Suture Types for Hysterectomy

Uterine Closure

The American College of Obstetricians and Gynecologists recommends delayed absorbable monofilament sutures, such as poliglecaprone (Monocryl), as the primary choice for uterine closure due to less bacterial seeding and reduced infection risk compared to multifilament options 1, 2
Alternative options include chromic catgut and polyglactin 910 (Vicryl), though evidence doesn't strongly favor one particular suture type 1, 2
Two-layer closure of the uterine incision may be associated with lower rates of uterine rupture in future pregnancies, though evidence is limited (recommendation grade: weak) 1, 2

Continuous non-locking suturing techniques are preferred over interrupted sutures as they distribute tension more evenly across the suture line, result in less short-term pain, reduce the need for suture removal, and improve postoperative sexual function 3

The American College of Obstetricians and Gynecologists states that the peritoneum does not need to be closed during hysterectomy as closure is not associated with improved outcomes, non-closure reduces operative times, and there is no evidence that peritoneal closure affects intra-abdominal adhesion formation 1, 2

Avoid overly tight sutures that can strangulate tissue and impair healing 4
Consider the mobility and tension of the area when selecting suture material 4
For high-mobility areas or tissues under tension, stronger suture materials with longer absorption profiles are preferred 4