Anatomy - Suturing and Knotting Technique

In all surgical fields, superficial and deep wounds are inflicted, organs are partially or completely resected, or structures – such as blood vessels – are severed. The resulting defects must be closed again using sutures and threads to support biological healing. In the past, threads made from natural materials (sheep intestine, bovine collagen, or even silk) were primarily used. With the introduction of "Carbol–Catgut" in 1860, the first “real” suture material was established in surgery.
From Egypt, there are depictions from around 3000 BC that already show surgical instruments like eye needles. The oldest surviving suture is found in the abdomen of a mummy and was performed around 1100 BC.
Since the discovery of bovine spongiform encephalopathy (BSE), suture materials from animal products are no longer permitted for use.
Modern products are today divided into absorbable (for example, made from polydioxanone or polyglactin) and non-absorbable threads (for example, made from polyamide or polypropylene). Depending on the material absorption, the absorbable threads are characterized by different half-lives; thus, various time spans can be achieved with regard to the remaining tensile strength of the threads. Material absorption is not to be equated with the tensile strength of the threads, however, with increasing half-life, the duration of strength also increases.
Suture materials are classified according to their structure into monofilament, braided, multifilament, or pseudomonofilament threads, which will be discussed in more detail in the chapter on the different areas of application.