Mechanical properties of suture materials in general and cutaneous surgery

Comprehensive studies comparing tensile properties of sutures are over 25 years old and do not include recent advances in suture materials. Accordingly, the objective of this article is to investigate the tensile properties of commonly used sutures in cutaneous surgery. Thirteen 3-0 sized modern sutures (four nonabsorbable and nine absorbable) were tensile tested in both straight and knotted configurations according to the procedures outlined by the United States Pharmacopeia. Glycomer 631 was found to have the highest failure load (56.1 N) of unknotted absorbable sutures, while polyglyconate (34.2 N) and glycomer 631 (34.3 N) had the highest failure loads of knotted absorbable sutures. Nylon (30.9 N) and polypropylene (18.9 N) had the greatest failure loads of straight and knotted nonabsorbable sutures, respectively. Polydioxane was found to have the most elongation prior to breakage (144%) of absorbable sutures. Silk (8701 MPa) and rapid polyglactin 910 (9320 MPa) had the highest initial modulus of nonabsorbable and absorbable sutures, respectively. The new data presented in the study provide important information for guiding the selection of suture materials for specific surgeries.