What are examples of non-absorption sutures?

October 2, 2025 •

4 min read

In modern medicine, the selection of surgical materials is crucial for effective wound healing. One important type is non-absorption sutures, which are made from materials that the body cannot metabolize and must be manually removed after a wound has sufficiently healed. These sutures offer long-term support for tissues that heal slowly or require permanent placement.

Quick Summary

Common examples of non-absorption sutures include natural materials like silk and synthetic ones such as nylon, polypropylene (Prolene), and polyester (Mersilene), along with metallic materials like stainless steel. Their use depends on the specific medical needs, with monofilament versions often used for cosmetic closures and multifilament types favored for secure knots in demanding procedures.

Key Points

Material Variety: Non-absorption sutures come in both natural (silk) and synthetic materials (nylon, polypropylene, polyester), each with unique properties.
Long-Term Support: These sutures are ideal for tissues that heal slowly or require long-term strength, as they are not absorbed by the body.
Filament Type Matters: Sutures can be monofilament (single strand, less tissue drag) or multifilament (braided, better knot security), with each type having distinct advantages and disadvantages.
Material Specific Uses: Polypropylene is favored for cardiovascular surgery due to its inertness, while nylon is commonly used for skin closures.
Removal Requirement: Except for certain permanent internal placements, non-absorbable sutures must be removed by a medical professional after the wound has healed.
Infection Risk: Multifilament sutures, like braided silk, can have a higher risk of infection compared to smooth monofilaments, making careful selection critical for wound management.

Understanding Non-Absorbable Sutures

Non-absorbable sutures are designed to remain in the body, providing continuous support to the tissue. Unlike their absorbable counterparts, which break down over time, these sutures must be either removed by a healthcare professional or, in some cases, left permanently. They are chosen for a variety of surgical applications, especially where long-term wound support is necessary. The materials used can be either natural or synthetic, and they are further categorized by their structure, either as a single strand (monofilament) or multiple braided or twisted strands (multifilament).

Examples of Synthetic Non-Absorbable Sutures

Synthetic materials have become a staple in modern surgery due to their predictable strength and minimal tissue reactivity. Several examples stand out for their specific properties and uses:

Polypropylene (Prolene)

Material properties: A monofilament suture with low tissue drag, meaning it passes smoothly through tissue. It has excellent tensile strength and is inert, causing very little tissue reaction. Its stiffness and high 'memory' (the tendency to return to its original shape) can make handling and knot security challenging.
Common uses: Frequently used in cardiovascular and vascular surgeries where long-term, low-reactivity support is crucial. It's also suitable for skin closure, as its smooth surface reduces the risk of infection.

Polyamide (Nylon)

Material properties: A popular monofilament suture known for its high tensile strength. While classified as non-absorbable, it can lose some tensile strength over time if buried in tissue.
Common uses: Very common for skin closures, as well as ophthalmic and neurological procedures. Its minimal tissue reaction makes it ideal for areas where inflammation needs to be minimized.

Polyester (Mersilene)

Material properties: A braided, multifilament suture material with superior strength compared to silk. It offers long-term tissue support and is not absorbed by the body.
Common uses: Widely used in cardiac and orthopedic surgeries, as well as for nerve and tendon repair due to its strength and durability.

Polybutester

Material properties: An elastic, monofilament suture that is particularly useful in areas that are prone to swelling (edema) during the healing process. It causes minimal tissue reaction and maintains its initial tensile strength.
Common uses: Primarily reserved for skin closures where a bit of elasticity is beneficial during healing.

Examples of Natural Non-Absorbable Sutures

Natural materials were the first to be used for suturing and are still valued for certain applications.

Silk

Material properties: A braided, multifilament suture known for its excellent handling properties and knot security. While technically non-absorbable, it does tend to lose tensile strength and degrade over about two years.
Common uses: Often used in dental surgery, mucosal tissues, and for ligating small vessels. Its pliability and secure knots make it a favorite for surgeons.

Surgical Stainless Steel

Material properties: A metallic suture material that is extremely strong, inert, and offers the best knot security among non-absorbables. It is available in both monofilament and multifilament forms. Its handling can be challenging due to its stiffness and springiness.
Common uses: Used in orthopedic procedures, such as sternal closures, and in infected wounds where its strength and inertness are critical.

Monofilament vs. Multifilament Non-Absorbable Sutures

The structural difference between monofilament and multifilament sutures has significant implications for their use in surgery.

Monofilament Sutures

Characteristics: Made of a single, smooth strand, such as nylon or polypropylene. They pass through tissue with less drag, causing less trauma. The smooth surface also reduces the risk of bacterial harboring, making them suitable for contaminated wounds or cosmetic procedures.
Trade-offs: Can have poor knot security and are stiffer than multifilament sutures.

Multifilament Sutures

Characteristics: Consist of several filaments braided or twisted together, such as silk or polyester. They are easier to handle and provide better knot security.
Trade-offs: The braided structure can harbor bacteria (capillary action), increasing the risk of infection. This feature makes them less ideal for use in infected wounds. Increased tissue drag can also lead to more tissue trauma during placement.

Comparison Table of Non-Absorbable Sutures


Feature	Silk	Nylon	Polypropylene	Polyester	Stainless Steel
Material Type	Natural (Protein)	Synthetic	Synthetic	Synthetic	Metallic
Filament Type	Multifilament (Braided)	Monofilament	Monofilament	Multifilament (Braided)	Mono or Multifilament
Handling/Knot Security	Excellent	Fair/Difficult	Fair/Difficult	Good	Poor/Difficult
Tensile Strength	Low/Degrades	High (Loses over time)	Excellent	High	Excellent (Strongest)
Tissue Reaction	Moderate	Low (Inert)	Very Low (Inert)	Low	Very Low (Inert)
Key Applications	Dental, mucosal tissue	Skin closure, ophthalmic	Vascular, skin closure	Cardiac, orthopedic	Orthopedic, sternal closure

How Non-Absorbable Sutures Impact Recovery

Choosing the correct non-absorbable suture type is critical for patient recovery. For external wounds, like skin incisions, a monofilament suture like nylon is often preferred for its reduced infection risk and easier removal. In procedures where long-term strength is paramount, such as in cardiovascular repair, polypropylene is the material of choice. Surgical judgment, based on the tissue type, required strength, and infection risk, guides the final selection.

For most external stitches, removal is a simple, relatively painless process performed by a healthcare provider. However, when left permanently in the body, such as for internal organ support or orthopedic procedures, the inert nature of the synthetic materials is key to preventing complications. Regardless of the type, monitoring the wound site for signs of infection or other complications is crucial for successful healing.

Conclusion

Understanding what are examples of non-absorption sutures provides insight into the tools used in a vast range of surgical procedures. From the easy-handling silk used in delicate tissues to the powerful and inert stainless steel wire for orthopedic applications, these materials play a vital role in ensuring long-term tissue stability. Their non-degradable nature makes them essential for external closures and internal repairs that need to withstand significant stress or require permanent support. Healthcare professionals meticulously evaluate the best option for each unique clinical scenario to achieve the most favorable outcome for the patient. For more detailed information on wound care, consult resources like the National Institutes of Health.

Frequently Asked Questions

The main difference is that non-absorption sutures are permanent and must be removed or remain in the body, while absorption sutures are designed to be broken down and metabolized by the body over time.

The removal of external non-absorbable sutures is generally a quick and relatively painless process. You may feel a slight tugging sensation, but it should not be painful.

Yes, in certain surgical situations, non-absorbable sutures are intentionally left in the body permanently. Examples include vascular surgery or certain orthopedic procedures where long-term support is necessary.

Nylon and polypropylene are frequently used for skin closure. Their monofilament structure glides smoothly and is less likely to harbor bacteria, which is beneficial for external wounds.

Surgical stainless steel is used because it is the strongest and most inert of the non-absorbable materials. This makes it ideal for high-stress applications like sternal closures in cardiac surgery and in infected wounds.

While technically classified as non-absorbable, silk sutures do degrade and lose tensile strength over about two years. However, they are not absorbed by the body in the same way as true absorbable sutures and are treated as non-absorbable.

Leaving external non-absorbable sutures in for too long can lead to complications such as infection, excessive scarring, the formation of an abscess, or the suture becoming buried under growing tissue.

Multifilament sutures like silk are often described as having better handling properties and knot security, making them easier to work with. Monofilament sutures, being stiffer, can have poorer knot security but cause less tissue drag.