Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

What type of sutures is typically used for the outer layer in a bowel anastomosis?

1. Absorbable

2. Non-absorbable

3. Self-tying

4. Interrupted

The correct answer is: Non-absorbable

In bowel anastomosis, the outer layer, which is the seromuscular layer, is typically closed using non-absorbable sutures. The rationale behind this choice is that non-absorbable sutures provide long-term strength and stability to the anastomosis, which is crucial for maintaining the integrity of the bowel over time. This outer layer plays a significant role in protecting the inner sutures from any potential tension, erosion, or contamination that may occur from the luminal contents. Absorbable sutures, although useful for inner layers where tissue healing occurs quickly, may not provide the necessary tensile strength over the prolonged healing period required for the outer layer. Self-tying sutures are not standard practice for bowel anastomoses, as traditional knot-tying techniques allow for better control of tension and security. While interrupted sutures can offer advantages in certain situations, the choice of non-absorbable material for the outer layer remains a standard preference for ensuring long-term structural support in bowel anastomosis.