Talk:Suture

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[edit] Surgical staples

Can internal staples cause problems later on, such as causing mysterous pains in the area of the staples? - Unsigned comment.

No. Surgical clips are small and made of an inert material (usually titanium or stainless steel). Dlodge 01:34, 26 January 2007 (UTC)

[edit] Surgical sutures

Discussion copied from Wikipedia:Reference desk

Article says "absorbable sutures" are used within the body, whereas for closing external skin wounds "non-absorbable sutures" are used. Are there cases where absorbable sutures are used for external closures ? What are the pros and cons of this ? Jay 17:31, 3 Jul 2004 (UTC)

Since I don't think we have a surgeon on board, I'll break one of my own rules about not posting speculation if someone else here probably has access to facts. As described in the article, the key characteristic of absorbable sutures is their ability to be dissolved by tissue enzymes. The two most important qualities for skin sutures are (1) that the wound not re-open before it is healed and (2) that the scar be as thin and subtle as possible. One of the advantages of removable sutures is that the time of removal is controlled-- the doctor can specify exactly when to remove them. Optimal timing to minimize scarring varies for skin of different parts of the body. Absorbable sutures do not have timed dissolution and so there is more potential variability as to when they disappear. The second thing that occurs to me (speculation) is that there may be a bit more inflammatory response to the foreign protein in some of the absorbable sutures. Inflammation can amplify scarring so if removable sutures are less antigenic it would represent a second potential way to reduce scarring. Alteripse 18:07, 3 Jul 2004 (UTC)
The above comment is correct; just to clarify a couple of points:
  • Absorbable sutures are used primarily within the body, rarely do they protrude through the skin (only thing I can think of is a modified subcuticular stitch used by plastic surgeons when the suture is inside the skin, and the ends are left external for tensioning).
  • Non-absorbables are frequently used inside the body when long-term strength is needed, particularly in cardiovascular surgery. E.g. replacing a peice of aorta or implanting coronary bypasses.
  • Absorbable sutures do have a controlled time period of dissolution - different materials take different time to break down. E.g. chromic gut takes 7-14 days. PDS is nominally 42-56 days.
  • In general, the shorter the time any suture is in the skin, the smaller the scar. There is a trade-off with healing, areas such as the elbows and knees take longer to heal to the required strength than a face for example. The concern about scarring is limited to sutures in the skin.Dlodge 01:34, 26 January 2007 (UTC)
Not yet a surgeon but I can confirm this - the main reason for using non-absorbable sutures is to reduce scarring - the inflammatory response described by Alteripse will cause quite noticeable scarring with absorbables.--inks 13:10, 7 Jul 2004 (UTC)
Thanks Alteripse and Inkypaws, the inflammation and scarring part were missing in the article, so those can be added. However only 1/3rd of my question has been answered. The other two - are there cases where absorbable sutures are used externally and what are the Pros if any. Jay 19:53, 7 Jul 2004 (UTC)
Sorry, I thought the "other two" answers were implied by the first. First, I haven't heard of absorbable sutures being used in the skin (I assume that's what you mean by externally). Second, only "pro" I can think of would be that absorbable sutures don't have to be removed, but this small advantage is far outweighed by the likelihood of greater scarring. Alteripse 03:19, 10 Jul 2004 (UTC)
Circumcision article says "The remaining skin is then stitched back using dissolvable stitches". If a dissolvable stich is same as the absorbable suture, then thats one example of usage in the skin. Jay 12:56, 10 Jul 2004 (UTC)
a subcuticular stitch is often used to close skin, but the stitch is then place a few milimeters below the surface, so even though strictly closing the skin, this is internal Erich 13:04, 10 Jul 2004 (UTC)

As I have been involved in the manufacture of sutures I know a bit about the braiding (braided sutures) and the extrusion (monofilament sutures) processes. It seems that this article might benefit from the addition of a segment comparing braided to monofilament sutures. As you know from dealing with fishing line, monofilament line does not lend itself to superior knot retention as does braided suture. --4.154.224.184 22:28, 10 Oct 2004 (UTC)

[edit] Chromic Gut Suture

Does anybody know where chromic gut sutures come from, and what kind of suture they are? They use some in my lab, and I do not know what it is.

Chromic gut suture-make from the goat or cow;s intestine. These sutures are absorb within 7-14 days, it had the fast absortion rate compare to synthetic which will absorb within 42-56 depending on the range of product. As different range of product the absorbtion rate varies. Normally gut sutures are being use for epsiotomy (vaginal delivery in old days)/skin but due to infection rate most of the surgeon had convert to synthetic sutures instead.

Although we have access to the more modern synthetic sutures, in veterinary work many surgeons prefer to use gut, as the extra scarring it produces causes a much stronger union, wherever adhesions and complications of scarring are unimportant, e.g. bovine caesarian section. Dlh-stablelights 21:52, 14 June 2007 (UTC)

[edit] size?

This quote: (To give an idea about these numbers, a #4 suture would be more or less the diameter of a tennis racquet string.) ... does not give an indication of the size. Does size go up with number, or down? The rest of the paragraph makes it clear, but this sentence is pointless. If you agree pls remove. 67.183.154.41 03:51, 5 December 2005 (UTC)

[edit] Picture

Do we really need such a graphic picture up top and so big? zafiroblue05 | Talk 06:08, 22 April 2006 (UTC)

Its not that graphic, is it? Plus, it illustrates the point magnificently. Limbs are fairly neutral as far as i am concerned in terms of squeemishness. At least it isn't internal organs, or worse, face or genitals. That would be far less acceptable - mastodon 20:40, 29 April 2006 (UTC)
Personally I find the image of the arm (the third image in the article) simply unhelpful, the detail isn't on the suture, so it doesn't help me learn anything. I'd personally suggest removing it from the article. The other two images are helpful. Sherurcij (Speaker for the Dead) 00:12, 27 August 2006 (UTC)
The images serve their purposes; squimishness is overcome esily by the mind - relax. We should also include images of suture removal, of wound appearence days/weeks/&months after surgery and of the sutures themselves along with the needles.DocEss 17:38, 6 September 2006 (UTC)
I'm quite willing to provide some images of my recent incision, which was closed a few days ago with a series of 16 surgical staples; the effect is very similar to a zipper. And as someone who can be very squeamish concerning wounds and blood, I can attest that the image would not be "graphic". However, I would expect that this article then covered the use of staples in more detail. At the moment I write this, I've found little to no information in Wikipedia about surgical staples at all; I suspect I'd be better served if I wanted to know which movies featured red staplers, if I may be snarky. -- llywrch 08:16, 13 February 2007 (UTC)
"Build it and he will come..." I started the page at surgical staple. Dlodge 20:10, 13 February 2007 (UTC)

(Undent) I've always believed that the informative value of an image should be balanced against its effect upon readability. In this case, the image is rather graphic, depicting an open wound, so I think that sort of imagery might actually be off-putting to readers who do not have an iron stomach. I think that Wikipedia should strive to maintain readability for as wide of an audience as possible and I would hate to think that sensitive readers might be deterred from reading this informative and useful article due to the presence of a rather vivid depiction of injury. But I understand that the image itself is informative and that its presence contributes to the article. That's why at Talk:Amniotic sac, after some discussion, we came to a compromise solution, and used Template:Linkimage to display a graphic image within the article. That way, the image was not directly displayed within the article but was still easily accessible from the article through the prominent template, and users who want to view the image can do so voluntarily. I see Template:Linkimage as being a "best of both worlds" approach. -Severa (!!!) 14:06, 5 March 2007 (UTC)

[edit] Pronunciation

How is this word pronounced? Is it like nature (ie. soo-chore), or is it more like ss-you-ter? someone get some IPA in here. Especially so for such an unusual word - mastodon 20:40, 29 April 2006 (UTC)

As someone who works in the medical device industry in Minnesota, USA, it's pronounced like soo-chore here.--70.92.13.102 22:39, 24 June 2006 (UTC)

In American, it's soo-chur (a typical slurred and gutural grunt pronuciation). In proper English, it's ssyoo-chyur (a tight-and-rounded-lipped lispy sort of pronunciation). DocEss 17:44, 6 September 2006 (UTC)

[edit] Superglue

The article says medicians have used cyanoacrylate to suture wounds, so, in an emergency, could I superglue a wound? Cuzandor 03:55, 2 August 2006 (UTC)

Are you a surgeon? I didn't think so. You "could" but you "should" not. If you need sutures, got to the doctor. FYI - look here Cyanoacrylate DocEss 17:46, 6 September 2006 (UTC)
wtf man its cyanide based. dont conduct that shit at home. go to the doctor, thats why they go to school 24 years of their life. they know their shit! Sf49rox 22:34, 10 January 2007 (UTC)
Cyanoacrylate glue is useful in superficial skin wounds; e.g. it is ideal for paper cuts. Cyanoacrylate is also excellent for patients who are unwilling to stay motionless while the wound is sutured - e.g. children. There is no need to "freeze" the wound using syringes, and there is no needle and thread to close the wound. Cyanide is a byproduct of the glue, but in a harmless concentration (keep in mind cyanide is a natural substance - found even in apples). Glue used in hospitals in FDA certified, but I (as a surgeon) use plain superglue on myself if I have a paper-cut. Dlodge 01:34, 26 January 2007 (UTC)
A paper cut is not an emergency - go to a doctor in an emergency. A good rule of thumb is "If there is blood, don't glue." You certainly don't want to pour glue into an open wound. Dlodge 01:37, 26 January 2007 (UTC)

[edit] TfD nomination of Template:Linkimage

Template:Linkimage has been nominated for deletion. You are invited to comment on the discussion at the template's entry on the Templates for Deletion page. Thank you.   — Jeff G. (talk|contribs) 22:46, 8 March 2007 (UTC)

[edit] Use in the Humanities

Is there currently a Wiki that describes the function [and radically different denotation] this term takes in film studies, psychoanalysis, and critical theory? SethHowes 23:40, 8 March 2007 (UTC)

No, there doesn't appear to be such an article on Wikipedia. Please feel free to be bold and add to this article or create one (or three). Suggested language: "Non-medical use of the term 'suture'".   — Jeff G. (talk|contribs) 17:36, 16 March 2007 (UTC)

[edit] abt distributor

               sir we want distributorship in namakkal

—Preceding unsigned comment added by 221.134.165.140 (talk) 10:09, 20 April 2007

Sorry, but if you really want a distributorship for sutures and/or suture-related supplies in Namakkal, this is not the way to request one. And neither is alienating half the planet. Also, please avoid using leading spaces in your wikitext. Thanks!   — Jeff G. (talk|contribs) 20:46, 5 May 2007 (UTC)

[edit] Disambiguation page needed

Looks like we need a disambiguation page for "suture" since there several competing meanings: stitches (this article); anatomy (not just cranial, I found the problem while editing crurotarsal ankle joint), film studies, psychoanalysis, and critical theory. That would mean this article needs to be retitled, e.g. "suture (surgical)". For the type I'm interested in, I'd go with the title "suture (skeletal)".Philcha 23:10, 27 June 2007 (UTC)

Since no-one has objected, I'll do this in a week.Philcha 22:28, 27 July 2007 (UTC)

[edit] Suture type comparison chart

I hope my huge edit didn't throw anyone off. I rearranged the laundry list into a table so it is easier to read at a glance. Some things didn't match up between sections - edit help would be appreciated.--Digitalgadget 19:11, 6 July 2007 (UTC)

[edit] History?

How long have stitches been used? What are the earliest reported cases? When did they become commonplace? —Preceding unsigned comment added by 98.196.115.197 (talk) 01:41, 13 April 2008 (UTC)