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The absorbable sutures are degraded in the tissues by a process of hydrolysis, by which they progressively lose their resistance to tension.
The degradation by hydrolysis causes a minimal reaction in the tissues. This process has two stages. In the first stage, the tensile strength decreases gradually and almost linearly. The second stage usually overlaps the previous one and is characterized by the loss of suture mass. In this phase, the leukocytes act to remove the remains of suture cells and materials from the wound.
Therefore, the loss of tensile strength and absorption are different processes. For this reason, the loss of tensile strength is the most important value to consider when selecting an absorbable suture.
There are different types of absorbable sutures with different periods of tensile strength and absorption, which will be selected depending on the tissues to be sutured.
Non-absorbable sutures consist of non-biodegradable material, so they can not be digested by enzymes or hydrolyzed in tissues.
Ultimately, fibroblasts encapsulate them permanently, so they maintain their maximum resistance over time, except in the case of being removed stitches in the post-surgical (skin suture).
There are different types of non-absorbable sutures with different levels of resistance. They can be monofilament or multi-filament which will be selected depending on the tissues to be sutured or at the discretion of the professional.