Sutures are an essential part of wound closure and surgical procedures. They help hold tissues together during healing and are available in different materials, structures, and absorption profiles. Two commonly discussed categories are plain catgut sutures and synthetic sutures.
Although both can be used for tissue approximation and ligation, they differ significantly in their source, absorption mechanism, tissue response, tensile strength, and clinical applications.
Understanding the differences between plain catgut and synthetic sutures can help healthcare professionals select an appropriate suture material based on the wound, healing period, and surgical requirements.
What Is a Plain Catgut Suture?
Plain catgut is a natural absorbable surgical suture manufactured from purified collagen derived from animal intestinal tissue.
Despite its name, catgut is not made from cats. Traditionally, the material is obtained from collagen-rich tissue, commonly from healthy sheep intestines.
Plain catgut is absorbed naturally by the body and is generally selected when relatively short-term wound support is required.
At Orion Sutures, ORIGUT® Plain Catgut Suture is designed as a fast-absorbing surgical gut suture for appropriate soft tissue approximation and ligation applications.
What Are Synthetic Sutures?
Synthetic sutures are manufactured using man-made polymer materials rather than natural biological tissue.
Synthetic sutures may be either absorbable or non-absorbable. Common synthetic absorbable materials include:
- Polyglactin 910
- Polyglycolic Acid
- Poliglecaprone
- Polydioxanone
Synthetic non-absorbable materials can include polypropylene, polyester and polyamide.
When comparing plain catgut with synthetic sutures for temporary wound support, the comparison is generally made with synthetic absorbable sutures.
Key Differences Between Plain Catgut and Synthetic Sutures
1. Source of Material
The most fundamental difference is their origin.
Plain catgut is made from naturally derived collagen, whereas synthetic sutures are manufactured using polymer-based materials under controlled production processes.
Because of this difference in composition, the two types of sutures behave differently once implanted in the body.
2. Absorption Mechanism
Plain catgut is broken down through biological and enzymatic processes within the body. Its absorption rate can therefore be influenced by local tissue conditions and individual biological responses.
Synthetic absorbable sutures are generally degraded through hydrolysis. Water gradually interacts with the polymer structure, causing the suture to lose tensile strength and eventually be absorbed.
Hydrolytic absorption usually provides a more predictable degradation profile compared with the enzymatic absorption of natural sutures.
3. Tissue Reaction
Natural sutures such as plain catgut may produce a comparatively greater inflammatory tissue response because they are biological materials.
Synthetic absorbable sutures are designed to create relatively low tissue reactivity and can therefore be preferred in procedures where minimizing inflammatory response is important.
The actual clinical response, however, depends on several factors including the suture material, tissue condition and surgical technique.
4. Tensile Strength Retention
Plain catgut is typically used when short-term tissue support is sufficient. It gradually loses its tensile strength as biological absorption progresses.
Synthetic absorbable sutures are available with different tensile-strength retention periods. Depending on the polymer selected, they can provide short-, medium- or longer-term wound support.
For example, different synthetic materials can be chosen depending on how quickly the targeted tissue is expected to regain adequate strength.
5. Predictability of Absorption
One of the major advantages of synthetic absorbable sutures is predictable absorption.
Because plain catgut is degraded through biological processes, factors such as infection, tissue environment and enzymatic activity may influence the rate at which it loses strength and is absorbed.
Synthetic sutures that degrade through hydrolysis generally demonstrate a more controlled absorption profile.
6. Handling Characteristics
Plain catgut is known for its flexibility and handling characteristics and has traditionally been used across several surgical applications.
Synthetic sutures are available in both monofilament and braided constructions. This allows surgeons to select a material according to handling, knot security, tissue passage and procedural requirements.
Braided synthetic sutures can provide good handling and knot security, while monofilament sutures may offer smooth tissue passage and reduced surface area for bacterial adherence.
Plain Catgut vs Synthetic Sutures: Quick Comparison
| Feature | Plain Catgut | Synthetic Absorbable Sutures |
|---|---|---|
| Origin | Natural collagen | Synthetic polymers |
| Absorption | Biological/enzymatic degradation | Primarily hydrolysis |
| Tissue reaction | Comparatively higher | Generally lower |
| Absorption predictability | More variable | More predictable |
| Tissue support | Primarily short-term | Varies by material |
| Structure | Natural processed strand | Monofilament or braided |
| Material options | Limited | Wide variety available |
Which Suture Should Be Used?
There is no single suture material suitable for every surgical procedure.
Plain catgut may be considered where short-term absorbable wound support is appropriate. Synthetic absorbable sutures can be selected when more predictable absorption, specific tensile-strength retention or different handling characteristics are required.
Suture selection depends on factors such as:
- Type of tissue being repaired
- Expected wound-healing period
- Required duration of tissue support
- Risk of infection
- Tissue reactivity
- Suture handling requirements
- Surgeon preference and clinical judgement
Healthcare professionals should always select sutures according to the requirements of the procedure and applicable clinical guidelines.
Conclusion
The main difference between plain catgut and synthetic sutures lies in their composition and behaviour inside the body. Plain catgut is a naturally derived absorbable collagen suture that undergoes biological degradation, while synthetic sutures are manufactured from polymers and offer a wider range of absorption profiles, tensile-strength retention periods and structural characteristics.
Both types continue to have applications in modern surgical practice, and the appropriate choice depends on the tissue, wound-healing requirements and surgical procedure.
Orion Sutures manufactures a comprehensive range of surgical sutures, including ORIGUT® Plain Catgut and multiple synthetic absorbable and non-absorbable suture options, designed to meet diverse surgical and healthcare requirements.