A consideration of the suture problem

Abstract

T HE existence of the suture probIem is manifested by the variety of suture materiaIs at hand as we11 as by the Iack of uniformity in the methods of their utihzation. Yet, the suture and its application is such an integra1 part of the surgeon’s, and for that matter, the general practitioner’s daiIy activities that it is too often taken for granted. Most of us, unfortunately, acquire our suture technique rather bIindIy from our elders and with it many time-honored and often time-disproved prejudices. At present, the ideal suture materia1 does not exist, and the materiaIs avaiIabIe represent compromises. The absorbable sutures produce varying degrees of tissue reaction, and their rates of loss of strength and of absorption are far from constant. Some of the non-absorbabIe sutures are remarkably inert in tissue and they maintain tensiIe strength far beyond any necessary time interva1, but, as the name implies, are of the nature of permanent guests. It is not too much to expect that the future wiI1 produce a material with the advantages of both and the disadvantages of neither. In the meantime, a knowIedge of the characteristics of both types is of considerabIe advantage to the surgeon.