What Suture Size Should I Use?

“What suture size should I use?” A Veterinary Practice News reader asked an excellent but tough question.

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.

That said, here are some general guidelines for various procedures:

Procedure Suture Size Suture Type
Enterotomy/Enterectomy 4/0 or 3/0 Monofilament, absorbable
Oral surgery such as tooth extraction 5/0 to 3/0 Absorbable. Braided is less irritating to the patient
Vessel ligation 4/0 to 0 Monofilament, absorbable
Cystotomy 4/0 or 3/0 Monofilament, absorbable
Splenectomy (ligatures) 4/0 or 3/0 Monofilament, absorbable
Subcutaneous tissue 4/0 or 3/0 Monofilament, absorbable
Intradermal 4/0 or 3/0 Monofilament, absorbable
Skin 4/0 or 3/0 Monofilament, non absorbable
Aural hematoma 4/0 to 2/0 Monofilament, non absorbable
Castration and spay (pedicles) 4/0 to 2/0 Monofilament, absorbable

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
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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