410 Appendix B

Table B.2 Selected Sutures Appropriate for Common Neonatal Procedures

Type Raw Material Tissue Use Advantages Disadvantages

Vicryl or Dexon Synthetic copolymers Subcutaneous

Fascia

Mild tissue reaction (2+)

Low infectivity rate

For absorbable suture or

ligature

Maintain knots

Cannot be used for approximation

under stress 60% strength at 2 wk

Safety in cardiovascular tissue not

established

Requires flat and square ties with

extra throws

Silk Braided protein filament

from silk worm

Skin

Fascia

Best knot holding

Easiest to use

Strong for size

High infectivity rate

High tissue reaction

Nylon Polyamide polymer

Mono- or braided filament

Monofilament: skin closure

and plastic surgery

Braided: any tissue

Inert

Least tissue reaction

Lowest infectivity

Poor knot holding, requires at least six

ties

Not as easy to handle

Prolene Polymer of propylene

Monofilament

Skin

Pull-out subcuticular

Inert

Low tissue reaction (0–1+)

Low infectivity

Very strong for size

Holds knot better than nylon

Remains encapsulated

Skin closure tape Reinforced nylon filaments to back or

porous paper tape

Skin superficial laceration or

when subcuticular suture

also used

Easy to place and remove

Quick to apply

No skin reactivity

Least scarring

No anesthetic required

Will not stick to wet or oily skin (wipe

skin with alcohol first)

Will not hold if wound is widely

separated or under tension

Cannot evert wound edges