sutures

Sutures are terms with two main meanings in medicine: anatomical sutures, the fibrous joints between skull bones in the developing skull, and surgical sutures, the threads used to close wounds and connect tissues.

Anatomical cranial sutures are immobile fibrous joints created by dense irregular connective tissue. They guide skull growth in infancy and early childhood and gradually ossify with age. Prominent sutures include the coronal, sagittal, lambdoid, and squamosal sutures; fontanelles are soft spots where sutures intersect in infants.

Surgical sutures are sterile threads or wires intended to approximate wound edges. They vary by material (natural vs synthetic), absorption (absorbable vs non-absorbable), and structure (braided vs monofilament). Common absorbables include polyglycolic acid and polydioxanone; non-absorbables include nylon, polyester, and polypropylene; stainless steel wires are used for bone and orthopedic repair. Needle types include tapered for delicate tissue and cutting for tougher tissue.

Suturing techniques such as interrupted, continuous, or mattress patterns are chosen according to tissue type, tension, and healing needs. Choice of suture size and coating, as well as knot-tying technique, influence wound security and tissue reaction.

Potential complications include infection, dehiscence, granuloma formation, tissue necrosis from excessive tension, and allergic reactions to suture material.

In modern medicine, suture materials are chosen to balance strength, handling, tissue reactivity, and absorption. Advances in biomaterials have produced sutures that minimize infection and scar formation and support rapid healing.