Suture Options in Hysterectomy for Gynecological Cases

Abstract

Gynaecologic procedures, including hysterectomy, have evolved significantly in recent years. Hysterectomy is one of the most commonly performed surgical procedures for women, typically indicated for conditions such as uterine fibroids, abnormal uterine bleeding (AUB), and pelvic organ prolapse. The choice of suture is crucial in abdominal hysterectomy, with various types of sutures being utilized based on the surgical requirements. Barbed sutures, for example, are commonly used in laparoscopic vaginal cuff closure and other plastic surgeries due to their ability to secure tissue without the need for knot-tying, thus reducing tension along the suture line. These sutures provide secure bites into tissue and distribute tension evenly, making them ideal for procedures that require minimal tissue trauma. Additionally, sutures can be classified as absorbable or non-absorbable, with absorbable sutures often used for deeper wound layers and non-absorbable sutures for superficial layers that are removed postoperatively. The composition of sutures, whether monofilament or multifilament, also affects handling properties and tensile strength. The use of monofilament sutures is favoured in vascular and microvascular surgeries, while multifilament sutures provide greater flexibility and strength for internal procedures. The choice between natural and synthetic sutures further influences the inflammatory response and degradation rate, with natural sutures generally causing more inflammation. Proper suture selection is critical for minimizing complications such as wound dehiscence, infection, and excessive bleeding, thereby improving patient outcomes. Understanding the properties of various sutures allows for better surgical planning and execution, optimizing both immediate and long-term recovery in abdominal hysterectomy.