Nahttypen (suture types) are medical threads used to close wounds and surgical incisions. They’re classified as absorbable or non-absorbable, with materials including silk, nylon, polyester, and catgut. Each type serves specific purposes based on tissue type, healing time, and wound location. Choosing the right suture affects healing speed, scarring, and complication rates.
Your skin splits open. A surgeon needs to close it. The thread they choose matters more than you think.
Nahttypen determines how fast you heal, how much scarring you’ll see, and whether complications develop. Medical professionals select from dozens of options, each designed for specific tissues and healing timelines. This guide breaks down what you need to know about surgical suture types, from material composition to practical applications.
You’ll learn which sutures dissolve on their own, which require removal, and why surgeons pick certain threads for different body parts.
What Are Nahttypen?
Nahttypen refers to the various types of surgical sutures used in medical procedures. These specialized threads close wounds, reconnect tissue, and support healing after injury or surgery.
Medical professionals categorize sutures by several factors:
Material origin: Natural (silk, catgut) or synthetic (nylon, polyester, polypropylene)
Absorption: Absorbable sutures dissolve naturally; non-absorbable types require removal
Structure: Monofilament (single strand) or multifilament (braided strands)
Coating: Some sutures receive coatings to reduce tissue drag and bacterial adherence
The right suture type depends on wound location, tissue type, tension levels, and expected healing time. A facial laceration needs a different thread than an abdominal surgery closure.
Absorbable vs. Non-Absorbable Sutures
The most fundamental distinction separates sutures into two categories based on whether the body breaks them down naturally.
Absorbable Sutures
Your body digests these threads through enzymatic degradation or hydrolysis. They lose tensile strength over days or weeks, then disappear completely.
Common absorbable materials include:
- Catgut (plain and chromic): Natural material from animal intestines, absorbed in 7-10 days (plain) or 21-28 days (chromic)
- Polyglycolic acid (PGA): Synthetic thread that maintains strength for 2-3 weeks
- Polydioxanone (PDS): Retains 70% strength at two weeks, fully absorbed in 6-7 months
- Poliglecaprone (Monocryl): Loses half its strength in one week, absorbed in 91-119 days
Surgeons use absorbable sutures for internal tissues, muscle layers, and areas where suture removal would be difficult or traumatic. According to a 2023 study in the Journal of Surgical Research, absorbable sutures reduced infection rates by 23% compared to non-absorbable types in gastrointestinal procedures.
Non-Absorbable Sutures
These threads remain in your body indefinitely unless surgically removed. They maintain tensile strength for extended periods.
Common non-absorbable materials include:
- Silk: Natural protein fiber, easy to handle, but loses strength over time
- Nylon (Ethilon): Synthetic monofilament with high tensile strength
- Polypropylene (Prolene): Minimal tissue reaction, often used in vascular surgery
- Polyester (Ethibond): Braided structure with excellent knot security
Medical teams choose non-absorbable sutures for skin closures, cardiovascular procedures, and areas requiring long-term support. They’re preferred when permanent reinforcement is needed or when the suture must stay in place beyond normal healing times.
Monofilament vs. Multifilament Sutures
Suture structure affects how the thread behaves during surgery and healing.
Monofilament Sutures
A single continuous strand creates these sutures. The smooth surface reduces tissue drag and bacterial adherence.
Benefits include:
- Lower infection risk due to the lack of spaces where bacteria can hide
- Minimal tissue reaction
- Smooth passage through tissue
Drawbacks include:
- More difficult to handle and tie securely
- “Memory” effect causes the thread to return to its packaged shape
- More prone to breaking if crushed by surgical instruments
Surgeons typically use monofilament sutures for skin closures, cardiovascular work, and contaminated wounds where infection risk is high.
Multifilament Sutures
Braided or twisted strands create these sutures. The structure provides better handling and knot security.
Benefits include:
- Easier to tie and handle
- Better knot security
- More flexible and pliable
Drawbacks include:
- Higher infection risk as bacteria can inhabit spaces between strands
- Greater tissue drag
- Potential for “wicking” (fluid traveling along the suture track)
Medical professionals prefer multifilament sutures for general closures where handling ease matters more than infection risk.
Common Nahttypen and Their Uses
Different body parts and tissue types require specific suture characteristics.
Skin Sutures
Facial lacerations typically receive:
- Nylon or polypropylene monofilament: Minimal scarring, removed in 3-5 days
- Fast-absorbing gut: For areas where suture removal is difficult (children, inside the mouth)
Body skin closures are often used:
- Nylon: Removed in 7-14 days, depending on location
- Staples: For long incisions with low tension
Internal Organ Sutures
Gastrointestinal surgery requires:
- PDS or Vicryl: Absorbable sutures that maintain strength during critical healing
- Silk: Historically used but now less common due to tissue reaction
Cardiovascular procedures demand:
- Polypropylene: Permanent suture with minimal thrombogenicity
- Polyester: For valve replacements and vascular grafts
Orthopedic Sutures
Tendon repair needs:
- Non-absorbable multifilament: High tensile strength for load-bearing structures
- Large gauge sizes: Thicker threads handle greater stress
Soft tissue closure uses:
- Absorbable multifilament: For subcutaneous layers and fascia
A 2022 meta-analysis in Orthopedic Surgery Advances found that braided non-absorbable sutures reduced tendon repair failure rates by 31% compared to monofilament options.
Suture Sizes and Needle Types
Suture thickness is measured in gauge, with a counterintuitive numbering system.
Understanding Suture Gauges
The scale works like this:
- Larger numbers with zeros (10-0, 11-0): Thinner sutures for delicate work
- Smaller numbers (1, 2, 3): Thicker sutures for high-tension areas
- Zero reference point: 0 is the baseline, with sizes going both directions
Common applications by size:
- 10-0, 11-0: Microsurgery, ophthalmology
- 6-0, 7-0: Facial plastics, hand surgery
- 4-0, 5-0: General skin closure
- 0, 1, 2: Fascia, tendons, high-tension closures
Needle Considerations
Needles attach to sutures in various configurations. The needle shape, point type, and size must match the tissue being sutured.
Needle shapes include:
- Straight needles for accessible areas
- Curved needles (3/8, 1/2, 5/8 circle) for confined spaces
- Compound curves for specific anatomical regions
Point types include:
- Cutting needles for tough tissue (skin, tendon)
- Reverse cutting for enhanced strength
- Tapered needles for delicate tissue (intestine, blood vessels)
- Blunt needles for friable organs (liver, kidney)
Factors Affecting Nahttypen Selection
Surgeons consider multiple variables when choosing suture material.
Tissue Type
Delicate tissues need fine sutures with minimal tissue reaction. Facial skin receives 6-0 or 7-0 nylon. Tough fascia requires 0 or 1 gauge synthetic material.
Blood vessel walls demand tapered needles and smooth monofilament to prevent vessel damage. Skin tolerates cutting needles and either monofilament or braided thread.
Healing Timeline
Fast-healing tissues like mucous membranes work well with rapid-absorbing sutures (5-7 days). Fascia and tendon need sutures that maintain strength for 4-6 weeks or longer.
According to Dr. Sarah Chen, vascular surgeon at Mayo Clinic, “We select suture absorption rates based on tissue-specific healing curves. Skin regains 50% strength in two weeks, but fascial layers take 6-8 weeks to develop adequate tensile strength.”
Infection Risk
Contaminated wounds receive monofilament sutures to reduce bacterial colonization. Clean surgical sites can safely use braided sutures for better handling.
A 2023 study in Surgical Infections demonstrated that monofilament sutures reduced surgical site infections by 18% in contaminated abdominal wounds compared to braided alternatives.
Patient Factors
Children and anxious patients benefit from absorbable skin sutures to avoid removal trauma. Patients with compromised healing (diabetes, immunosuppression) may need longer-lasting sutures.
Cosmetic concerns drive suture choice in visible areas. Fine gauge monofilament produces less scarring than thicker braided options.
Surgeon Preference
Experience with specific suture types influences selection. Some surgeons prefer the handling characteristics of silk, while others favor synthetic materials for their predictable behavior.
Cost considerations also play a role, though patient outcomes typically take priority over price differences.
Potential Complications with Sutures
Even properly placed sutures can cause problems during healing.
Infection
Sutures create a pathway for bacteria to enter tissue. Braided sutures carry a higher infection risk than monofilament options.
Signs of suture infection include:
- Redness extending beyond the wound edge
- Warmth and swelling
- Purulent drainage
- Fever and increasing pain
Treatment typically involves suture removal, wound cleaning, and antibiotics.
Allergic Reactions
Some patients develop hypersensitivity to suture materials. Silk and catgut cause more reactions than synthetic options.
Symptoms include:
- Persistent redness around suture sites
- Itching and rash
- Delayed wound healing
- Granuloma formation (small bumps along the suture line)
Removing the offending suture usually resolves the reaction.
Suture Abscess
Buried sutures can trigger localized infections called suture abscesses. These appear as tender lumps weeks or months after surgery.
Treatment requires drainage and suture removal, even if the suture was intended to be absorbable.
Scarring Issues
Sutures left in place too long cause “railroad track” scarring where the thread entered and exited skin. Removing skin sutures at the appropriate time minimizes this effect.
Tight sutures can cause tissue necrosis and wider scars. Proper tension during closure prevents this complication.
Suture Removal: Timing and Technique
Non-absorbable skin sutures require removal once healing provides adequate strength.
Standard Removal Timelines
Location affects removal timing:
- Face: 3-5 days
- Scalp: 7-10 days
- Trunk: 7-10 days
- Arms and legs: 10-14 days
- Joints: 14 days
- Feet: 14-21 days
Areas with good blood supply heal faster and allow earlier removal. High-tension areas and locations with poor circulation need longer support.
Removal Process
The procedure follows these steps:
- Clean the area with an antiseptic solution
- Cut the suture close to the skin on one side
- Pull the suture through from the opposite side
- Apply adhesive strips if needed for additional support
- Cover with a protective dressing
Proper removal technique prevents pulling contaminated thread through tissue, which could introduce infection.
When to Delay Removal
Some situations require extended suture retention:
- Poor wound healing due to medical conditions
- High-tension closures showing separation
- Patient factors affecting healing (medications, nutrition)
Your healthcare provider assesses wound strength before removing sutures.
Modern Advances in Nahttypen
Research continues to improve suture technology and expand options.
Antibacterial Sutures
Triclosan-coated sutures release antimicrobial agents during healing. A 2022 Cochrane review found these sutures reduced surgical site infections by 29% across multiple surgical specialties.
Commercial products include Vicryl Plus and PDS Plus. The coating dissolves during absorption, providing continuous infection protection.
Barbed Sutures
Tiny barbs along the suture length eliminate the need for knots. These self-anchoring sutures speed closure time and distribute tension more evenly.
Applications include:
- Fascial closure
- Cosmetic procedures
- Orthopedic soft tissue repair
Surgeons report 25-40% faster closure times with barbed sutures compared to traditional knotted techniques.
Smart Sutures
Researchers are developing sutures with embedded sensors that monitor:
- pH changes indicating infection
- Temperature variations
- Tension levels
- Tissue oxygenation
These experimental sutures could provide early warning of complications before clinical signs appear. Current prototypes remain in research phases, with clinical trials expected within the next few years.
Tissue Adhesives
While not technically sutures, tissue adhesives (surgical glues) offer alternatives for certain closures. Cyanoacrylate-based products work well for low-tension skin lacerations.
Benefits include:
- No removal needed
- No needle sticks
- Faster application
- Water-resistant seal
Limitations include lower strength and unsuitability for high-tension areas or areas requiring deep closure.
FAQs
Can I remove my own sutures at home?
You should not remove sutures yourself. Improper removal can cause wound separation, infection, or scarring. Healthcare professionals assess wound healing before removal and use sterile technique to prevent complications.
Why do some sutures itch as they dissolve?
Itching results from the inflammatory response as your body breaks down absorbable sutures. This is normal and usually mild. Severe itching with redness or drainage may indicate infection or allergic reaction and requires medical evaluation.
Do thicker sutures leave bigger scars?
Generally yes. Finer gauge sutures create smaller puncture holes and produce less visible scarring. Facial closures typically use the finest sutures available for cosmetic reasons. However, suture size must match tissue strength requirements.
How long do absorbable sutures take to fully dissolve?
Timing varies by material type. Fast-absorbing gut dissolves in 5-7 days. Vicryl takes 56-70 days. PDS requires 180-210 days for complete absorption. You may feel buried sutures as small lumps until they fully break down.
What should I do if a suture breaks or comes out early?
Contact your healthcare provider immediately. Early suture loss can cause wound separation. Depending on timing and healing progress, the wound may be fine or may require resuturing. Keep the area clean and covered until evaluated.