TissueDB/Materials/Suture

Suture is surgical thread used to close wounds and to join tissues, and in simulation it is the consumable the trainee places into whatever substrate the simulator provides — it is not a tissue simulant itself. A suture is described by three things. The material: silk; nylon, also called polyamide and sold under the brand name Ethilon; polypropylene, sold as Prolene; and the absorbable polyglactin-910, sold as Vicryl. The construction: monofilament, a single smooth strand, or braided, several strands twisted together. And the gauge, on the USP scale, where more zeros means a finer thread — 3-0 is coarse and 10-0 is microsurgical. Thread is normally sold pre-mounted on a needle. A round-bodied (tapered) needle spreads tissue apart rather than cutting it, which is what bowel and vessel work calls for. Non-absorbable types (silk, nylon, polypropylene) stay until someone removes them. Absorbable types (polyglactin) break down in place. This class is the home for every one of those forms — sold as surgical suture, silk suture, silk thread, silk ties and brand-named Ethilon suture. Specific brands and gauges are recorded in the table below and in each simulator's build steps, not in the class title.

Suture is a consumable rather than a tissue simulant. This page therefore carries no tissues table: nothing here stands in for a tissue. The gauge and material are chosen per procedure. Every specification in the table below is the one its published source states.

Used In Simulators

Simulator	Purpose	Notes
STA-MCA Bypass Trainer	Microsurgical end-to-side anastomosis	9-0 and 10-0 polyamide (nylon) microsuture; the source specifies Ethilon, with 5.0 mm (9-0) and 3.8 mm (10-0) round-bodied needles. 9-0 was used in 15 of 24 anastomoses and 10-0 in the other 9; 10-0 also ligates the vessel's accessory branches. 3-0 polyglactin-910 (Vicryl) secures the IV cannulas to the vessel stumps. The dominant consumable cost across the 24-session series. The source's Methods section and the Ethilon brand both indicate polyamide (nylon); its Results section calls the sutures "polyethylene" — polyamide is followed here.^[1]
Grapefruit Distal ACA Bypass Simulator	Microsurgical side-to-side anastomosis	10-0 nylon for the side-to-side anastomosis, consumed during practice. 3-0 nylon serves as the cannulation tie. Practised on grapefruit septal membranes and chicken wing brachial artery segments. This build uses no 9-0.^[2]
Vascular Anastomosis Simulator (Cubas)	Bench vascular anastomosis	6-0 and 7-0 polypropylene on plastic-straw vessel surrogates.^[3]
Neonatal Enterocutaneous Anastomosis Simulator	Bowel anastomosis	4-0 or 5-0 silk on a round-bodied (tapered) needle. The source chooses inexpensive silk deliberately, to maximise affordability and accessibility for learners in low- and middle-income countries. For the actual procedure on patients, the source notes 4-0 or 5-0 Vicryl or PDS on a round-bodied needle.^[4]
VesselBox Vessel Ligation Trainer (Hu)	Vessel ligation	3-0 silk ties. The source used Hefei Fast Nonwoven Products Co (Anhui, China). With reused expired gloves, the silk is the dominant per-attempt consumable cost.^[5]
Knot Tying Force-Feedback Simulator (Amiel)	Knot-tying under force feedback	3-0 silk, a use-time consumable. The source used Sofsilk 3-0 (Medtronic). Tied one-handed square-knot technique.^[6]
Suture Simulator (Almeida)	Skin and general suturing practice	Mononylon 4-0 gives the firmest edge apposition and resists tearing. Finer 5-0 and 6-0 threads can tear the pad edges under higher-intensity manual traction.^[7]
Lumbar Laminectomy and Dural Closure Simulator (Bakhshi)	Dural closure under the microscope	6-0 Prolene (polypropylene) closes the latex-glove dura. A use-time consumable, not a build material: the vendors in the source bootcamp supplied it free of charge.^[8]
Acute Appendicitis Simulator	Appendix stump ligation	Silk ties close the cut, inverted glove. The closed glove retains the sand and cotton fill. The build instructions state no gauge.^[9]

References

↑ Akdag BA, Akdag B, Ikizoglu E, Husemoglu B, Kizmazoglu C, Aydin HE, Ozer E. "A Novel Training Model for Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Using Microsurgical Techniques." World Neurosurgery. 2024;190:e665–e674. DOI 10.1016/j.wneu.2024.07.200. PMID 39098505.
↑ Cikla U, Rowley P, Jennings Simoes EL, Ozaydin B, Goodman SL, Avci E, Baskaya MK, Patel NJ. "Grapefruit Training Model for Distal Anterior Cerebral Artery Side-to-Side Bypass." World Neurosurgery. 2020;138:39–51. DOI 10.1016/j.wneu.2020.02.107. PMID 32109640.
↑ Cubas WS. "Building and training a low-cost and portable vascular anastomosis simulator: initial experience of a surgical resident." Cirugía Cardiovascular. 2022;29:82–88. DOI 10.1016/j.circv.2021.10.007. CC BY-NC-ND 4.0.
↑ Wong J, Udeigwe-Okeke C, Ameh E. Colostomy in Newborns training module. Appropedia, 2021. Available at: https://www.appropedia.org/Colostomy_in_Newborns
↑ Hu Y, Le IA, Goodrich RN, Edwards BL, Gillen JR, Smith PW, Schroen AT, Rasmussen SK. "Construct validation of a cost-effective vessel ligation benchtop simulator." Journal of Surgical Education. 2015;72(3):381–388. DOI 10.1016/j.jsurg.2014.11.003. PMID 25678049.
↑ Amiel I, Anteby R, Cordoba M, Laufer S, Shwaartz C, Rosin D, Gutman M, Ziv A, Mashiach R. "Feedback based simulator training reduces superfluous forces exerted by novice residents practicing knot tying for vessel ligation." American Journal of Surgery. 2020;220(1):100–104. DOI 10.1016/j.amjsurg.2019.11.027. PMID 31806168.
↑ Almeida NRC, Braga JP, Bentes LGB, Lemos RS, Fernandes MRN, Andrade GL, Araújo VMM, Santos DRD, Yasojima EY. "Low-cost suture simulator to gain basic surgical skills." Acta Cirúrgica Brasileira. 2023;38:e384223. DOI 10.1590/acb384223. PMID 37851786.
↑ Bakhshi SK, Ahmad R, Merchant AAH, Noorali AA, Abdul Rahim K, Shaikh NQ, Afzal N, Lakhdir MPA, Shamim MS, Haider AH. "Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level." BMC Medical Education. 2022;22:896. DOI 10.1186/s12909-022-03965-9. PMID 36578075. Licensed CC BY 4.0.
↑ ALL-SAFE Consortium. ALL-SAFE Acute Appendicitis Simulation Build Instructions. Global Surgical Training Challenge, 2022. Build-instruction document not indexed in PubMed; primary source linked directly.

At a Glance

Overview

Suture is bought as sterile packaged thread, usually pre-mounted on a needle, and is single-use per pass. It is a medical supply obtained from stores and discarded after use. That is what makes it a consumable rather than a material that simulates a tissue. Sterile clinical grades come from surgical and medical supply distributors. Non-sterile practice grades, which are what most of the builds above call for, are stocked by general online retailers and training-supply shops. They are sold in packs of individually wrapped strands or as bulk spools of thread.

Gauges in use across TissueDB builds run from 3-0 to 10-0. The coarse 3-0 serves ligature ties and cannulation. Gauges 4-0 to 6-0 serve skin, bowel and dural closure. Gauges 7-0, 9-0 and 10-0 serve microsurgical anastomosis under an operating microscope. The finer the gauge, the more it costs. Finer gauges also need a microscope and micro-instruments to use at all.

This page does not record cost as a single figure, because no TissueDB source states a per-strand price. The table above records what the sources do state, simulator by simulator. On the VesselBox trainer, the 3-0 silk is the dominant per-attempt cost. On the Bakhshi bootcamp, the vendor donated the 6-0 Prolene.

Stored dry and out of direct sunlight in its original packaging, suture keeps for years. Braided types such as silk take up moisture more readily than monofilaments.

Synonyms

Common names: Surgical suture, suture material, surgical thread, stitch. Former page titles now folded into this class: Surgical Suture, Silk Suture, Silk Thread, Ethilon Suture. By material: silk suture, silk thread, silk ties, nylon (polyamide) suture, Ethilon, mononylon, polypropylene suture, Prolene, polyglactin-910 (Vicryl) suture. By construction and use: monofilament suture, braided suture, microsuture, non-absorbable suture, absorbable suture. Brand names are recorded in the notes, not the class title.

Background

Clinical Context for Simulation

Processing & Preparation

Safety Considerations

Related Materials

Page data
Keywords	suture, surgical suture, suture material, surgical thread, nylon suture, polyamide, polypropylene, vicryl, silk suture, microsuture, knot tying, anastomosis, suturing practice
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Authors	Arturopelayo
License	CC-BY-SA-4.0
Language	English (en)
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Redirects	TissueDB/Materials/Silk Thread, TissueDB/Materials/Surgical Suture, TissueDB/Materials/Silk Suture, TissueDB/Materials/Ethilon Suture
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Created	July 4, 2026 by Arturo Pelayo
Last edit	July 27, 2026 by Arturo Pelayo
Cite as	Arturopelayo (2026). "TissueDB/Materials/Suture". Appropedia. Retrieved July 27, 2026.
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[akdag2024-1] Akdag BA, Akdag B, Ikizoglu E, Husemoglu B, Kizmazoglu C, Aydin HE, Ozer E. "A Novel Training Model for Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Using Microsurgical Techniques." World Neurosurgery. 2024;190:e665–e674. DOI 10.1016/j.wneu.2024.07.200. PMID 39098505.

[cikla2020-2] Cikla U, Rowley P, Jennings Simoes EL, Ozaydin B, Goodman SL, Avci E, Baskaya MK, Patel NJ. "Grapefruit Training Model for Distal Anterior Cerebral Artery Side-to-Side Bypass." World Neurosurgery. 2020;138:39–51. DOI 10.1016/j.wneu.2020.02.107. PMID 32109640.

[cubas2022-3] Cubas WS. "Building and training a low-cost and portable vascular anastomosis simulator: initial experience of a surgical resident." Cirugía Cardiovascular. 2022;29:82–88. DOI 10.1016/j.circv.2021.10.007. CC BY-NC-ND 4.0.

[wong2021-4] Wong J, Udeigwe-Okeke C, Ameh E. Colostomy in Newborns training module. Appropedia, 2021. Available at: https://www.appropedia.org/Colostomy_in_Newborns

[hu2015-5] Hu Y, Le IA, Goodrich RN, Edwards BL, Gillen JR, Smith PW, Schroen AT, Rasmussen SK. "Construct validation of a cost-effective vessel ligation benchtop simulator." Journal of Surgical Education. 2015;72(3):381–388. DOI 10.1016/j.jsurg.2014.11.003. PMID 25678049.

[amiel2020-6] Amiel I, Anteby R, Cordoba M, Laufer S, Shwaartz C, Rosin D, Gutman M, Ziv A, Mashiach R. "Feedback based simulator training reduces superfluous forces exerted by novice residents practicing knot tying for vessel ligation." American Journal of Surgery. 2020;220(1):100–104. DOI 10.1016/j.amjsurg.2019.11.027. PMID 31806168.

[almeida2023-7] Almeida NRC, Braga JP, Bentes LGB, Lemos RS, Fernandes MRN, Andrade GL, Araújo VMM, Santos DRD, Yasojima EY. "Low-cost suture simulator to gain basic surgical skills." Acta Cirúrgica Brasileira. 2023;38:e384223. DOI 10.1590/acb384223. PMID 37851786.

[bakhshi2022-8] Bakhshi SK, Ahmad R, Merchant AAH, Noorali AA, Abdul Rahim K, Shaikh NQ, Afzal N, Lakhdir MPA, Shamim MS, Haider AH. "Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level." BMC Medical Education. 2022;22:896. DOI 10.1186/s12909-022-03965-9. PMID 36578075. Licensed CC BY 4.0.

[allsafe_appendicitis-9] ALL-SAFE Consortium. ALL-SAFE Acute Appendicitis Simulation Build Instructions. Global Surgical Training Challenge, 2022. Build-instruction document not indexed in PubMed; primary source linked directly.

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