How do you choose which suture you need?

What are the different types of suture available?

Whenever I'm doing a case it's the same question every time...what suture do you want doc?

If you're unable to answer this question for the cases on your schedule today then this video is for you!


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Every day I have to make a decision on what type of suture I'm going to use for various problems. If you don't know what suture you're going to use you're going to be standing there with a blank look and mounting anxiety.

What suture for a bowel anastomosis?

What suture for sewing skin?

What suture for a fascial closure?

What suture for a vascular anastomosis?

There are so many different kinds of suture to use that it can make your head spin.

In this video on surgical suture I'm going to make it easy.

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Surgical suture can be broken down into three main categories as every suture has these three properties:

1. It's either monofilament or multifilament (braided)
2. It's either synthetic or biologic (natural) in source
3. It's either absorbable or permanent.

For example, monocryl is a monofilament, synthetic absorbable suture!

In this video I'm going to go through the strengths and weaknesses of each of the categories. I'm going to tell you why I love to tie with multifilament suture and why monofilament suture can be a pain!

One thing that is incredibly important with surgical suture is knowing how long each suture is going to last. For example, how long does monocryl last in a wound? How about PDS? Vicryl? Why is FAST absorbing gut a poor suture choice for fascia? What makes it a great suture choice for closing facial lacerations?

I'm also going to tell you what suture I like for the following problems:

1.). Sewing skin
2.). Bowel anastomosis
3.). Fascial closure
4.). Vascular anastomosis

Check out these AMAZING timestamps and fast forward if you need to:

Start 00:00
Strengths and Weaknesses of Different Suture 03:05
How is Suture Sized 11:54
Absorbable Suture: What, Why When? 13:44
What suture to use for what purpose? 19:38

REFERENCES
Ethicon Suture Guide https://citizensurgeon.co/ethicon
Stat Pearls Suture https://citizensurgeon.co/StatpearlsS...

SOME RECENT READS
The Miracle Morning by Hal Elrod http://citizensurgeon.co/MiracleMorning
Atomic Habits by James Clear http://citizensurgeon.co/AtomicHabits

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WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!

DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. If you have medical questions definitely consult a medical professional. Good luck and enjoy!

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