INTRODUCTION
Physicians have used sutures to close wounds for at least 4,000 years. Archaeological records from ancient Egypt show that Egyptians used linen and animal sinew to close wounds. In ancient India, physicians used the pincers of beetles or ants to staple wounds shut. They then cut the insects' bodies off, leaving their jaws (staples) in place. Other natural materials used to close wounds include: flax, hair, grass, cotton, silk, pig bristles, and animal gut.
The fundamental principles of wound closure have changed little over 4,000 years. Successful closure of wounds involves surgical techniques coupled with knowledge of the physical
characteristics and handling of the suture and needle. The selection of proper suture material in closing any surgical defect
is important in wound healing, minimizing infection, and achieving optimal cosmetic and functional results.
A great deal of progress has been made since Egyptian times with regard to suture materials and manufacturing processes. Today, sutures are available with a wide variety of characteristics, configuration, manipulability, coefficient of friction, solubility, strength, and immunogenic properties. Yet, sutures are currently
rather crudely classified based on a numeric scale according to diameter and tensile strength; descending from 1 to 10, and then descending again from 1-0 to 12-0. This study aims to explore
the factors that are important to a surgeon when choosing sutures via evaluating surgeon preference for two types of synthetic, absorbable, monofilament sutures: glyconate and poliglecaprone 25. We hope to initiate a more nuanced exploration
of how suture characteristics influence surgeon preference, beyond filament type and size, and how makers of sutures may better report and represent these factors.
BACKGROUND
There are two categories of sutures, absorbable and non-absorbable. Most absorbable sutures are absorbed by enzymatic degradation or hydrolysis, and lose at least 50 percent of their tensile strength within two months.1,2 These sutures are generally used as buried sutures to close the dermis and deeper subcutaneous layers; however, they may be used as surface sutures when suture removal is impractical.
1,2 Absorbable sutures provide temporary support and maintain wound-edge approximation until the wound has healed enough to prevent dehiscence or splitting.1 Non-absorbable sutures are mainly used on the surface to align wound edges. They are resistant to enzyme degradation and hydrolysis, and are generally removed 5-14 days post-operatively
when wound edges have re-epithelialized.1,2
