Since two-thirds of health care dollars are spent on consumable supplies and physician preference items, ECRI Institute decided to release a study that assessed more than 30 types of surgical sutures.

“Many times, surgeons train on sutures from one manufacturer and may not be inclined to change to another because of a certain level of comfort they have with the product,” Julie Miller, project officer, Health Devices Group at ECRI, told HCB News. “Facilities should make sure the sutures (and the attached needles) they are selecting meet the safety, workflow, and performance requirements from their clinicians.”

This evaluation study is intended to provide health care organizations with data that can help them make informed purchases. Sutures can cost a small hospital $51,000, a medium-sized hospital $320,000 and a large hospital $1.3 million.
The analysts evaluated performance and safety-related factors including strength, knot retention and needle sharpness. Some sutures were found to have major knot slippage, which could lead to harm like patient bleeding.

They focused on most of the available suture product lines from Ethicon and Medtronic Minimally Invasive Therapies, which are two of the leading manufacturers in the market. The product lines differ significantly in terms of construction, material, size, absorbability, needle shape and tip geometry.

“Sutures come in both nonabsorbable materials for indefinite wound support and absorbable materials for short-, mid-, or long-term support,” said Miller. “Within each of those categories, they vary in construction between monofilament sutures which may cause less tissue trauma, and braided sutures which may be stronger or more pliable.”

Surgeons have very different requirements for each individual procedure and patient. For example, the same patient could require several different types of sutures depending on the tissue layer that is being closed.

“Further, a neonatal patient is going to have very different tissue properties than an elderly patient,” said Miller. “The different suture options allow for the appropriate type of closure for what the situation requires.”

She noted that clinicians may be surprised to see the categories where their findings do or do not reinforce their beliefs about the sutures they use on a daily basis.

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