The ideal suture material is usually sterile, easy to handle, strong, resistant to infection, and affordable. It should also behave the way we want it to, i.e., consistent. As you can see, it is incredibly challenging to produce the perfect suture and precisely why there are varied materials available that offer unique characteristics.

Suture types are split into different categories:

Non-absorbable

Non-absorbable ones such as prolene suture get used for offering long-term tissue approximation. They are ideal for skin and removed later. Sometimes, they are used inside the body where they get retained. Typical uses of these non-absorbable sutures are vessel repair, bowel repair, tendon repair, and skin closure.

The prolene suture and nylon one offer good strength to low tissue reactivity and are hence used widely. Prolene 6-0 is one example here that is commonly used for facial wounds where the cosmetic outcome is essential. The low reactivity causes less scarring. Prolene gets used widely for vascular anastomoses, abdominal wall closure, and C-section surgeries. They get dyed blue for helping with visibility.

Absorbable

The absorbable sutures get broken down by the body over time through hydrolysis and enzymatic degradation. The time it takes depends not only on the material but also on the insertion and the individual patent characteristics. The suture's absorption rate increases in patients due to infection, fever, or protein deficiency. Skin closure of the surgical wound is commonly achieved with absorbable sutures. One of the absorbable sutures used in practice is Polyglactin 910 sutures. It is a sterile surgical suture made of copolymer, made of 90 per cent glycolide and 10 per cent L-lactide.

Even braided sutures under the absorbable ones are useful as they loosen at the surgical knot. But they may cause local tissue reaction.

Are catgut sutures still used?

The naturally made sutures like catgut do not get used as commonly they once were. It is a good suture material made by twisting together the strands of bovine intestine collagen. They have excellent handling properties and are currently banned in Europe and Japan due to the risk of transmission of mad cow disease.

Does the size matter?

The strength and handling properties get affected by the thickness of the suture thread. Hence, these threads get manufactured in varied sizes. The size determines the diameter of the suture strand. The larger the number prefix, the smaller the diameter of the thread.

When do you need a hip replacement?

So, how to recognise the right option? What are the signs which prompt you for surgery? Following are the reasons –

Chronic and significant pain

Damage to your hip joint can cause massive pain not only to your hips but anywhere between the hips and knees. You could be taking painkillers for reducing the pain, keeps you awake in the night, becomes a task to walk around, resting does not help during day or night, conservative treatments are not helpful, you compensate the pain with limping, and reliable on a walking aid for relieving the pain.

Severe pain is one of the reasons people opt for total hip replacement. But it is not the only symptom which indicates you need surgery.

Hip disability makes the completion of tasks challenging

One of the deciding factors of hip replacement surgery is how much the injured hip affects your life. Even if you can handle this pain, massive disability of the hip can make even the most routine task a daunting one like putting on your shoes or socks, walking an average distance, or standing one leg.

Limits the normal range of motion

Stiffness is another reason for surgery. If you experience joint stiffness which makes normal walking or bending difficult, or if you cannot lift your leg, approach an orthopaedic specialist soon.

Conservative treatments do not help all the time

Many who have conditions affecting their hip joint, such as arthritis, do not require surgery immediately. Doctors might opt for conservative treatments such as physical therapy, steroids injection, and anti-inflammatory medications. Although they might not cure hip conditions, they make you go about with the daily routine and more tolerable towards the pain. However, there are chances these treatments might be less effective and fail to offer relief. This is when doctors recommend surgery.

Tests reveal significant arthritis

Massive joint damage owing to arthritis or other joint conditions can cause inflammation, resulting in the cartilage wearing away. Without the cartilage, there is no cushion between the bones rubbing together, and they start wearing down. Advanced cases of joint damage may need some form of surgery.

What is hip surgery?

A hip replacement surgery is where the doctor removes a painful hip joint with arthritis and replaces them with an artificial joint that are made of metal and plastic components surgically. It is a treatment opted when other options have failed to provide enough relief from the pain. The surgery should relieve you from a painful hip joint, making the walking easier.

Sometimes, there are complications, and there is no way out then C-section surgery. So, why do they get done? Such surgeries take place when the traditional vaginal birth gets difficult, and when the mother or child is at risk. Sometimes, such delivered get planned, but they are performed when complications arise during labour.

Reasons for C-section delivery include –

• When the child has developmental conditions
• The child’s head is too big for the birth canal
• When there is a breech birth
• Pregnancy complications
• Mother’s health conditions such as high BP or unstable heart disease
• Mother has active genital herpes which gets transmitted to the baby
• Previous C-section delivery
• Problems with placenta
• Problems with umbilical cord
• Reduced oxygen supply to the baby
• Stalled labour
• When there is transverse labour

How to prepare for such surgeries?

If you and the doctor decide for C-section surgery, the doctor offers you a list of instructions about what you can do to lower the risk of complications and have a successful delivery. As with any pregnancy, prenatal appointments involve several check-ups. This includes blood tests and other such examinations for determining the health and possibility of caesarean.

The doctor checks your blood type if you need a blood transfusion. This, however, is not much of a hassle in C-section surgeries. Even if you do not plan to have this delivery, always remain prepared for the circumstance. At the prenatal appointments, check with the doctor, discuss the risk factors, and what you can do to lower them.

Make sure your questions get answered and that you understand what needs to get done if a C-section happens before the due date.

Since the caesarean deliveries take a longer time for recovery than regular deliveries, arranging to have an additional set of hands around the house helps. Not only do you recover from the surgery, but the new baby gets attention as well.

Post the surgery:

Once you complete the caesarean delivery, your newborn child and you stay in the hospital for at least three weeks. Immediately after the surgery, you remain on the IV. This enables for adjusted levels of painkillers to get delivered in your bloodstream while the anaesthesia wears off.

Your doctor encourages you to walk around as well. This helps to avoid blood clots and constipation. A nurse teaches you how to position your child for breastfeeding. So, this eliminates additional pain from C-section surgery.

Doctors provide some home care recommendations as well after the surgery and these typically involve –

• Correct posture for supporting your abdomen
• Drinking plenty of fluids for replacing those lost during the delivery
• Avoiding sex for four to six weeks
• Taking pain medications as and when needed

Seeking help if you experience postpartum depression such as significant mood swings or extreme fatigue