When performing surgery, it becomes necessary to connect tissues, vessels. Suture materials in surgery have undergone a certain evolution, and to date they have a number of specific properties that contribute to the rapid healing of wounds. Modern medicine has also taken into account the cosmetic aspect: the seams become less noticeable, and quite often there is no trace left of them.
Characteristics of the 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 the resistance to sterilization, because it is the absence of pathogenic flora that is very important for surgical intervention. And, of course, the suture material should be strong, not to injure the tissues through which it passes. It is important and its elasticity, and the ability to form nodes. All materials can be in the form of one thread or be formed from several (twisting, weaving). Depending on the ability of the substance in biodegradation, the classification of suture material is as follows: absorbable threads, slowly absorbable, and those that do not dissolve at all. Also such an element in surgery can be of both natural and synthetic origin.
Materials that do not resolve
Similar materials were used even before the appearance of more modern analogues. However, even now they are widely used in cases where it is necessary to obtain a strong and reliable connection. In this case, the tissue will be held for a long time by a similar suture. This category includes silk threads (conditionally absorbable, as they become invisible after several years), lavsan, polypropylene, polyvinyl, metal fixtures, staples. Silk is quite strong. This thread is very easy to manipulate, tie knots. In this case, reactions in tissues are often observed. Often, such a suture material is used in ophthalmology, plastic surgery, operations on the organs of the gastrointestinal tract. The inert threads include polypropylene. Because of its great strength, it is used when laying nets, fixing various elements. The metal wire is made of high-quality steel, can be used when connecting sternum sections, 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 a reaction in the tissues. It can be of several types: twisted, woven, coated with fluorine rubber. The cost of such a thread is relatively low. Often, such a suture material is used for tissue prosthetics, for operations on hard healing areas, as well as for areas where constant tension is observed. However, there are a number of shortcomings. Being in the body constantly, such strands can cause inflammation.
Characteristics of the material that can be absorbed. Catgut
Substances of this category can be natural and synthetic. To natural belong to the catgut. This surgical suture material is made from the small intestines of mammals (healthy), which are processed in a special way. Initially, this material has sufficient strength, but it is soon lost. For a week or two its indicators are reduced by half. In order to slightly increase the resorption time, the catgut is treated with chromium salts. This manipulation increases the dissolution time by a factor of two. It is important to note the fact that such a suture material dissolves in different ways depending on the tissues in which it was placed, as well as the intensity of the blood supply of the site, the individual characteristics of the organism. The drawbacks can be attributed to the rigidity of the thread, as well as the possibility of allergic reactions. The main areas of application are gynecology, urology, operations on respiratory and digestive organs, wound closure.
Synthetic absorbable threads
This type includes substances that have optimal properties. When applying them, it is easy to predict the time of loss of strength. In addition, such threads are convenient in work, they are quite strong. Another undoubted plus is the inertness and lack of allergic reactions. One of the varieties is a polyglycolic suture material that is absorbable. It is characterized by increased strength and is able to hold the wound in critical periods of healing. Dexon is one of the most widely used materials in general surgery, as well as in gynecology and urology. Such synthetic substances have a common origin. They are polymers of lactic acid. After the thread has got into the tissue, the process of hydrolysis takes place. At the end of all chemical reactions, the suture material decomposes to molecules of water and carbon dioxide. The most commonly used synthetic resorbable threads for the connection of abdominal and pleural cavity tissues . In these areas, the regeneration period is from one week to a month, while it coincides with the reduction in strength of the material.
Vicryl suture material for tissue connection
To connect soft tissues and areas that do not require prolonged tension, modern material is used for vikril. It has a synthetic origin and has in its composition glycolide and L-lactide. Reactions of tissues at its application are minimal, strength decreases after 4 weeks. Complete dissolution in the body occurs by hydrolysis after 50-80 days. Such threads are used in both ophthalmology and gynecology. But those areas in which its use is inexpedient - neurosurgery and heart surgery. Vicryl suture material, which can be supplied both in unpainted form, and have a violet color. Threads exist in different thickness and length. The kit may include stainless steel needles.
Storage of surgical threads
In order for the filaments to retain their physical properties, it is important to adhere to the correct temperature regime. Suture materials in surgery lose strength if stored at temperatures above 30 ° C or at negative levels. If the yarn was removed from the package, but not used, then it is recyclable. It is important to follow and expiration dates. Upon their expiration, the properties change somewhat. Contact with moisture is also highly undesirable. Repeated procedure of sterilization of suture material is inadmissible.