During surgery, there is a need to connect tissues, blood vessels. Suture materials in surgery have undergone a certain evolution, and today they have a number of certain properties that contribute to the rapid healing of wounds. Modern medicine has taken into account the cosmetic side: the seams become less noticeable, and often from them there is no trace at all.
Characteristics of crosslinking materials
Suture material must have a number of specific abilities. First of all, such a substance should not be toxic, cause allergic reactions. Another necessary quality is resistance to sterilization, because it is the absence of pathogenic flora that is very important for surgical intervention. Well and, of course, the suture material must be strong, not injure the tissue through which it passes. It is important and its elasticity, and the ability to form nodes. All materials can take the form of one thread or can be formed from several (torsion, weaving). Depending on the ability of the substance in biodegradation, the classification of suture material looks like this: absorbable sutures, slowly absorbable, and those that do not absorb at all. Also, such an element in surgery can be of both natural and synthetic origin.
Materials that do not absorb
Similar materials were used even before the advent of more modern analogues. However, even now they are widely used in those cases when it is necessary to obtain a strong and reliable connection. At the same time, fabrics will be held for a long time by a similar seam. Silk threads (conditionally absorbable, since they become invisible after a few years), lavsan, polypropylene, polyvinyl, metal devices, staples belong to this category. Silk has a sufficiently large strength. Such a thread is very easy to manipulate, tie knots. In this case, reactions in the tissues are often observed. Often such suture material is used in ophthalmology, plastic surgery, and operations on the organs of the gastrointestinal tract. Inert filaments include polypropylene. Because of its great strength, it is used when applying nets, fixing various elements. The metal wire is made of stainless steel, can be used when connecting sections of the sternum, etc.
Lavsan in surgery
Surgical suture material based on polyester has undoubted advantages: high strength, handling properties are also on the level. In addition, it very rarely causes reactions in tissues. It happens in several types: twisted, braided, coated with fluororubber. The cost of such a thread is relatively low. Often, such suture material is used in prosthetics, during operations on difficult to heal areas, as well as in areas where constant tension is observed. However, there are a number of disadvantages. Being in the body constantly, such threads can cause inflammatory processes.
Characteristic of absorbable material. Catgut
Substances in this category can be natural and synthetic. Catgut is classified as natural. This surgical suture material is made from the small intestines of mammals (healthy), which are processed in a special way. Initially, such a material has sufficient strength, but it is soon lost. For a week or two, its indicators are reduced by half. In order for the resorption period to slightly increase, catgut is treated with chromium salts. Such manipulation doubles the dissolution time. It is important to note the fact that such suture material is absorbed differently depending on what tissue it was placed in, as well as on the intensity of blood supply to this area, individual characteristics of the body. The disadvantages include the stiffness of the thread, as well as the possibility of allergic reactions. The main applications are gynecology, urology, operations on the respiratory and digestive organs, wound closure.
Synthetic absorbable suture
This type includes substances that have optimal properties. With their use, it is easy to predict the timing of loss of strength. In addition, such threads are convenient to use, they are quite strong. Another undoubted plus is inertness and the absence of allergic reactions. One of the varieties is absorbable polyglycolide suture. It is characterized by increased strength and is able to hold the wound during critical periods of healing. Dexon is one of the most used materials in general surgery, as well as in gynecology, urology. These synthetic substances are of common origin. They are polymers of lactic acid. After the thread got into the tissue, the process of hydrolysis. At the end of all chemical reactions, suture material breaks down to water molecules and carbon dioxide. The most commonly used are synthetic absorbable sutures to connect the tissues of the abdominal and pleural cavity. In these areas, the regeneration period is from one week to a month, while it coincides with indicators of a decrease in the strength of the material.
Vikril - a suture material for connecting fabrics
To connect soft tissues and areas that do not require prolonged tension, modern vikril material is used. It has a synthetic origin and incorporates glycolide and L-lactide. Tissue reactions during its use are minimal, strength decreases after 4 weeks. Complete dissolution in the body occurs by hydrolysis in 50-80 days. Such threads are used in ophthalmology and gynecology. But those areas in which its use is inappropriate is neurosurgery and heart surgery. Vicryl is a suture material that can be supplied both unpainted and purple. Threads exist in different thicknesses and lengths. Options may include stainless steel needles.
Surgical filament storage
In order for the threads to maintain their physical properties, it is important to adhere to the correct temperature regime. Suture materials in surgery lose their strength if stored at temperatures above 30º C or at negative rates. If the thread was removed from the packaging but not used, then it must be disposed of. It is important to monitor expiration dates. After their expiration, the properties change somewhat. Contact with moisture is also highly undesirable. Repeated sterilization of suture material is not permissible.