Surgical gut suture is an absorbable, sterile surgical suture composed of purified connective tissue (mostly collagen) derived from either the serosal layer of beef (bovine) or the submucosal fibrous layer of sheep (ovine) intestines. Surgical gut sutures are available in plain or chromic.
Surgical gut suture is indicated for use in general soft tissue approximation and/or ligation, including use in ophthalmic procedures, but not for use in cardiovascular and neurological tissues.
Surgical gut sutures, being absorbable, should not be used where extended approximation of tissue is required.
When surgical gut suture is placed in tissue, a moderate tissue inflammation occurs, which is characteristic of foreign body response to a substance. This is followed by loss of tensile strength and a loss of suture mass, as the proteolytic enzymatic digestive process dissolves the surgical gut. This process continues until the suture is completely absorbed.
Many variable factors may affect the rate of absorption. Some of the major factors which can affect tensile strength loss and absorption rates are:
Type of suture: plain gut generally absorbs more rapidly than chromic gut.
Infection: surgical gut is absorbed more rapidly in infected tissue than non-infected tissue.
Tissue sites: surgical gut will absorb more rapidly in tissue where increased levels of proteolytic enzymes are present, as in the secretions exhibited in the stomach, cervix and vagina.