Chromic sutures fall into the category of absorbable sutures and are used in a wide range of different soft tissue ligation and approximation. It is considered to be an ideal option for ophthalmic surgery because of the uniformity in diameter and the smooth surface that allows the surgeon to easily knot the suture and have the knots remain tight for optimum wound closure and healing.
Chromic sutures are natural gut that is treated with a chromic solution. The gut can be from cattle or sheep, depending on the particular suture type and brand. These sutures can be treated with the chromic salt solution at various concentrations to ensure that the absorption time remains standard for a specific period of time. These sutures can be marketed as plain, mild chromic, medium chromic or extra chromic. Most suture manufacturers ensure that the absorption time for plain sutures is 10 days, mild at 20 days, medium at 30 days and extra chromic for up to 40 days.
Variations in the individual patient as well as the presence of inflammation or infection can impact the absorption time of the sutures, although this is not as problematic as with natural catgut that is much more variable. Other factors that may increase the absorption rate and decrease the tensile strength more rapidly than typically seen include the specific tissue in which the sutures are found as well as the type of suture. While the manufacturer cannot indicate absolutely the range of tensile strength and absorption time factors such as uniform treatment with the chromic salt, standard and uniform diameter and the use of pure collagen all contributes the tensile strength and uniform absorption rate.
Chromic sutures, like natural gut sutures, dissolve in the body by an enzymatic process. This is the same general process by which all protein is broken down in the human body. It is considered a good option for any wound closure where nonabsorbable sutures are not indicated. However, due to the difficulty in predicting absorption rates and tensile strength combined with the short absorption time in the body, it is not recommended for cardiovascular or neurological surgery. The various types of absorbable sutures are considered to be a good choice for both ophthalmic and cuticular use.
Chromic sutures, also known as chromic gut sutures, come in a variety of different sizes. This is ideal for having a variety of different suture materials on hand. There is the option to choose chromic sutures that are needled and precut to specific lengths. This is a great option for busy emergency rooms, clinics and hospital settings but is also practical for smaller doctor's offices where suturing may be required only infrequently. There is also the option to have chromic sutures provided on a larger reel, perfect for frequent use or for specialized surgical procedures.
Chromic sutures are a good option for many types of soft tissue repair and wound closures. Having options for suture material available is essential in providing the best care for patients based on the specific needs presented.