Editing Suturing (section)

== Materials ==

* Monofilament - less tissue reaction, less infection, less scarring
* Braided - can harbour infection, more likely to catch or cut out

* Nylon (Ethilon/polyamide) - usually monofilament. Poor handling/knotting. Ensure knots are tied square to avoid slippage. Remove memory prior to use. Breaks down very slowly. 6 throws. Handles better when wet.
* Silk - easy handling, secure knots, rare slippage. Low tensile strength. Rougher on tissues, so hurts on removal. Nidus for infection. Do produce an inflammatory reaction. 3 throws only required. Loses tensile strength at 1 year and disappears after 2 years.
* Polypropylene - '''prolene''' - non-absorbable, non-reactive. 6 throws. Can be used for bowel anastomosis. Biologically inert.  Expensive. 
* Polydioxanone - '''PDS'''. Synthetic, monofilament, absorbable. Minimal tissue reaction. Hydrolysis starts at 90 days, complete at 6 months. Needs four throws to knot securely. Maintains strength in the presence of infection or exposure to harsh substances such as urine, bile and pancreatic juice. 
* Polyglactin 910 ('''vicryl'''). Synthetic, multifilament, absorbable. Braided. Absorption commences 20-30 days, complete by 60-90 days, loses 50% of tensile strength within 3 weeks. Minor inflammatory reaction. 
** Standard Vicryl - coated with polyglactin 370 and calcium stearate, to reduce bacterial adherence, improve handling and decrease resistance
** Vicryl Plus - also coated with the antiseptic triclosan - has been shown to reduce surgical site infections
** '''Vicryl rapide''' - coated polyglactin 910 (lower molecular weight coating than standard Vicryl) - strength retention for 7-10 days, complete absorption 40-60 days, but lower tensile strength than normal Vicryl. Mucosa and skin (falls out on its own after a week or so).
* Poligecaptone 25 ('''Monocryl''', kaprosyn). Synthetic, monofilament, absorbable. Little tissue reaction, great handling. Fully absorbed 90-120 days. All tensile strength lost by 21 days.
** Monocryl - poligecaptone 25 with a lubricant coating. Comes undyed or purple. Available as a Plus version, coated with triclosan. 
* Ethibond (braided polyester coated with polybutylate). Non-absorbable. Expensive. Strong. 
* TiCron (braided polyethylene coated with silicone)