Suture

A suture is a strand or filament used to approximate tissues or close wounds in surgical procedures. In anatomy, the term suture also denotes a fibrous joint where bones are united by dense connective tissue, most notably the immovable sutures between skull bones.

Surgical sutures are manufactured from natural materials such as silk, and from synthetic polymers such as nylon, polypropylene, polyester, polyglycolic acid, polyglactin 910, and polydioxanone. They can be absorbable, breaking down in tissue over time, or non-absorbable, remaining in place until removed or until healing stabilizes. Absorbable sutures provide temporary support; non-absorbables provide long-term support.

Sutures are categorized as monofilament (single strand) or multifilament (braided). Monofilament sutures tend to cause less tissue drag and infection risk, while braided sutures offer greater knot security and ease of handling. Common closure patterns include interrupted and continuous sutures, vertical or horizontal mattress techniques, and subcuticular or intradermal closures.

Material choice depends on tissue type, tension, risk of infection, and required duration of support. Suture use requires sterile technique; knot-tying skill is a key part of many closures. Complications can include infection, foreign-body reaction, tissue necrosis at the suture line, dehiscence, and granuloma formation. Some newer sutures are barbed and self-retaining, avoiding knots in certain applications.