Sutures, Ligatures and Surgical Fixation Textiles
topic
Surgical sutures are sterile filaments used to approximate tissue and ligate blood vessels, manufactured as monofilament or braided multifilament structures from absorbable (PGA, polyglactin 910, PDS polydioxanone, catgut) or non-absorbable (PP, nylon, PTFE, silk, polyester) materials. Braided PGA sutures (USP size 2-0 to 1, diameter 0.3–0.6 mm, tensile strength 15–35 N) lose 50% strength in 14–21 days (ISO 10334) as hydrolytic degradation proceeds, with complete absorption in 60–90 days. Polydioxanone (PDS) monofilament retains 70% strength at 28 days and absorbs completely in 180 days, preferred for fascial closure. Non-absorbable PP monofilament (diameter 0.1–0.7 mm, tensile strength 20–80 N/mm²) provides permanent suture for cardiovascular and hernia repair. Suture needle attachment (swaged connection) requires pull-out strength >0.5N (USP requirements). Barbed sutures (unidirectional or bidirectional barbs cut at 90–120° intervals, 0.5–1.5 mm barb depth) eliminate knot tying, reducing suturing time by 40–60% and improving wound tension distribution. Global suture market is valued at $4.5 billion; Ethicon (J&J) and Covidien (Medtronic) hold 60% combined market share.
Role
Surgical sutures are the most universally used medical textile device, with their mechanical properties, degradation kinetics, and tissue biocompatibility directly determining wound healing quality and complication rates across every surgical specialty worldwide.