How do you determine if a suture is dissolvable or not?

How to Determine if a Suture is Dissolvable

Check the suture packaging label or surgical documentation first—this is the most reliable method to identify whether a suture is absorbable (dissolvable) or non-absorbable.

Primary Identification Methods

1. Packaging and Documentation

• The suture package will explicitly state whether the material is "absorbable" or "non-absorbable" 1
• Surgical records should document the specific suture material used (e.g., Vicryl, Monocryl, Prolene, Ethibond) 2
• Brand names provide immediate identification: absorbable sutures include polyglactin 910 (Vicryl), poliglecaprone (Monocryl), polyglyconate (Maxon), and polyglycolic acid (Dexon); non-absorbable sutures include polypropylene (Prolene) and polyester (Ethibond) 2, 1

2. Visual and Physical Characteristics

Color coding patterns:

• Rapidly absorbable sutures like Vicryl Rapide are often violet or undyed 2, 3
• Standard synthetic absorbable sutures (Vicryl, Monocryl) typically come in violet, undyed, or other colors 2
• Non-absorbable sutures like Prolene are commonly blue or clear 3

Material structure:

• Monofilament sutures (single strand) can be either absorbable (Monocryl, Maxon) or non-absorbable (Prolene) 2, 1
• Multifilament/braided sutures can also be either type (Vicryl is absorbable; Ethibond is non-absorbable) 2, 4

3. Clinical Context and Timeline

Absorption timeframes help identify suture type:

• Rapidly absorbable sutures (Vicryl Rapide) dissolve within 42 days and are preferred when suture removal is undesirable 2
• Standard slowly absorbable sutures maintain tensile strength for 42-49 days (Maxon) to 65-80 days (PDS), with complete dissolution at 120-240 days 2, 5
• Non-absorbable sutures remain indefinitely and require removal 2, 1

Location-specific patterns:

• Facial wounds often use absorbable sutures (5-0 Vicryl Rapide or similar) to avoid removal and reduce patient discomfort 6, 3
• Deep tissue layers typically use absorbable sutures (4-0 Monocryl or similar) 3
• Fascial closures in emergency laparotomy preferentially use slowly absorbable monofilament sutures 2
• Perineal repairs use absorbable sutures (catgut, Vicryl, Monocryl, or Maxon) 2

Common Pitfalls to Avoid

• Don't rely solely on appearance: Both absorbable and non-absorbable sutures can be monofilament or braided, making visual distinction unreliable without knowing the specific material 2, 1
• Don't assume all buried sutures are absorbable: Some deep sutures may be non-absorbable depending on the surgical indication 1
• Don't confuse "synthetic" with "non-absorbable": Modern synthetic sutures include both absorbable (Vicryl, Monocryl, Maxon, PDS) and non-absorbable (Prolene, Ethibond) options 2, 1

Practical Algorithm

1. First: Check the suture package or surgical documentation for explicit labeling 1
2. Second: Identify the brand name (Vicryl/Monocryl/Maxon = absorbable; Prolene/Ethibond = non-absorbable) 2, 1, 3
3. Third: Consider the clinical context—facial wounds and internal layers typically use absorbable sutures 2, 6, 3
4. Fourth: If uncertainty remains after 6-8 weeks and sutures are still visible, they are likely non-absorbable and require removal 2, 5