Sutures are used daily in medicine for approximating skin edges as in trauma and lacerations and during all surgical procedures. Hence, it is necessary to know what sutures are used in today’s era as they will be frequently heard during transcription.
Every suture used is selected on the criteria mentioned below:
1. It’s easy of handing
2. Minimal tissue reaction
3. High breaking and tensile strength
4. Does not support bacterial growth
5. Easy sterilization
6. No allergic reaction
7. No carcinogenic action
8. Absorbed after serving its function
Suture materials are classified in two major types depending on their absorbability characteristic. A small classification with some examples are given below.
Classification of suture materials:
|Plain gut Or catgut
||Polyglactin 910 eg. Vicryl, Ethicon)
|Kangaroo tendon absolute
||Polyglycolic acid (eg. Dexon)
|Ox gut ribbon gut obsolete
||Floss silk –obsolete
|Suture martial made from amniotic membrane
||Horse hair –obsolete
||Stainless steel wire
Plain gut - Prepared from the mucosa or submucosal or sheep or beef intestines.
Chromic gut - Plain gut tanned with chromic salt
Polyglactin 910 - is made of glycolic acid and lactic acid
Coated Vicryl: polyglactin 910 coated with polyglactin 370 + calcium stearate
Dexon S: Braided polyglycolic acid without coating
Dexon plus: treated with surface lubricant Poloxamer 188
Polyamide (Nylon) – Monofilaments.
Silk – Two types of fine silk sutures: virgin silk and braided silk.
Polypropylene - Eg. Prolene
Polyester - Eg. Mersilene
Transcribing suture sizes in Transcription
The two most commonly used systems for suture sizes are:
1. USP system.
2. Brown and Sharp gauge.
USP system stands for United States Pharmacopeia System. This system classifies sizes of all types of suture materials. The start sizes range from 11-0, which is the smallest size to 7, which is the largest size.
For eg size 9-0 stands for 9 0's in a row, 000000000. Since this is too cumbersome to write, it is transcribed as 9-0, where 9 is for the number of zeros, followed by a hyphen, followed by the digit “0” without a space. Similarly, 000 will be 3-0 and 0000 will be 4-0. Sizes greater than 0 are expressed by whole numbers.
A symbol # is placed before the suture size while transcribing with any space in between.
Number three 0 Dacron is to be transcribed as “#3-0 Dacron.”
Number two Prolene is transcribed as “#2 Prolene.”
Brown and Sharp Gauge: This system is meant for expressing stainless suture steel sutures only. Here, whole numbers from 40 through 20 are used to specify the size in ascending amount wherein 40 is the smallest size and 20 is the largest. As mentioned before, symbol # is used if the word number is dictated before suture size.
Number thirty stainless steel wire is transcribed as “#30 stainless steel wire.”