Types of sutures and when to use them

Suture materials can be broadly classified by whether they are absorbable or non-absorbable, and by whether they are monofilament or braided. Understanding this helps students choose the right material for different tissues and clinical situations.

Absorbable sutures are broken down by the body over time and are useful when long-term support is not needed. They are commonly used for deeper layers, buried sutures, and tissues that heal relatively quickly. Examples include Vicryl and Monocryl in many clinical settings. Absorbable sutures are often selected for subcutaneous closure, deep tissue approximation, and mucosal or internal layers depending on the situation.

Non-absorbable sutures remain in place unless removed or permanently retained. These are commonly used for skin closure, especially when reliable wound edge approximation is needed. Examples include nylon and polypropylene. In a beginner suturing workshop, these are often the easiest materials for learning because they provide clear practice for knot tying, spacing, and skin-edge approximation.

Braided sutures are easier to handle and tie, but they may create more tissue drag and can harbor bacteria more than monofilament sutures. Monofilament sutures glide more smoothly through tissue and are often preferred when lower tissue reactivity or reduced infection risk is desired. However, they can be more slippery and may require more careful knot security.

A simple teaching rule is:

• Use absorbable sutures for deeper or buried layers.

• Use non-absorbable sutures for skin closure.

• Use braided sutures when ease of handling is helpful.

• Use monofilament sutures when minimal tissue reaction is preferred.