Tianfu Roud, Dongcheng District,Shan County, Heze City, Shandong, China 274300
In clinical applications, should surgical sutures be able to absorb absorbable sutures or non-absorbable sutures? There are many factors that determine the choice of suture, such as the choice of surgical incision, the patient's own factors, the nature of the surgery, the sutured tissue, and so on. The doctor needs to properly select the appropriate suture in order to maintain the strength of the suture sufficient to withstand the tension of the suture until the sutured tissue is fully healed. In addition, the doctor should consider the biochemical reaction of the suture material to human tissue. Most suture materials have only a slight tissue reaction, and the tissue reaction of synthetic materials tends to be smaller than natural fibers.
We usually use the finest sutures that match the natural strength of the sutured tissue, and choose to apply non-absorbable sutures or long-lasting absorbable sutures to suture slow-healing tissues such as fascia, tendons, and the like. Tissues that heal faster, such as the stomach, colon, bladder, etc., are sutured with absorbable sutures. For potentially contaminated tissues, the use of multi-strand fiber sutures should be avoided, but single-strand sutures or absorbable sutures that are not easily adhered by bacteria should be avoided, especially antibacterial absorbable sutures. For areas where beauty is particularly important, consider using the finest inert single-strand sutures, such as nylon sutures, polypropylene sutures, and more. At the same time, the subcutaneous tissue should be sutured as much as possible to avoid skin suture alone. If possible, consider using sterile skin suture tape to ensure a tight fit on the edges of the skin. Since foreign matter present in a solution containing a high concentration of crystal may cause precipitation and stone formation, an absorbable suture should be used for urinary and biliary surgery.
The choice of sutures also takes into account the principles and techniques of knotting. Stable and exact knotting techniques are also an important part of good suturing techniques during surgery. The choice of knot type depends on the suture used, the depth and location of the incision, and the amount of tension the wound is subjected to after surgery. The knotting must be slow and detailed, and the knotting speed is too fast to position the sutures poorly. At the same time, the amount of tension applied to the wound must also be considered, leaving room for the formation of postoperative tissue edema. At present, the general principles for knotting various sutures are:
(1) The knot must be firm and not slippery. The simplest knot is ideal for all specifications and characteristics of the suture material.
(2) When the knot is firm and safe, the traditional square knot is replaced by intradermal suture.
(3) Avoid inter-tissue friction sutures.
(4) Avoid excessive tension to break the suture and cut the tissue.
(5) Excessive knots do not increase the strength of the appropriate knot, but only make the knot larger. The coefficient of friction of the wire knot directly affects its firmness. The larger the friction coefficient, the stronger the wire knot. In contrast, multi-strand fiber sutures are easier to handle and knot than single-strand fiber sutures.
The ideal suture needle is made of high quality stainless steel. As long as it does not affect the strength, it is as thin as possible. It can be gripped securely by the needle holder. The damage caused by guiding the suture through the tissue is minimal. Sharp enough to pass through the tissue with minimal resistance. The perfect balance of rigidity and toughness, both resistant to bending and without breaking. Sterile, anti-corrosive, prevent microbes or foreign bodies from entering the wound. Surgical sutures are available in different sizes and sizes, and the needles are also available in different shapes. The diversity of the two is very important. The size and physical properties of the needle must match the thickness of the suture to coordinate work.