Needles and Suture Thread
- Surgeons historically used reusable needles with separate suture thread.
- Swaged needles consist of a pre-packed needle attached to a specific length of suture thread.
- Atraumatic needles have a narrower suture end, reducing tissue trauma.
- Needles can be straight, various curved shapes, or compound curve.

Suture Materials
- Suture material can be absorbable or non-absorbable.
- Monofilament fibers have less tensile strength but create less tissue trauma.
- Polyfilament (braided) sutures have greater tensile strength but can cause greater tissue reaction.
- Natural absorbable materials include plain catgut, chromic catgut, and fast catgut.

Natural Absorbable Materials
- Plain catgut, chromic catgut, and fast catgut are produced from collagen extracted from bovine intestines.
- Plain Gut maintains strength for 7-10 days and degrades fully in 10 weeks.
- Chromic Gut maintains strength for 21-28 days and degrades fully in 16-18 weeks.
- Fast Gut is treated with heat for more rapid absorption and has a tensile strength of less than a week.

Absorbable vs Non-absorbable Sutures
- Absorbable sutures are degraded via proteolysis or hydrolysis and are used internally or for individuals unlikely to return for suture removal.
- Short-term wound outcomes are equivalent for absorbable and non-absorbable sutures.
- Natural absorbable materials have high tissue reactivity, while non-absorbable synthetic sutures have the lowest tissue reactivity.
- Non-absorbable sutures require removal, while absorbable sutures are not removed.

Suture Techniques
- Types of Stitches/Suturing Techniques: interrupted stitch, mattress stitch, continuous stitch, continuous locking stitch, chest drain stitch, corner stitch.
- Placement: mounting needle, pressing into flesh, tying knot.
- Stitching Interval and Spacing: considerations for wound lengthening and burst wounds.
- Layers: single layer vs two layer suturing.
- Removal: timing of suture removal, techniques for removal.