Advancements in Suturing Materials: From Passive Threads to Intelligent Systems

Sutures are fundamental to surgical practice, providing mechanical support for wound closure and tissue approximation. Historically, innovations in suturing materials have focused on improving tensile strength, biocompatibility, and handling properties. However, recent advances extend far beyond mechanical function, incorporating antimicrobial activity, knotless designs, bioactive release systems, and even sensorized “smart” sutures capable of monitoring or stimulating the wound environment. This review synthesizes contemporary evidence on suturing innovations, evaluates their clinical applicability, and outlines future directions for integration into surgical practice.