What suture material for gum?

RE: What suture material for gum?

Evelyn Barbour-Hill — Fri, 08 Jan 2016 18:07:42 GMT

[quote user="Anthony Dennison"]I use the 4/0 a lot (for other things,[/quote]

That's good 'cos it's too thick for dentistry

RE: What suture material for gum?

Anthony Dennison — Fri, 08 Jan 2016 14:09:45 GMT

[quote user="Michael Woodhouse"]£27 for Clinimono 5/0 12pk with reverse cutting needle from IMS. I can't tell the difference.[/quote]

I use the 4/0 a lot (for other things, not just dentistry). Really like it.

RE: What suture material for gum?

Rob Davis — Thu, 07 Jan 2016 19:55:51 GMT

[quote user="Michael Woodhouse"]

[quote user="Rob Davis"]Monocryl 5-0 16mm 3/8c reverse cutting Ethicon code W3204. Available from Henry Schein for £45.88 for 12 packs[/quote]

£27 for Clinimono 5/0 12pk with reverse cutting needle from IMS. I can't tell the difference.

[/quote]

Thanks for the tip, I'll try a box next time I order some

RE: What suture material for gum?

Michael Woodhouse — Thu, 07 Jan 2016 19:29:15 GMT

[quote user="Rob Davis"]Monocryl 5-0 16mm 3/8c reverse cutting Ethicon code W3204. Available from Henry Schein for £45.88 for 12 packs[/quote]

£27 for Clinimono 5/0 12pk with reverse cutting needle from IMS. I can't tell the difference.

RE: What suture material for gum?

Rob Davis — Thu, 07 Jan 2016 17:52:24 GMT

[quote user="Evelyn Barbour-Hill"]Give 6/0 a try then, Rob![/quote]

Perhaps I'll order some of that too!

RE: What suture material for gum?

Evelyn Barbour-Hill — Thu, 07 Jan 2016 17:47:19 GMT

Give 6/0 a try then, Rob!

RE: What suture material for gum?

Rob Davis — Thu, 07 Jan 2016 10:26:25 GMT

Monocryl 5-0 16mm 3/8c reverse cutting Ethicon code W3204. Available from Henry Schein for £45.88 for 12 packs. Unfortunately as Evelyn pointed out, it is only available undyed in the UK. The dyed version is available from Accesia and costs 244 Euros for 36 packs (£180), so it is a little more expensive, and I guess there would be delivery charges on top of that. I haven't tried it before, but I may order some now I've looked!

RE: What suture material for gum?

Rob Loxley — Wed, 06 Jan 2016 21:21:46 GMT

[quote user="Kate Richardson"]I will have another look for monocryl with a cutting needle- I couldn't find one when I looked previously. What size needles are they?[/quote]

Ethicon's website is good for finding their product codes which can then be referenced to the wholesaler catalogue:

http://woundclosure.ethicon.com/advanced-search

RE: What suture material for gum?

Aisling McGrath — Wed, 06 Jan 2016 20:50:30 GMT

Thank you everyone, you've all been very helpful - I'll place an order tomorrow!

RE: What suture material for gum?

Kate Richardson — Wed, 06 Jan 2016 20:47:21 GMT

I will have another look for monocryl with a cutting needle- I couldn't find one when I looked previously. What size needles are they? One of the features I like about Monofast is the tiny needle, but I do a lot of cats so this is a priority for me

RE: What suture material for gum?

Hannah Wynne Richards — Wed, 06 Jan 2016 16:44:27 GMT

Fine biosyn

Wynne

RE: What suture material for gum?

Rob Davis — Wed, 06 Jan 2016 16:42:40 GMT

I pretty much always use 5/0 monocryl with a reverse cutting needle, very rarely anything larger in the mouth.

RE: What suture material for gum?

Evelyn Barbour-Hill — Wed, 06 Jan 2016 14:19:15 GMT

The tissues are tough to penetrate yet paradoxically easy to split, so you need a reverse cutting needle or something very similar.

6/0 is perfectly adequate for most situations. I use Vicryl (or V Rapide, but I see little advantage)) because it's easier to handle than Monocryl, and I have trouble seeing undyed Monocryl even with magnification (very frustrating, I know it's available dyed on the Continent but I can't get it at a reasonable price); although Monocryl is officially "better" because it's not capillary and accumulates less plaque.

I also use 5/0 Vicryl or Monocryl when I feel something stouter is required in a dog. 5/0 Monocryl is not so bad for visibility although it can still be annoying to handle.

There is never a need for anything thicker than 5/0, unless we are straying from the OP into the field of heavy traumatic injury repair, when one might well use Prolene and use 4/0 in a dog.

The Ethicon codes are W9500T, W9824, and W3204

PS Keep Vicryl wet and the drag is very much reduced. Human cleft palate surgeons doing astonishingly clever stuff on little children use Vicryl.

RE: What suture material for gum?

Stephen Courtney — Wed, 06 Jan 2016 14:09:27 GMT

[quote user="Lucy Fleming"]

I use monocryl 4/0 reverse cutting (I think, currently having a mental blank). Do like the idea of violet suture though as the monocryl is virtually transparent! I don't like the tissue drag with vicryl either and would rather a monofilament in that environment.

[/quote]

Me too. our dentist uses finer stuff but I can't see it very well, and yes the colour is an issue - it's about the same colour as the average cat's whisker... not helpful!

I like the way monocryl handles, and reverse cutting needles seem to do the job well. I've not had any issues with them going blunt, even when I have to place a lot of sutures.

RE: What suture material for gum?

Rob Loxley — Wed, 06 Jan 2016 13:33:43 GMT

[quote user="Lucy Fleming"]I use monocryl 4/0 reverse cutting[/quote]

same here

RE: What suture material for gum?

grumpyoldman — Wed, 06 Jan 2016 11:59:59 GMT

4-0 biosyn seems to work well.

RE: What suture material for gum?

Lucy Fleming — Wed, 06 Jan 2016 11:41:25 GMT

RE: What suture material for gum?

Bob Russell — Wed, 06 Jan 2016 10:44:03 GMT

Biosyn here. The mouth is a very aggressive environment for dissolvable sutures. Seems to last just long enough to do the job.

RE: What suture material for gum?

Anthony Dennison — Wed, 06 Jan 2016 10:26:48 GMT

[quote user="Kate Richardson"]I used to use Monocryl, think it was 4/0, minimal reation in the mouth, softened very quickly so very comfortable and very happy with healing, but monocryl only came with a round bodied needle which I found blunted quite easily and bent (poss my technique which has since improved). [/quote]

I have some 4/0 MonoQ from CliniSut that comes with a reverse cutting needle.

RE: What suture material for gum?

Kate Richardson — Wed, 06 Jan 2016 10:19:48 GMT

I used to use Monocryl, think it was 4/0, minimal reation in the mouth, softened very quickly so very comfortable and very happy with healing, but monocryl only came with a round bodied needle which I found blunted quite easily and bent (poss my technique which has since improved).

Tried Vicryl but found too much tissue drag.

Then I discovered Monofast- cutting needle, 4/0 and 5/0, 19mm or 13mm needle so perfect for little mouths, with a monofilament suture material- this stuff is GREAT- no drag, needle cuts through gingival tissue easily so minimal trauma, knots well, heals well, comfortable- only problem is it is white, but I have recently discoved it comes in violet so will be ordering that when the white one runs out. Believe it is Kruuse product. Love it

RE: What suture material for gum?

Julian Earl — Wed, 06 Jan 2016 09:45:22 GMT

Vicryl as it issoft and less irritant as a result, than say, gut or PDS. Always swaged onto the needle. 3-metric is usually okay. Gums do heal quickly of course.

HTH

RE: What suture material for gum?

Anthony Dennison — Wed, 06 Jan 2016 09:14:42 GMT

[quote user="Martin Atkinson"]taper cut needle.[/quote]

I don't like these compared to reverse cutting, just seem to blunt more quickly so I'm left doing more trauma to the gume

RE: What suture material for gum?

Martin Atkinson — Wed, 06 Jan 2016 08:47:06 GMT

I use the finest Vicryl Rapide I can handle easily which will be probably 4-0 with a reverse cutting or taper cut needle.