Suture Kit

The oral cavity has limited operating space, particularly in cats, and suture instruments should be selected on this basis. Ophthalmic style instruments work best - e.g. fine Castroviejo or 5.5 inch Olsen Hegar needle holders with tungsten carbide jaws. Bishop Harmon tissue forceps and appropriate absorbable suture material in 3/0 (2 metric), 4/0 (1.5 metric) or 5/0 (1 metric) sizes.

Needle size and type also need to reflect the tough tissues of the oral cavity. Curved needles are most useful in confined spaces - for example for cats and caudal oral locations in dogs. Cutting or reverse cutting needles are required. Reverse cutting needles have the cutting surface on the greater (outer) curvature of the needle and are less likely to cut the tissue between the needle and the wound than cutting needles. This can be important when suturing gingival or buccal mucosa.

The most common materials used in the mouth are:

Monocryl™(Ethicon)
Polyglecaprone 25. Monofilament: Good knot security in the mouth (4 throws needed) and superior handling. Use reverse cutting FS2 needle. Lasts around 20 days in the mouth.

Vicryl™ (Ethicon)
Polyglactin910 - braided multifilament. Poor knot security in the mouth - needs 5 throws plus. Retained for at least 28 days in the mouth.

Vicryl Rapide™ (Ethicon)
As for Vicryl with faster absorption time in tissue. Expensive.

PDS 11™ (Ethicon)
Polydioxanone. Monofilament with 56 days retention in the mouth and long (180+ days) absorption period.

Chromic Catgut
Reasonable handling but may dissolve before flaps are healed. Cheapest.