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Sutures are stitches sewn by doctors to hold tissue together until the body has time to heal itself. Absorbable sutures are stitches that naturally decompose in the body, usually disappearing within 10 days to 8 weeks. Since they break down in the body, there is no need for them to be removed.
Absorbable sutures are usually used as surgical sutures to hold together internal body tissues. They may also be used in patients who cannot return to the doctor to get the more traditional sutures removed. In some instances, absorbable sutures may be either rejected and/or attacked by the body as a foreign substance and cause inflammation. For this reason, they are not commonly used on skin wounds. In addition, scarring is generally less common with non-absorbable sutures.
There are many different types of absorbable sutures for physicians to choose from, depending on the type of wound. They are divided into two broad categories: organic and synthetic. Organic sutures contain catgut, which is derived from the intestines of cows. Catgut sutures are banned from use in Japan and Europe for fear of bovine spongiform encephalopathy (BSE), although the herds are tested for BSE before harvesting is begun. Synthetic dissolving sutures are made from a wide range of materials, including glycolide, polydioxanone, and caprolactone.
A physician bases his or her suture decision on the type and the mobility of the wound area. The strength of suture required for the job, the amount of time the suture will need to remain strong, the risk of infection, and aesthetics are also considered. The doctor must also take into account the flexibility of the suture material, as a knot generally ties off each stitch.
In addition to dissolving sutures, physicians have many other options available to them in closing wounds. The class of non-absorbable sutures includes those that are organic, such as silk sutures, and those that are synthetic. These include nylon, polyester, polypropylene, stainless steel wire, and surgical staples. Skin closure tapes, which are special adhesive strips used to hold the skin together, may be used to close smaller wounds or in place of sutures if the patient's skin is especially fragile or compromised. Another alternative is to use adhesive agents, which act like a kind of glue to hold the wound closed while it heals.
No matter how the wound is held together, it is important to follow a physician's instructions on caring for the wound, especially with regard to bandaging, applying anything topically, and keeping the wound area dry. All of these are factors in preventing infection, minimizing scarring, and in keeping the integrity of the sutures intact so they can do their job. Follow-up appointments are important and should be rescheduled as soon as possible if they must be missed.