Suturing materials in ancient Indian surgery: An outlook in present surgical practice

Abstract

Suturing is the closure of surgical as well as the traumatic wound and also final step of every surgical procedure. Acharya Sushruta is the pioneer surgeon of ancient Indian surgery, has mentioned eight different surgical procedures (Ashthavidha Shastrakarma), like Chedana (Excision), Bhedana (Incision and drainage), Lekhana (Scarification), Vedhana (Aspiration), Eshana (Probing), Aharana (Extraction), Visravana (Evacuating) and Sivanakarma (Suturing) in his classical text Sushruta Samhita. Among these Sivanakarma (suturing) is of prime importance as proper suturing with specified suturing material leads to early healing of the wound and avoids scar formation which plays an important role cosmetically. In present contemporary medicine many of suturing materials are developed as per the need of surgical procedures. These suture materials vary accordingly in their absorption, tensile strength and viability. However many of these materials are synthetically processed substances and may cause tissue incompatibility. In ancient Indian surgery the suturing materials were developed depending on availability of natural resources like plant and animals and were successfully used in the various surgical procedures for closure of wound as well as for supporting to the body tissues. In present surgical practice these are not tried may be because of the poor understanding or improper analysis. However, if these suturing materials described in ancient text processed and developed with modern techniques may bring the revolution in utilizing the natural suturing materials which are more compatible to the tissues of the body and helps in quick healing of wound with minimal or negligible scar formation.