As if negotiating with and cajoling representatives, trying to buy in bulk and maintaining par levels wasn't difficult enough, when it comes to buying sutures, you face the added challenge of a field of choice that's limited at best. Three factors tend to virtually eliminate wiggle room for those who are making the buying decisions. One is the quality of the product, a second is physician comfort and the third is the general lack of market - there are a ton of options, but few manufacturers in the game.