Absorbable Vs Non-Absorbable Sutures

Have you ever wondered why some stitches dissolve while others have to be taken out? The answer lies in the two main types of sutures used in medical care.

Absorbable stitches are made to break down naturally in the body, while non-absorbable stitches stay in place and either need to be removed or are left in permanently. This basic difference plays a big role in how wounds heal and what kind of care is needed after surgery.

In this guide, we’ll explain what absorbable and non-absorbable stitches are, how they work, when doctors use them, and what that means for you as a patient.

What Are Absorbable Sutures?

Absorbable sutures are special threads designed to naturally break down in the body over time. This means they don’t need to be removed, making them ideal for internal stitches or for patients who may not return for a follow-up visit.

These sutures break down in two main ways. Natural materials like catgut are broken down by the body’s enzymes in a process called enzymatic degradation.

Synthetic sutures, on the other hand, use a process called hydrolysis—where fluids in the body slowly dissolve the suture. Hydrolysis tends to be more reliable and causes fewer unexpected reactions.

Some commonly used absorbable sutures include:

• Vicryl (polyglactin 910): dissolves in about 56–70 days
• PDS (polydioxanone): holds strength for 4–6 weeks
• Monocryl (poliglecaprone 25): fully absorbed in 91–119 days
  

These options give surgeons flexibility to choose the right suture for each type of wound and healing timeline.

What Are Non-Absorbable Sutures?

Non-absorbable sutures are made to stay in the body without breaking down over time. Because the body can't naturally dissolve these materials, they provide long-lasting support—especially in areas under constant stress or where permanent reinforcement is needed.

Unlike absorbable sutures, non-absorbable ones resist both enzymatic breakdown and hydrolysis. 

While the body may form a layer of tissue around them, the sutures themselves stay intact. This makes them essential in surgeries like heart procedures, orthopedic repairs, or high-tension wound closures where strength must be maintained long-term.

Common types of non-absorbable sutures include:

• Nylon (Polyamide): strong with good flexibility
• Prolene (Polypropylene): causes minimal tissue reaction
• Stainless Steel: extremely strong, used in specialized procedures

These sutures are a reliable choice when durability and long-term support are critical. Surgeons carefully select them based on the specific needs of the procedure and the demands placed on the healing tissue.

Suture Classification by Material and Structure

Sutures are classified based on the materials they’re made from and their physical design, which both affect how they perform during healing.

Natural Absorbable Sutures

Plain and chromic catgut are traditional absorbable sutures that break down through enzymatic degradation. Plain catgut dissolves quickly—within 7 to 10 days—making it suitable for fast-healing tissues. 

In contrast, chromic catgut is treated with chromium salts to slow absorption, extending its use to about 2 to 3 weeks while remaining biocompatible.

Synthetic Absorbable Sutures

Modern synthetic sutures offer greater predictability and control, thanks to their breakdown through hydrolysis.

Among them, Vicryl (polyglactin 910) is known for its excellent handling and absorption within 56–70 days. 

Similarly, Dexon (polyglycolic acid) provides reliable strength for 2–3 weeks before gradually dissolving. 

For wounds that require longer support, PDS (polydioxanone) maintains tensile strength longer than most absorbables, making it ideal for slow-healing tissues. 

Meanwhile, Monocryl (poliglecaprone 25) combines low tissue reactivity with predictable absorption over 91–119 days.

Natural Non-Absorbable Sutures

Silk remains popular because of its exceptional handling and secure knots. Although it’s classified as non-absorbable, silk slowly loses strength over months to years due to enzymatic breakdown. 

In contrast, surgical steel offers maximum tensile strength and is completely inert, making it indispensable for specialized cardiovascular and orthopedic surgeries where permanent support is crucial.

Synthetic Non-Absorbable Sutures

Nylon (Ethilon) is valued for its excellent elasticity, strong retention, and minimal tissue reaction. Similarly, Prolene (polypropylene) stands out for its inertness and smooth passage through tissue. 

For high-tension repairs, polyester sutures provide exceptional strength. Meanwhile, Novafil combines the ease of handling found in monofilament sutures with the durability required for demanding surgeries.

The Ultimate Comparison: Absorbable vs Non-Absorbable

When deciding between absorbable and non-absorbable sutures, understanding their key differences can help clarify which option is best suited for a particular surgical need. Below is a detailed comparison highlighting the main features of each type.

By keeping these differences in mind, patients and surgeons can work together to choose the suture type that best fits the specific needs of the procedure and the patient’s recovery.

Clinical Applications and Use Cases

Absorbable sutures are ideal for internal tissue repairs because removing them would mean another surgery. They are commonly used for closing fascia, subcuticular skin layers, and reconnecting organs. 

In pediatric surgeries, absorbable sutures help avoid the stress of removal for young patients.

These sutures are also favored in cosmetic procedures for subcuticular closures, as they promote healing with minimal scarring. 

Additionally, absorbable sutures are a good choice when follow-up visits are difficult or uncertain, reducing the risk of complications from leftover stitches.

On the other hand, non-absorbable sutures are necessary for high-tension areas that need lasting support. They are used in cardiovascular surgeries, tendon repairs, and orthopedic procedures where the material must remain strong over time. 

For adult skin closures, non-absorbable sutures often provide better cosmetic results and allow controlled timing for removal.

Non-absorbable sutures also work well in cases where precise tension is important, as they keep their strength throughout healing. 

In emergency surgeries where reliable suture performance is critical, surgeons usually prefer these proven, durable options.

Frequently Asked Questions

How long do absorbable sutures take to dissolve?

Absorption times vary by material type and individual patient factors. Vicryl typically dissolves in 56-70 days, while PDS maintains strength for 4-6 weeks before gradual absorption over several months. Factors like infection, patient age, and tissue type can influence these timelines.

What happens if non-absorbable stitches aren't removed?

Non-absorbable sutures left in place can cause chronic inflammation, infection, or suture granulomas. External sutures may create permanent marks or scarring. However, internal non-absorbable sutures are often intentionally permanent and generally well-tolerated.

Do dissolving stitches leave a scar?

All sutures can potentially leave scars, but absorbable sutures placed subcuticularly often result in minimal scarring. The absorption process typically doesn't increase scarring compared to removed sutures when properly placed and cared for during healing.

Can you be allergic to sutures?

Suture allergies are rare but possible, particularly with natural materials like catgut or silk. Synthetic materials generally cause fewer allergic reactions. Signs include excessive redness, swelling, or delayed healing around suture sites.

Trust the Right Choice for Your Surgical Needs

Knowing the difference between absorbable and non-absorbable sutures is important, but mastering how to use them properly takes hands-on practice. For healthcare professionals aiming to excel in suturing, regular training with quality equipment makes a big difference.

The Advanced Suture Practice Kit from Artagia Med offers everything needed for skill-building in a safe, controlled setting. This 35-piece set includes realistic materials and medical-grade tools that help users practice everything from simple closures to complex repairs.

For those wanting to perfect their knot-tying skills, the Advanced Surgical Knot Tying Board Kit provides focused training to build confidence and precision. Secure knots are essential for successful wound closure, no matter the suture type, and this kit helps develop the muscle memory needed for clinical success.

Whether you’re a medical student, nurse, or emergency responder, investing in your suturing skills will benefit you throughout your career. Take the next step by training with tools trusted by medical professionals worldwide.