Types of Sutures: Absorbable, Non-Absorbable, and When to Use Each

Absorbable vs. Non-Absorbable Sutures

The most fundamental distinction in suture selection is whether the suture material is absorbed by the body over time or must be removed manually.

• Absorbable sutures are broken down by the body through enzymatic degradation or hydrolysis. They are used for internal layers, subcutaneous closures, and situations where suture removal would be impractical or distressing (pediatric patients, mucosal tissue). Absorption timelines range from 10 days to several months depending on the material.
• Non-absorbable sutures remain intact indefinitely and must be removed by a clinician. They are preferred for skin closures, external wounds, and situations requiring long-term tensile strength. Common removal windows are 3–14 days depending on wound location.

Monofilament vs. Braided Sutures

Thread construction affects handling, knot security, and infection risk:

• Monofilament: A single continuous strand that glides through tissue with minimal drag and has lower bacterial wicking. Easier to remove. Requires more throws to secure a knot and has more memory (springback during tying). Common monofilament sutures include nylon (Ethilon), polypropylene (Prolene), and poliglecaprone (Monocryl — absorbable).
• Braided / multifilament: Multiple strands twisted or braided together for superior knot security and handling. Braided sutures have more tissue drag and a higher theoretical risk of bacterial colonization in contaminated wounds. Common braided sutures include polyglactin 910 (Vicryl — absorbable), polyester (Ethibond), and silk.

Common Suture Materials and Their Uses

Understanding each material helps clinicians select the right suture for the tissue type and healing environment:

• Polyglactin 910 (Vicryl): Braided, absorbable. Absorbed in 56–70 days. Widely used for subcutaneous closures, fascial repair, and mucosal tissue. Excellent knot security.
• Poliglecaprone (Monocryl): Monofilament, absorbable. Absorbed in 91–119 days. Smooth passage through tissue; often used for subcuticular skin closures and delicate tissue.
• Chromic gut: Natural absorbable suture treated with chromic salts to slow absorption (21–28 days). Used in mucosal and highly vascular tissue such as the vaginal cuff, oral mucosa, and bladder.
• Nylon (Ethilon, Dermalon): Monofilament, non-absorbable. Excellent tensile strength with low reactivity. Standard choice for skin closure; must be removed post-healing.
• Polypropylene (Prolene): Monofilament, non-absorbable. Minimal tissue reactivity; used in vascular anastomosis, cardiovascular surgery, and skin closures where long-term strength is needed.
• Silk: Braided, non-absorbable (though it does degrade slowly). Easy handling and knot security; historically common but now largely replaced by synthetic materials. Still used in ophthalmic and cardiovascular settings.
• Polyester (Ethibond, Mersilene): Braided, non-absorbable. High tensile strength for cardiovascular and orthopedic applications.

Suture Size and Tissue Selection

Suture size is expressed as a number of zeros — the more zeros, the finer the suture. A 2-0 (two-zero) suture is thicker than a 5-0:

• 0 – 1: Heavy tissue — fascia, abdominal wall closure, orthopedic repair.
• 2-0 – 3-0: Subcutaneous layers, muscle, and moderate-tension skin closures.
• 4-0: General skin closure on most body areas; also used for oral mucosa and pediatric wounds.
• 5-0 – 6-0: Delicate tissue — facial lacerations, hand and finger repairs, plastic surgery closures.
• 7-0 and finer: Ophthalmic and microsurgical procedures.

Wound Closure Best Practices

Suture selection is one component of successful wound closure. Additional considerations for clinical settings:

• Match suture absorption timeline to expected wound healing time — a suture that loses strength before the wound closes creates dehiscence risk.
• Use absorbable suture for internal layers so patients do not require a second procedure for removal.
• In contaminated or infection-prone wounds, monofilament sutures reduce bacterial wicking compared to braided alternatives.
• Needle selection matters as much as thread — tapered needles for soft internal tissue, cutting needles for tough skin and fascia.

MDSupplies carries sutures and wound closure supplies from established manufacturers. Browse the wound care category and surgical sutures to find the right material, size, and needle type for your clinical needs.