Review of Suturing

(Suture Material review and

Knot tying

Div Oncology
Faculty of Medicine, University of Indonesia
What are the different?
 At the end of this session
participants have

Competency to explain a kind of suture

material
 Anatomy

Energy

Dissection

Recontruction
= Suturing =
Knot Tying
 Objective

To review suture material

To review of suturing technique
To review of knot tying technique
 The purpose of suturing
To ligate the blood vessel

To approximate the tissue

 Ideal suture material
Easy to use
Less trauma
Adequate tensile strength
Minimal tissue reaction

Save
 Cat gut
Easy to find in developing country
Not used anymore in develop country
Poly glecaprone has a tensile strength of 28 days, than completely
absorb between 60 to 90 without a significant tissue reaction

15 days 70 days

Many implantation studies shows the

excellent bio-compatibility of Monosyn
Monosyn
 PGA New Completely
Synthetic Coating
New Coating
Glycolide Acid 10%
TMC 30%
e-Caprolactone 60%

Similar Component to Poly glecaprone

Minimal tissue reaction
Excellent knot properties
 Polydioxanone
Tensile strength 60 days
Absorbed 180-210
The best suture material
Single or Double loop

Strong and less trauma

Monoplus
Tissue Suture Material
Peritoneum PGA 2.0 3.0
Muscle PGA 2.0 3.0
Fascia PGA 1, Polidiaxon loop,
Poly 4Hydroxybutirat
Mass closure Polydiaxon, Maxon,
Premilene
Uterus Glyconate, Polyglecaprone
Subcutaneus PGA 3.0 4.0, Premilene
clear
Skin Glyconate 3.0 4.0,
Polyglecaprone 3.0 4.0
Premilene 4.0 7.0
 Poly-4-hydroxybutirate
(MomomaxR)

Good elaticity, good handling

50% TS after 90 days
0% TS after 180 days
Complete absorbtion in round 13 months

Abdominal wall closure

,
 Summary
Best suture material is available
No published data why many surgeon do
not use the suture material