The two biggest considerations when choosing a suture are the location and tension of the wound. Other important considerations are tensile strength, knot strength, handling, and tissue reactivity. Stitches are divided into two major groups:
Absorbable – lose most of their tensile strength in less than 60 days. They are generally used for burial stitches and do not require removal.
Non-Absorbed – Maintain most of your tensile strength for more than 60 days. They are typically used for skin surface sutures and require subsequent removal.
Suture needles also come in many types of shapes and sizes. Curved needles are used almost exclusively in dermatological surgery. The cutting needle moves more easily through the tissue and may have their primary cutting edge on the inside of the curve (conventional cutting) or outside the curve (reverse cutting). The advantage of reverse cutting is that the thin puncture left by the suture is directed away from the edge of the wound and therefore tissue tearing is less common. Non-cutting round needles also cause less tissue tear and can be particularly useful in delicate areas and fascia.