Suture material

Suture material is material for surgical sutures and bandages blood vessels. He should have a durable, smooth surface, transfer sterilization, tying themselves into a solid nodes. For absorbable sutures used catgut, and the threads of polyvinyl alcohol and some other organic substances. Catgut is made of submucosal layer of thin intestines of sheep. After special treatment and purification twisted yarns with thickness from 0.2 to 0,73 mm Thin thread- № 000, 00, 0, 1, 2; average - 3, 4; thick - 5, 6.
Applies catgut for bandaging medium-sized vessels, for submersible seams (stomach, intestines, subcutaneous tissue and other), for skin joints under plaster bandages, for intradermal cosmetics seam, seam parenchymatous organs to stop bleeding when suturing on the mucous membranes. Shown kedgotoline seams and ligatures, especially when a wound infection, when the silk sutures can give long-term healing ligature fistulas. Resolved catgut usually within 7-9 days, special processing slows the absorption of up to 1 month. Catgut is produced in Hanks (unsterilized) thread length 2.5 m Packed in envelopes. For sterilization of catgut usually apply various modifications impregnation iodine, often in the form of immersion for different periods in the Lugol solution.
The big distribution for the imposition of submersible (non-absorbable) and removable skin sutures has silk. Its advantage is durability even in small thickness. Fine silk- № 000, 00, 0, 1, 2; average - 3, 4, 5 and thick - 6, 7, 8, 9, 10. Is produced in Hanks. Silk is gradually giving way to a synthetic non-absorbable threads (nylon, kapron, lavsan and others). As substitutes silk, except synthetic fibres, apply linen threads, simple or impregnated with collodion. In cosmetic surgery for skin sutures used horse hair.
Widespread receives for joints kapron. The advantage of it before silk - he doesn't soak the wound plasma. The disadvantage is most inclined seams to be untied and drawn out, what makes tie him than double the surgical site, another direct-site (see the surgical Sutures).
Metal suture material (from tantalum, stainless steel or cobalt alloy) is recommended in bone surgery, neurosurgery (see Nervous seam, Osteosinteza). It is used in the form of metal brackets (see staplers).
Sterilization suture material - see Sterilization surgery.

Suture material - material for surgical sutures. Suture material must be strong, smooth, better hydrophobic surface, easily sterilized, to be dense, i.e. with small capillarity, good tying themselves in knots that should not be untied and stretched. The most common soft ligature thread - biological absorbable (catgut), synthetic absorbable (thread polyvinyl alcohol) and non-absorbable (silk, nylon, polyester, and other). The most common absorbable suture material is still catgut, made of elastic fabric submucosal layer of thin intestines of small cattle. In the USSR catgut produce 11 rooms and numbered by the thickness of the thread from # 000 to № 8 (diameter from 0,2 mm to 0,73 mm). The term resorption of catgut - from 7 to 14 days. A special sort of catgut long resorption (up to 30-40 days) is obtained by processing a 5% solution of benzoquinone. Due to the fact that catgut contains tromboticeskie substance, it has a certain degree of hemostatic properties. Kedgotoline seams should tie a double surgical site or single, leaving the ends in 1-1,5 see as non-absorbable suture material is still widely used silk ligature threads made from natural silk with a small addition to the strength of the highest grade of cotton. But gradually silk (with a negative feature of vitalnosti) instead of synthetic non-absorbable threads. In the USSR to produce Lisle thread GOST 396-52 (13 rooms from 000 to 10). Unsterilized silk produced in Hanks; in a range of rooms from 000 to 2 - thread length 45 of + / -1 m, from 3 to 10 with length of 9±5 m Breaking load silk thread should be for woven silk № 000 at least 370 g № 1 - 1 kg 250 g, and for no 8 - not less than 10 kg 500, the Zero non silk used in vascular surgery, middle (3-5) - for stitching various soft tissues. The thicker silk is used for tightening force dense tissue, such as convergence of intercostal spaces in thoracic surgery. In ampoules release sterilized by the factory of dry catgut and silk in Hanks; the last - in antiseptic preserving solution. Thin non silk for vascular seams and silk on atraumatic needles are sterilized by boiling in vaseline oil, and store. Silk, produced in coils, rewind with the help of special devices on the glass coil. During the operation recommend the use of glass or metal egg cartons with coil inside. A sister or a surgeon, holding the box in the left hand, can, without violating the minor, to retrieve the thread needed
the length. Silk ligature tied direct sea or double surgical site, all of which need to be cut short (without the "antennae"). Around silk ligature develops cellular infiltration so that the inflammatory centres dominated polinucleares determined even a year after the operation. Therefore silk may have advantages over the other suture material only when necessary to keep the wound edges in the connection for a long period.
Offered as a non-absorbable suture material fibre hemp, hemp (abacus), coconut fiber, etc. For stitching blood vessels before used the women's hair. Horse hair and now finds application in cosmetic surgery, skin sutures. As a substitute silk, except synthetic threads, you can use cheap, well-sterilisable linen, heald (coil) thread, simple or impregnated celluloid or collodion and other
Does not cause significant tissue reaction non-absorbable suture material in the form of flexible metal tantalum wire or stainless steel, or of cobalt alloy CHM. Metal suture material is recommended for bone surgery, neurosurgery (see Nervous seam, Osteosynthesis), as parentheses sewing machines (see staplers). Sterilization suture material - see Sterilization surgery.
Cm. also surgical Sutures.