What Suture Size Should I Use?
By Phil Zeltzman, DVM, Dipl. ACVS
 A Veterinary Practice News reader asked an excellent but tough question: “What suture size should I use?” It is very difficult to answer this question, as there are multiple variables. Choices are debatable and subjective. Among many other factors, suture sizes will obviously vary with the size of the patient, hence the ranges suggested.
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A Refresher on Suture Materials
There are several ways to classify suture material, mentioned with a few suture types.
Absorbable vs. non absorbable:
Absorbable sutures include catgut, polyglactin 910 (Vicryl), polyglycolic acid (Dexon) , polydioxanone (PDS) and polyglecaprone (Monocryl).
Non absorbable sutures include silk, polypropylene (Prolene) and nylon.
Natural vs. synthetic:
Natural sutures include cotton, catgut and silk.
Synthetic sutures include polyglactin 910 (Vicryl), polyglycolic acid (Dexon), polydioxanone (PDS), polyglecaprone (Monocryl), polypropylene (Prolene) and nylon.
Multifilament vs. monofilament
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Multifilament sutures include catgut, silk, polyglactin 910 (Vicryl) and polyglycolic acid (Dexon).
Monofilament sutures include polydioxanone (PDS), polyglecaprone (Monocryl), polypropylene (Prolene) and nylon.
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That said, here are some general guidelines for various procedures:
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Procedure
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Suture Size
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Suture Type
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Enterotomy/Enterectomy
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4/0 or 3/0
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Monofilament, absorbable
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Oral surgery such as tooth extraction
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5/0 to 3/0
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Absorbable. Braided is less irritating to the patient
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Vessel ligation
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4/0 to 0
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Monofilament, absorbable
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Cystotomy
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4/0 or 3/0
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Monofilament, absorbable
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Splenectomy (ligatures)
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4/0 or 3/0
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Monofilament, absorbable
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Subcutaneous tissue
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4/0 or 3/0
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Monofilament, absorbable
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Intradermal
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4/0 or 3/0
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Monofilament, absorbable
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Skin
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4/0 or 3/0
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Monofilament, non absorbable
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Aural hematoma
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4/0 to 2/0
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Monofilament, non absorbable
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Castration and spay (pedicles)
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4/0 to 2/0
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Monofilament, absorbable
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What Suture Size Should I Use?
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