Guidelines for re-sterilising sutures
In some countries the idea of re-sterilising sutures is not acceptable; however, in other situations people re-sterilise sutures routinely. If you do sterilise sutures, the following should be considered.
1. How to sterilise sutures
The two recommended methods are:
a) Soak for a full 10 minutes completely immersed in povidone iodine 10% solution, then rinse in sterile saline/ water.
b) Ethylene Oxide – gas sterilisation. Sterilising/disinfecting by other methods (autoclaving, boiling, alcohol-soaking) are not recommended. Glutaraldehyde has been taken off the market since May 2002. It was never intended to be a suture soaking solution due to its high toxicity and the inability to ensure that all the solution is rinsed off before use
2. Sutures which can be re-sterilised
a) Any monofilament (Prolene or Nylon/ Ethilon) suture can be soaked in povidone iodine 10% solution with no risk of HIV, or hepatitis B transmission.
b) This also applies to ‘coated’ sutures, e.g. some Vicryl or Ethibond. On the outside of the packets it states whether the suture is coated or not. If coated, there should be no problem with soaking the suture material.
c) Multi-filament or twisted fibres, such as Chromic, Silk, Mersilene and non-coated Ethibond should be discarded after use.
3. Tensile strength
There are no reports of wound breakdowns due to loss of tensile strength in sutures following soaking (Nylon, Prolene, coated Vicryl or Ethibond sutures).
4. Needle sharpness
Povidone iodine does not affect needle sharpness.
- Monofilament and coated sutures are the only sutures suitable for re-sterilising.
- The recommended technique is 10 minutes fully immersed in povidone iodine 10% solution followed by rinsing in sterile saline/water.