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| Dr. Joel Aronowitz |
Dr. Joel Aronowitz: “Okay, let's pick sutures. How do you pick a suture? Well, it depends on what the need is. So there's a lot of different kinds of suture. They fall into these categories: Absorbable, non-absorbable, monofilament, and braided. So for example, Vycrel is going to be a braided suture that's absorbable, whereas PDS is a monofilament that's absorbable, but Proline is a monofilament that is non-absorbable. So it'll stay forever or it has to be. So now, sometimes we want a stitch that ties easily, the knot stays and doesn't unravel, and we don't care that it's braided because it's buried deep in the tissues and it's unlikely to cause a reaction because it's braided.
So in those cases, Vycrel is good. It lasts about six weeks before it's absorbed and it loses its strength. If it's a situation where we don't want the irritation caused by a braid and the higher risk of infection caused by braided suture, but we want something that remains strong forever, maybe we would use a monofilament, non-absorbable suture like Proline. So it just depends on what the need is. The other factor here, besides the suture material itself, is the needle. So needles fall into two categories: needles that are sharp at the tip and cut, and needles that are tapered. On our suture packaging, it'll show us all that information. It'll show us what the suture looks like. We can tell from the brand if it's monofilament or if it's a braided suture, and we should know by the brand of the type of suture it is, whether it's absorbable or not.
And then here's a diagram of the needle. This is going to be a half-circle. And here is a cross-section of the needle showing us that it's got a pointy tip, but it's round, so it's tapered. Let's take a look at a cutting needle then. For example, here, this is another half-circle. It's got a cutting tip. Here's a cross-section of the tip. And as that tip goes through the skin or whatever we're sewing, the sharpness at the tip will cause a little tiny incision and allow the rest of the needle and the suture to go through. So depending on exactly what the situation is, we might need a very small needle that is a half-circle or a partial circle.
We may need one that's tapered that doesn't cause a cut as it goes through the tissue. So it just depends on the particular need and also sometimes just a particular preference of that surgeon. But that's how we choose suture. And there are literally thousands of types of suture, some that are standard, some that are made custom for a particular surgeon or particular purpose. But about 150 different sutures would be standard and would accomplish almost everything that we need.
So I hope that little tour of suture material helps. And if you're ever in the operating room, stop by and I'll show you all the different colored boxes and explain the suture material to you. So, hope that you enjoyed that, and we'll see you later, direct from Aronowitzland.”
And then here's a diagram of the needle. This is going to be a half-circle. And here is a cross-section of the needle showing us that it's got a pointy tip, but it's round, so it's tapered. Let's take a look at a cutting needle then. For example, here, this is another half-circle. It's got a cutting tip. Here's a cross-section of the tip. And as that tip goes through the skin or whatever we're sewing, the sharpness at the tip will cause a little tiny incision and allow the rest of the needle and the suture to go through. So depending on exactly what the situation is, we might need a very small needle that is a half-circle or a partial circle.
We may need one that's tapered that doesn't cause a cut as it goes through the tissue. So it just depends on the particular need and also sometimes just a particular preference of that surgeon. But that's how we choose suture. And there are literally thousands of types of suture, some that are standard, some that are made custom for a particular surgeon or particular purpose. But about 150 different sutures would be standard and would accomplish almost everything that we need.
So I hope that little tour of suture material helps. And if you're ever in the operating room, stop by and I'll show you all the different colored boxes and explain the suture material to you. So, hope that you enjoyed that, and we'll see you later, direct from Aronowitzland.”
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