Umm Al-Qua University Pharmacy Collage Pharmaceutics Department

1. Umm Al-Qua UniversityPharmacy CollagePharmaceutics Department Presented By Manal AlShareef Surgical Sutures

2. Surgical : used in surgery. Surgery is a medical procedure involving an incision with instruments; performed to repair damage or arrest disease in a living body.

3. Sutures (stitches): are materials used to close a wound. They are used in an attempt to improve and speed healing. Pulling the edges of a wound together and stitching help in healing process. Sutures are used to close cuts from injuries or surgery. They are commonly used on the skin, internal tissues, organs, and blood vessels.

5. Goals of Suturing • To closing dead space. • Supporting and strengthening wounds until healing increases their tensile strength. • Minimizing the risks of bleeding and infection.

6. Sutures Properties • They must be strong ► Do not break • Non-toxic and hypoallergenic ► Avoid adverse reactions in the body • Flexible ► Can be tied and knotted easily • They must lack the "wick effect", ► Sutures must not allow fluids to penetrate the body through them from outside, which could easily cause infections

7. Suture Types

8. Sutures Divided up on Their Degradation Properties

9. Absorbable VS Non Absorbable Sutures

10. Sutures Divided up on Their Source of Material • Different types of materials can be used to close a wound depending upon the style of wound, location and depth in the body. The material can be special glue, staples, animal protein or thread like materials. Usually , the suture material comprises • Polymers • Silk • Nylon • Fibers • Stainless steel wire, …etc

11. Natural sutures VS Synthetic Sutures

12. Sutures Divided up on Their No. of Material Strand or Filaments

13. Monofilaments VS Non Multifilament Sutures

14. Choice of Suture • Familiarity and availability • Ease of handling • Tissue characteristics, Location and layers • Knowledge of physical and biological characteristics of the suture • Patient factors-infection, debility, obesity

15. Antimicrobial Sutures • There is a recent development in wound closure involves the use of sutures coated with antimicrobial substances to reduce the chances of wound infection. • While long-term studies are not yet available. • preliminary results indicate that these sutures are effective at keeping bacteria out of wounds.

16. Sizes of Sutures • Suture sizes are defined by the (U.S.P.) which is the official compendium for the suture industry. • Sutures were originally manufactured ranging in size from #1 (smallest)to #6. • #4 suture would be roughly the diameter of a tennis racquet string. • The manufacturing techniques, derived at the beginning from the production of musical strings, did not allow thinner diameters. • As the procedures improved, #0 was added to the suture diameters • later, thinner and thinner threads were manufactured, which were identified as #00 (#2-0 or #2/0) to #000000 (#6-0 or #6/0). • Atraumatic needles are manufactured in all shapes for most sizes. • The actual diameter of thread for a given U.S.P. size differs depending on the suture material class.

18. Surgical Needles for use with Sutures There are several shapes of surgical needles: straight, half curved or ski, 1/4 circle, 3/8 circle, 1/2 circle, 5/8 circle, compound curve

19. U.S.P. Needle Pull Specifications

20. Removal of Sutures • For a permenant sutures: "Different parts of the body heal at different intervals. Common time to remove stitches will vary: facial wounds 3–5 days; scalp wound 7–10 days; limbs 10–14 days; joints 14 days; trunk of the body 7–10 days. "Not all stitches must be removed. If a small area remains unhealed, notify the health care practitioner. Then if ordered, remove sutures from the healed area only."

21. Thank You