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Writer's pictureDavid Chen, DDS

What Are Dissolvable Stitches Made Of?

Updated: Jan 24

Dissolvable stitches can be naturally made of intestinal linings of ruminant animals or synthetically made of polymers or copolymers. Regardless of what they're made of, they will all get absorbed by our bodies in due time.


However, depending on the type of material the sutures are made of, they will dissolve at different rates and also via different mechanisms. Please read carefully because there are many different kinds of dissolvable sutures. It also doesn't help that some of their names look incredibly similar to one another.


Table of dissolvable stitches materials

We've created a table below which organizes all of the absorbable stitches based on how they're made, the type of material used to make them and also how they dissolve.


Type of Suture

How its made

Type of material

How it dissolves

Fast Gut

Natural

Animal intestines

Proteolytic enzymes

Plain Gut

Natural

Animal intestines

Proteolytic enzymes

Chromic Gut

Natural

Animal intestines

Proteolytic enzymes

Polyglycolic acid

Synthetic

Polymers

Hydrolysis

Polydioxanone

Synthetic

Polymers

Hydrolysis

Polytrimethylene carbonate

Synthetic

Copolymers

Hydrolysis

Polyglactin 910

Synthetic

Copolymers

Hydrolysis

Glycomer 631

Synthetic

Copolymers

Hydrolysis

Polyglytone 6211

Synthetic

Copolymers

Hydrolysis

Poliglecaprone

Synthetic

Copolymers

Hydrolysis

The simplest way to think of them is by broadly categorizing them into three groups:

  • Group 1 - All natural

  • Group 2 - Synthetic polymers

  • Group 3 - Synthetic copolymers (multiple types of polymers)


If you attempt to look at each dissolvable suture individually and what they're made of, your head will spin based on the chemistry heavy terminology. Above is the simplest way that we can group them together and make sense of them.


Nonetheless, for completeness sake we will go into further depth for each type including what color they are so you know how to identify them.


Natural dissolvable stitches

The all natural dissolvable stitches called catgut are made of collagen that is derived from the small intestine of ruminant animals (cows, goats, & sheeps).


chromic gut sutures

Contrary to its name, it is not actually made out of the guts of cats but rather ruminant animals instead. Since it is basically made of collagen, it is similar to food. That means it can be dissolved and absorbed just like collagenous foods.


Specifications:

  • Types: Plain gut, Fast gut, Chromic gut

  • Stitch color: Light yellow, gold, can be mistaken as white colored

  • Dissolution time: 5-14 days

  • Dissolution mechanism: Naturally dissolves by body's proteolytic enzymes.


The chromic gut sutures are commonly used for wisdom teeth stitches.


Dissolvable synthetic polymer sutures

Dissolvable synthetic polymer stitches are made of long chains of repeating monomers.


Polymer vs monomer:

  • Monomer - single molecule, often organic meaning it has carbon atoms.

  • Polymer - multiple monomers that are stringed together into a long chain.


In the case of sutures, you can think of the polymers as a long thread (no pun intended) of the same monomer repeating itself over and over again. They are connected to form a long string.


Two types of dissolvable polymer sutures:

  • Polyglycolic acid (Polysyn)

  • Polydioxanone (PDS)


Suture Name

Monomer

Stitch color

Dissolving time

Dissolving mechanism

Polyglycolic acid

Glycolide

Violet

Hydrolysis

Polydioxanone

Paradioxanone

Violet

Hydrolysis


Due to these polymers being dissolved via hydrolysis in lieu of proteolytic enzymatic degradation, there is less of a tissue inflammatory reaction. This characteristic is preferred by surgeons since it is less impeding upon the healing of the wound.


Dissolvable synthetic copolymer sutures

Dissolvable synthetic copolymer stitches are made of long chains of different polymers that are stitched together (no pun intended).


Copolymer vs polymer vs monomer:

  • Monomer - single molecule, often organic meaning it has carbon atoms.

  • Polymer - multiple monomers that are stringed together into a long chain.

  • Copolymer - multiple polymers that are stringed together into a long chain.


An alternative way to think of what these terms mean and what the sutures are is in terms of lego blocks.

  • Monomers are different colored lego blocks. A single monomer represents one lego block.

  • Polymers are multiple lego blocks of the SAME COLOR that are attached together.

  • Copolymers are multiple lego blocks of DIFFERENT COLORS that are attached together.


Suture Name

Copolymers

Stitch Color

Dissolving time

Dissolving Mechanism

Polytrimethylene carbonate

Glycolide, Lactide, Trimethylene carbonate

Green

Polyglactin 910

Glycolide, Lactide

Violet

Glycomer 631

Glycolide, Paradioxanone, Trimethylene carbonate

Violet

Hydrolysis

Polyglytone 6211

Glycolide, Caprolactone, Trimethylene carbonate, Lactide

Violet

Hydrolysis

Poliglecaprone

Glycolide, epsilon-capralactone

Violet


A suture isn't a single molecule but rather a long strand of a combination of monomers stringed together. You may have also noticed that a lot of the dissolvable ones are violet/purple in color.


Takeaway

Dissolvable stitches are either synthetically made or naturally made from the intestines of ruminant animals. The synthetically made ones consist of either polymers or copolymers, which are essentially long strands of various monomers.


The natural sutures will dissolve via proteolytic enzymatic degradation while the synthetic ones all dissolve via hydrolysis. The latter produces less tissue inflammation while it breaks down so is currently preferred over the former.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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