Choose the Perfect Suture!

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!

MUST HAVE SURGERY BOOKS

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.

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

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!

Affiliate Links - There are a few links in the description that may lead to a kickback to me to help support the channel.

[PoloMan-kc]

Thank you. I am a newer OR Nurse and I have struggled learning suture because I'm told to get suture but can't see where the surgeon uses it. Last week I was asked to get suture and I said "SH or CT?" The surgeon said he was using it for bowel. I started studying deeper into my books and as found your videos. Big help.

[schan]

Still remember what my consultant told me while I was doing my O&G placement back in med school. PDS stands for "Pretty Damn Strong", that's why you use it to close the abdominal fascia.

[rightpa]

Thanks for the video Dr. Pearson. It was very helpful. Clear and well organized so it really helped get the info through my thick skull. Subbed.

One thing I noticed: The stated strengths on the chart at 13:59 are flipped. The >3-0 column should have the higher retained tensile strength after placement.

[chrispin]

You’re doing a great job, I appreciate your dedication and sharing knowledge. Thank you

[somecallmedaniel]

Helpful for a junior surgery resident here - thanks!

[ahwang]

Outstanding video on sutures! It should be a required viewing by all the medical students and surgical residents.

[ARAVance]

I learned this while in Surgical assistant school. I love being a first assistant!

[petersielski]

Thanks for putting together this video. As a surgical trainee I find it hard to find material related to more practical and comprehensive guide to fundamental elements in surgery.

[annejoylemasurier]

Great video, I am doing my SFA placement and I needed to know more about the sutures so this information that you have provided has given me the basic knowledge of sutures and I love the category or classification, beautifully done. I would like to know about the retratures used in different specialities next and why.

[DerekEvilsizor]

Great video. I like how you help us remember the way you remember. Perfect dang suture. Cool

[laidyssolar]

Thank you so much for this video doctor! I am a recently graduated surgical tech and after watching this video I have a better understanding of how and why surgeons use the different type of sutures.

[TheBlurayHacker]

Your videos are a god send 🙏🙏🙏
The topics you choose are always the most relevant. I thank you.

[abuderbala]

amazing video doc, very helpful and informative . please keep the great work, thank you very much

[sidharthagoutam]

Huge fan of yours.
Surgery resident from India

[harrimakela]

Thanks, just want to say, you are very motivating! :)

[UnyimeJohn-fwjt]

Dr thank you so much for this video, I can suture boldly now am not afraid

[neuroxplorein]

My go-to surgical channel! Is the difference in infection rate between absorbable & non-abs that absorbable may potentially lead to EARLY infections (incr soft tissue infections, esp in superficial) vs non-absorbable can be a nidus to LATE infections?

[paulak]

Thank you so much for this video, easy to understand.

[VanessaManwau]

Thanks much i wana know more on sutures this helps alot

[medicomedico]

thank you dr
can you make a vedio on what type of closure we mostly use for differnt circumstances... when simple when continuos when matress and so on.