Tianfu Roud, Dongcheng District,Shan County, Heze City, Shandong, China 274300
The history of human use of sutures is very long. In fact, ancient Egyptians and Syrians began to use sutures and ligatures as early as 2000 BC.
Briefly, medical surgical sutures are the lines that surgeons use to suture tissue together, can be used to suture wounds from wounds or wounds in surgery, and can also be used to ligature blood vessels. Several sutures of different materials are used to suture subcutaneous tissue, fascia or deep tissue.
The composition, thickness or structure of different sutures are quite different. Usually doctors choose different material sutures depending on the location and nature of the wound. Stitching the sutures of deep tissue not only accelerates wound healing, but also limits the extent of scarring. The surface skin is stitched to obtain a better cosmetic effect. It is very important to use the correct type of suture, which is directly related to the healing process. The US Pharmacopoeia recommends that the suture box must contain complete information about the material of the suture, including the type and size, and the type of needle.
Characteristics and application of suture
Because the suture is a foreign body to the body, it can cause an inflammatory reaction in the skin. The inflammatory response peaked from the second to the seventh day of suturing. When suturing a wound or incision, the surgeon must ensure that the subcutaneous tissue does not leave a dead space. Stitching should not be too tight, so as not to affect the blood supply and cause tissue necrosis. The tension of the wound should be as small as possible.
Medical surgical sutures should have several characteristics:
2, Sufficient tensile strength
3, Easy to control
4, Knotted firmly, provide sufficient support for the edge of the tissue until it is completely healed
5, It is not easy to hide bacteria or pathogenic microorganisms
6, Will not cause damage to the organization
Regardless of the suture of the material, the purpose is to ensure that the wound heals quickly. Over the years, humans have developed many different types of sutures and classified them according to their characteristics.
Natural sutures and chemically synthesized sutures
The material of the suture is divided into natural suture and chemical synthetic suture. Natural sutures are derived from natural materials and are typically represented by silk, flat gut and chrome gut.
The gut is absorbed in the body by protease degradation. Because these sutures are made up of multiple fibers, they are very strong during the first few days of wound healing. However, in the next few weeks, their intensity will drop rapidly. The gut can be used to suture the muscles because the muscles heal quickly, but high-strength sutures are needed in the early stages of healing.
With the emergence of higher-strength chemical synthetic lines, the use of gut has decreased.
The chemical synthesis line is made of various polymers such as polyglycolic acid (PGA), polyesterene (POLYESTERS), polydioxanone (PDO) and the like. The degradation of the chemical synthesis line is not due to the action of the enzyme, but is accomplished by a hydrolysis process. Formally because of this, unlike the gut, the synthetic line does not cause a strong inflammatory response and only causes a slight tissue reaction.
Sutures can also be divided into absorbable sutures and non-absorbable sutures The absorbable suture can be degraded or completely absorbed by the tissue in the body, and the time required for complete absorption varies depending on the material, size, local environment, wound location, and overall patient health. The absorbable sutures produced by Heidico include PGA, PGLA, PDO, and gut, non-absorbable sutures, silk, nylon, polyester, and polypropylene.
For tissues that have a fast healing rate and require less support, people often use sutures, such as the oral mucosa or surgery involving superficial blood vessels. PGA is commonly used to suture muscle and adipose tissue, or the dermis and subcutaneous tissue of the skin. PDO is often used to suture fascia and muscle. Absorbable sutures are often used for suturing subcutaneous tissue because they cause significant scar formation.
In contrast, non-absorbable sutures can remain intact at all times. Some sutures can be permanently present in the tissue without being degraded. Non-absorbable sutures are typically used for suturing internal organ tissues, which typically have a long healing time. Polypropylene is mostly used to suture muscles, blood vessels and fascia. Silk thread is mainly used to suture the intestines or blood vessels. Nylon threads are often used to suture skin wounds or incisions.
In short, the correct choice of suture is very important for wound healing. In addition to using the right size and choosing the right material, using the right equipment and applying the right suture technique is also important to reduce tension and scarring. Stitching methods for suturing wounds include simple interrupted suture, simple continuous suture, subcutaneous suture, subepidermal suture, and the like. In order to ensure a smooth healing, it is necessary to ensure that the blood supply to the wound is normal. If the suture is disengaged or the wound is cleaved, there are signs of redness or bloody or purulent secretions around the wound. You should notify the competent doctor for treatment as soon as possible.
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