Choose the Perfect Suture!

How do you choose which suture you need?
What are the different types of suture available?
Whenever I'm doing a case it's the same question every time...what suture do you want doc?
If you're unable to answer this question for the cases on your schedule today then this video is for you!
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Moore's Clinically Oriented Anatomy citizensurgeon.co/Moore
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Schwartz Principles of Surgery citizensurgeon.co/Schwartz
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Zollinger's Atlas of Surgical Operations citizensurgeon.co/Zollinger
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Every day I have to make a decision on what type of suture I'm going to use for various problems. If you don't know what suture you're going to use you're going to be standing there with a blank look and mounting anxiety.
What suture for a bowel anastomosis?
What suture for sewing skin?
What suture for a fascial closure?
What suture for a vascular anastomosis?
There are so many different kinds of suture to use that it can make your head spin.
In this video on surgical suture I'm going to make it easy.
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Surgical suture can be broken down into three main categories as every suture has these three properties:
1. It's either monofilament or multifilament (braided)
2. It's either synthetic or biologic (natural) in source
3. It's either absorbable or permanent.
For example, monocryl is a monofilament, synthetic absorbable suture!
In this video I'm going to go through the strengths and weaknesses of each of the categories. I'm going to tell you why I love to tie with multifilament suture and why monofilament suture can be a pain!
One thing that is incredibly important with surgical suture is knowing how long each suture is going to last. For example, how long does monocryl last in a wound? How about PDS? Vicryl? Why is FAST absorbing gut a poor suture choice for fascia? What makes it a great suture choice for closing facial lacerations?
I'm also going to tell you what suture I like for the following problems:
1.). Sewing skin
2.). Bowel anastomosis
3.). Fascial closure
4.). Vascular anastomosis
Check out these AMAZING timestamps and fast forward if you need to:
Start 00:00
Strengths and Weaknesses of Different Suture 03:05
How is Suture Sized 11:54
Absorbable Suture: What, Why When? 13:44
What suture to use for what purpose? 19:38
REFERENCES
Ethicon Suture Guide - citizensurgeon.co/ethicon
Stat Pearls Suture citizensurgeon.co/StatpearlsS...
SOME RECENT READS
The Miracle Morning by Hal Elrod - citizensurgeon.co/MiracleMorning
Atomic Habits by James Clear - citizensurgeon.co/AtomicHabits
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WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!
DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. If you have medical questions definitely consult a medical professional. Good luck and enjoy!
Affiliate Links - There are a few links in the description that may lead to a kickback to me to help support the channel.

[@schan2975]

Still remember what my consultant told me while I was doing my O&G placement back in med school. PDS stands for "Pretty Damn Strong", that's why you use it to close the abdominal fascia.

[@citizensurgeon]

Love it, those stories stick with you, thanks for sharing

[@user-cr8gx4jl1h]

Thank you. I am a newer OR Nurse and I have struggled learning suture because I'm told to get suture but can't see where the surgeon uses it. Last week I was asked to get suture and I said "SH or CT?" The surgeon said he was using it for bowel. I started studying deeper into my books and as found your videos. Big help.

[@OluwatomisinAremu-bs7ij]

Well-done doctor

[@abuderbala7414]

amazing video doc , very helpful and informative . please keep the great work , thank you very much

[@asubabong5354]

Thanks

[@chrispin8996]

You’re doing a great job, I appreciate your dedication and sharing knowledge. Thank you

[@citizensurgeon]

Awesome thanks! Glad you enjoyed!

[@annejoylemasurier9922]

Great video, I am doing my SFA placement and I needed to know more about the sutures so this information that you have provided has given me the basic knowledge of sutures and I love the category or classification, beautifully done. I would like to know about the retratures used in different specialities next and why.

[@TheBlurayHacker]

Your videos are a god send 🙏🙏🙏 The topics you choose are always the most relevant. I thank you.

[@citizensurgeon]

So happy you enjoyed it, I try to keep it real!

[@ahwang4628]

Outstanding video on sutures! It should be a required viewing by all the medical students and surgical residents.

[@citizensurgeon]

Thanks so much! I’ll have another one coming up on needles, happy you found this helpful!

[@VanessaManwau]

Thanks much i wana know more on sutures this helps alot

[@somecallmedaniel16]

Helpful for a junior surgery resident here - thanks!

[@citizensurgeon]

Thanks Dr. Gehle! Glad it is helpful, let me know if there is a topic you would like me to cover!

[@Idontrememberasking]

Thank you, so helpful

[@citizensurgeon]

Awesome! So happy you enjoyed it!

[@VanceAMayle]

I learned this while in Surgical assistant school. I love being a first assistant!

[@citizensurgeon]

Awesome Vance, love that you love being in surgery, I definitely agree!

[@nasrullahjan1231]

Wonderful ..thanks again for this video

[@citizensurgeon]

Absolutely!

[@DrSarychev]

Great job! Thank you!

[@citizensurgeon]

Absolutely! Glad you enjoyed it!

[@harrimakela1433]

Thanks, just want to say, you are very motivating! :)

[@citizensurgeon]

Awesome, comments like yours keep me motivated to keep motivating! So happy you found value!

[@nohandle740]

thanks

[@annagrijalva7127]

Great information ❤

[@citizensurgeon]

Thanks so much Anna!

[@blahblah5308]

Perfect video

[@citizensurgeon]

Rockin, glad you enjoyed it!

[@walawymohammed4311]

I love it 😻

[@citizensurgeon]

Awesome!

[@mimishaadmasu5956]

Thank you so much doc, its effective and awesome 🙏

[@citizensurgeon]

Sweet, glad you liked it!

[@mimishaadmasu5956]

@@citizensurgeon absolutely doc 🥰

[@Sky-gy2xz]

Thank you so much ❤️for video

[@citizensurgeon]

Absolutely love that you found it helpful!

[@iestynmalaki9712]

love this. Final yr med student from Samoa 🇼🇸

[@citizensurgeon]

Awesome! Congratulations on making it to final year! What kind of doctor do you want to be?

[@falmingz]

thanks for the video and nice infos god bless you

[@citizensurgeon]

Thanks so much Zaid, I’m glad you found value!

[@sidharthagoutam5794]

Huge fan of yours. Surgery resident from India

[@citizensurgeon]

Awesome! Thanks Dr. Goutam! Let me know if there is a topic you want me to cover!

[@UnyimeJohn-fw2jt]

Dr thank you so much for this video,I can suture boldly now am not afraid

[@citizensurgeon]

Awesome! So happy it helped!

[@paulak929]

Thank you so much for this video, easy to understand.

[@citizensurgeon]

Paula I’m so pumped you enjoyed it!

[@paulak929]

@@citizensurgeon soon I will be in clinic hours as a surgical tech. I am so nervous; thanks again.🙏

[@citizensurgeon]

@@paulak929 awesome, you’re going to be great, just be patient :)

[@medico2024medico]

thank you dr can you make a vedio on what type of closure we mostly use for differnt circumstances... when simple when continuos when matress and so on.

[@citizensurgeon]

Absolutely, thanks for your support. Just put out a video on deep ties, will get some wound closure videos out as well.

[@oscarmolina32]

You’re my idol

[@citizensurgeon]

Hahaha…too funny! Happy to inspire! Have a great weekend!

[@laidyssolar8813]

Thank you so much for this video doctor! I am a recently graduated surgical tech and after watching this video I have a better understanding of how and why surgeons use the different type of sutures.

[@laidyssolar8813]

following up on that needles video too!! thanks again!!

[@citizensurgeon]

Thanks so much for the comment and I’m so happy you found this valuable, there are loads of different sutures and needles and I tried to at least tackle the suture part :)

[@rightpa]

Thanks for the video Dr. Pearson. It was very helpful. Clear and well organized so it really helped get the info through my thick skull. Subbed. One thing I noticed: The stated strengths on the chart at 13:59 are flipped. The >3-0 column should have the higher retained tensile strength after placement.

[@citizensurgeon]

Thanks so much for the feedback, apologies for the mistake but happy you noticed it! Have a Great day!

[@fatmaabdirahman9872]

My faviorate department of medicine ❤❤SURGERY❤❤

[@citizensurgeon]

Awesome! Mine too!

[@fatmaabdirahman9872]

@@citizensurgeon keep going Dr citizen

[@kerrickakinola7398]

great introduction video. Gen Surg resident here.

[@citizensurgeon]

Awesome Kerrick! So glad you found me, sorry for the delayed reply, somehow I missed you! Let me know if there is a topic you want covered!

[@petersielski3550]

Thanks for putting together this video. As a surgical trainee I find it hard to find material related to more practical and comprehensive guide to fundamental elements in surgery.

[@citizensurgeon]

Thanks so much Peter, I was thinking about doing a needle one as well…helpful?

[@petersielski3550]

@@citizensurgeon Absolutely Dr. Pearson, that would be wonderful! This is another topic that could use some clarity and I am sure many of us would be greatly appreciative.

[@blueworldadam]

Omg god finally i understand size and needle shape

[@citizensurgeon]

Awesome!!

[@naturevideos.8802]

Great video Doc. I'm a layperson showing interest in sutures as I had rotator cuff repair last year using permanent synthetic braided suture in a knotless repair. My question is.. are permanent sutures used in such tendon repairs as they need long term support to heal and the absorbable sutures lose their tensile strength too quickly? Thank you once again for a great video.

[@citizensurgeon]

Thanks for the question and Yes! Every different operation has different goals. Absorbable sutures, for example those for a bowel anastomosis or sewing skin, we want to go away over time. Permanent sutures we want to hold their strength forever and we see those used in both orthopedic surgery and in vascular surgery. Long term support is exactly right. I appreciate you engaging and I'm glad you enjoyed the video. Thank you again!

[@naturevideos.8802]

Thanks Doc. All the way from Australia.

[@jorgeluismosquerazavaleta3403]

Amazing. Please needles video next 🙏🏽

[@citizensurgeon]

Sounds good will do, I have a short on needles that will give you a quick once over :)

[@citizensurgeon]

Which needle do you want to use? #shorts kzbin.info0CBSk5GANKA?feature=share

[@andresraulmalpartida]

I learned a lot , that was awesome , quick question do I need to close the subcutaneous fat ? A professor told me to use cat gut

[@citizensurgeon]

Thank you for engaging, you can certainly closer the adipose layer of the abdominal wall to decrease dead space and this suture line can be placed in scarpa’s layer. I think catgut has such a short half-life that it may not provide sufficient strength. I personally use a 3-0 victuals for this layer in adults, sometimes as a running continuous layer and other times as interrupted sutures. Hope that is clear.

[@andresraulmalpartida]

@@citizensurgeon thanks for replying . By “victuals “ do you mean vicryl ?

[@Tom-kt8lu]

Is it fair to say that, from a purely cosmetic point of view, skin-closures are best made with non-absorbable sutures and then the sutures removed at a time indicated by on monitoring of the wound?

[@jermainegiles631]

🅿🆁🅾🅼🅾🆂🅼 🙃