Surgical suture on needle holders. Packaging shown above.

Catgut suture is a type of surgical suture that is naturally degraded by the body's own proteolytic enzymes. Absorption is complete by 90 days, and full tensile strength remains for at least 7 days. This eventual disintegration makes it good for use in rapidly-healing tissues and in internal structures that cannot be re-accessed for suture removal.

Catgut suture has high knot-pull tensile strength and good knot security due to special excellent handling features. It is used for all surgical procedures including general closure, ophthalmic, orthopedics, obstetrics/gynecology and gastrointestinal surgery. It is absorbed faster in patients with cancer, anemia, and malnutrition. It also absorbed faster when used in the mouth and in the vagina, due to the presence of microorganisms.

Catgut has largely been replaced by synthetic absorbable polymers such as Vicryl and polydioxanone. It is not used at all for human surgery in some countries. In Europe and Japan, gut sutures have been banned due to concerns that they could transmit bovine spongiform encephalopathy (mad-cow disease), although the herds from which gut is harvested are certified BSE-free.

[edit] History

The first known absorbable sutures were made of the intestines of sheep. The manufacturing process was similar to that of natural musical strings for violins and guitar, and also of natural strings for tennis racquets. The inventor, a 10th century surgeon named al-Zahrawi, reportedly discovered the dissolving nature of catgut when his lute's strings were eaten by a monkey.

[edit] Manufacture

Catgut suture is made by twisting together strands of purified collagen taken from bovine intestines. The natural plain thread is precision ground in order to achieve a monofilament character and treated with a glycerol-containing solution. The suture is sterilized eith ethylene oxide gas, is straw-colored, and is available in sizes USP 6-0 (1 metric) to USP 3 (7 metric).

[edit] Variants

Chromic catgut suture is a variant treated with chromic acid salts. This treatment produces roughly twice the stitch-holding time of plain catgut, but greater tissue inflammation occurs. Full tensile strength is extended to 18–21 days. It is brown rather than straw-colored, and has improved smoothness due to the dry presentation of the thread (plain catgut is wet). It is otherwise similar to plain catgut.

Fast catgut suture is heat-treated to give even more rapid absorption in the body.

[edit] External links

Wikimedia Commons has media related to: Suture

• Sutures_04_Introduction Surgical sutures on Wikisurgery