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

Which type of sutures should be avoided in the presence of infection?

1. Absorbable sutures

2. Braided or twisted non-absorbable sutures

3. Monofilament sutures

4. Retention sutures

The correct answer is: Braided or twisted non-absorbable sutures

The recommendation to avoid braided or twisted non-absorbable sutures in the presence of infection is rooted in their structure and behavior during wound healing. Braided sutures are more likely to harbor bacteria due to the interstices between the strands, which can promote infection, delay healing, and potentially lead to complications such as sutures becoming a nidus for further infection. Additionally, the absorbent properties of braided sutures can retain fluids, further providing a conducive environment for bacterial growth. In contrast, monofilament sutures are typically preferred in infected wounds because they do not have the same propensity for bacterial colonization and are easier to clean. Absorbable sutures can also be utilized in certain situations as they resolve over time, minimizing long-term irritation to the tissue. Retention sutures, while not the first choice in cases of infection, are generally non-braided and serve a specific purpose in wound support; they may occasionally be used in infected wounds with careful consideration. Thus, braided or twisted non-absorbable sutures pose the greatest risk in the context of infection, making them the type to avoid.