THE USE of nonabsorbable suture material in surgery is more and more encroaching on the domain of surgical gut. Long ago Kocher1 and Halsted2 focused attention on the use of silk, while Meade and Ochsner3 and Meade and Long4 have demonstrated the superiority of cotton. More recently Whipple,5 Shambaugh,6 Hyde7 and others have advocated the use of nonabsorbable sutures.
Of the various materials belonging to this group, cotton has gained the greatest popularity, its only drawback being the relatively low tensile strength. Size for size, dry surgical gut is the strongest suture material, with silk, linen and cotton following in order. Cotton, size for size, is two thirds as strong as surgical gut and three fourths as strong as silk.3b The tensile strength of a suitably twisted high grade egyptian cotton remains below that of true Bombyx mori silk. The "United States
NARAT JK, CIPOLLA AF, CANGELOSI JP. FORTISAN® (REGENERATED CELLULOSE YARN), A NEW SUTURE MATERIAL. Arch Surg. 1950;60(6):1218–1230. doi:10.1001/archsurg.1950.01250011243018
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