Polydek sutures are another variety of medical suture. They’re made from a specific kind of polyester with a PTFE (polytetrafluoroethylene) coating. Versatile and suitable for various tasks, Polydek sutures have many advantages. 

For example, Polydek sutures have excellent levels of handling, which makes them quite easy to work with. They’re also relatively strong and able to maintain their tensile strength for long periods. The PTFE coating also helps to reduce the risk of tissue reactivity.

Some of the most common uses of Polydek sutures are for general soft tissue approximation and ligation. They’re helpful in a range of neurological procedures, as well as orthopedic operations and cardiovascular surgery.

4. Polybutester Sutures

Polybutester sutures are another type of non-absorbable sutures. You may hear them referred to under the brand name Novafil. These types of surgical sutures are made from polybutester, a relatively new type of polyester that is comprised of polyglycol terephthalate and polybutylene terephthalate.

Polybutester sutures are known for their low levels of tissue reactivity and good handling. They also have quite high levels of tensile strength, especially when compared to many other monofilament sutures, and they’re helpful in a wide range of cases.

Some of the most common uses of polybutester sutures include tendon repairs. They’re also helpful for general soft tissue ligation and approximation, but they can’t be used in patients who may have allergies or sensitivities to the materials involved.

5. Nylon Sutures 

Nylon is another commonly-used material that is non-absorbable and has good tensile strength. Manufactured in both monofilament and polyfilament form, nylon sutures are sold under brand names like Dermalon and Ethilon, as well as Nurolon and Surgilon.

There are certain advantages and unique features associated with nylon sutures. Specifically, these kinds of sutures stand out due to their excellent levels of strength and usability. They can have poor knot security, depending on the specific type of nylon sutures you use, although polyfilament nylon sutures tend to be better in this aspect.

When it comes to uses, nylon sutures are often used for standard soft tissue repairs. They can also be used for general ligation, skin closure, and vessel ligations. They’re the most common type of skin closure suture.

6. Silk Sutures 

Silk is another material that can be used to make surgical sutures. Surgical silk is a strong protein that comes from silkworms. It’s sold in polyfilament form under brand names like Permahand and Sofsilk, and it is specially coated in order to reduce levels of friction while maximizing water absorption.

Silk has several key advantages that make it a good choice as a medical suture in certain situations. For instance, silk sutures have strong levels of tensile strength, and they’re generally easy to handle and work with. They also have good knot security. However, silk sutures can produce high levels of tissue reactivity.

Due to the risks of tissue reactivity, silk sutures have to be used with care. They cannot be used internally and are only good for mucosal surfaces. In general, these kinds of sutures are very rarely used nowadays in most medical fields, but can be used in dentistry.

7. Steel Sutures

Last but not least, we have steel sutures. These are some of the strongest and thickest kinds of surgical sutures. As the name suggests, they are made from surgical steel, which is a mixture of various alloys. 

There are several advantages of using steel sutures. Their high levels of strength are almost unmatched by any other kind of suture, and they have low levels of tissue reactivity, as well, which gives them a lot of versatility and makes them relatively safe to work with. On the downside, due to their thickness, steel sutures can be hard to handle.

In terms of actual use cases in the modern medical world, steel sutures are primarily used for closing very hard and strong sections of bodily tissue together. They can be used for sternum closures, for example, as well as in orthopedic procedures.

The Leading Suture Brands and Manufacturers

Covidien

Covidien is a medical device brand that was started in Dublin, Ireland, back in 2007. The company was originally part of Tyco International but later split from the company, before eventually merging with Medtronic in 2015.

In terms of sutures and wound closure products, Covidien is an industry leader. It makes some of the best absorbable sutures under brand names like Velosorb, Caprosyn, Polysorb, and Biosyn.

Ethicon

Ethicon is a medical company that was originally founded in Edinburgh, Scotland. It was first created by George F. Merson in 1915 and dedicated to manufacturing catgut, silk, and nylon sutures. The company was purchased by Johnson & Johnson in 1947.

Ethicon is one of the leading names when it comes to surgical sutures, with around 80% of the market share in the US alone. This company produces sutures under names like Monocryl and Vicryl.

B Braun 

B Braun, also known as B Braun Medical Inc, is a medical company based in Melsungen, Germany. A global brand with offices around the world, B Braun produces thousands of different medical products and devices.

This company makes both absorbable and non-absorbable sutures. Some of its top non-absorbable varieties include the likes of Dafilon, Dagrofil, and Optilene, while its best-selling absorbable suture varieties include Monosyn, Novosyn, and MonoPlus.

Medtronic

Medtronic is another name that you may often hear when shopping for or using medical sutures. This American company is headquartered in Minneapolis, Minnesota, and is linked with Covidien, as the two companies merged in 2015.

So, when it comes to Medtronic sutures, you’ll see the same brand names that you would see with Covidien. This includes the likes of Velosorb, Caprosyn, and Biosyn.

Aesculap

Aesculap is another medical company that produces a wide range of medical supplies and healthcare devices, including sutures. This company is connected to B Braun and offers its products for sale around the world. 

Some of the top-rated and most-used Aesculap sutures include MonoPlus sutures, Softcat sutures, and chromic gut sutures in various lengths and thicknesses.

Teleflex

Teleflex is an American healthcare and medical company that produces and sells a range of medical devices that are mainly used in critical care and surgical operations. The company was founded in the 1940s and is based in Wayne, Pennsylvania.

In terms of sutures, Teleflex mainly specializes in the likes of braided polyester sutures and polypropylene sutures. Some of the product names associated with this brand include Deklene sutures and Polydek sutures.

Where Can I Buy Sutures From These Top Brands?

If you’re interested in purchasing surgical sutures from the best brands in the business, like Ethicon and Covidien, CIA Medical is the place to be. One of the leading wholesale medical providers in the business, CIA Medical has years of experience, competitive prices, and one of the biggest and best ranges of medical sutures for sale. Check out the full range and place your order today.