Silk Sutures: 2,500 Years of Stitching People Together

One of the Oldest Medical Materials Still in Use

Silk has been used to close wounds for something like two and a half thousand years, and it is still approved for surgical suture today. Very few materials in medicine have that continuity.

India, by 500 BC

Sushruta — frequently called the father of surgery — described the use of silk among other materials for suturing in the Sushruta Samhita, as early as 500 BC. This was not an experiment; it was a documented surgical practice with a named material.

China, Earlier Still

Silk was being woven in China from around 2600 BC, and ancient Chinese texts record medicinal uses including the suturing of wounds. The material and the medical application appear close together in the record.

Rome, and the Gladiators

The Greek surgeon Galen of Pergamon — who served as physician to gladiators — recorded using silk or catgut to suture severed tendons. Catgut was made from the twisted intestines of sheep or horses. Silk was the alternative, and the better one to work with.

Why Silk, Specifically

It is strong at very small diameters, it handles and knots well, and it comes as a continuous filament rather than something you have to spin. For most of history there was no manufactured fibre that came close.

Still Here

Silk fibroin remains approved by the US Food and Drug Administration for clinical use, including suture. Modern work has gone further: tissue scaffolds and drug delivery, and electronics designed to biodegrade.

The through-line is unusual. A material chosen by surgeons before germ theory existed is still in the operating theatre, and is now the basis of implantable devices.

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