The introduction of several suture

1. Silk and cotton is a natural fiber spun into the surface often coated with wax or resin. Silk, are the most commonly used suture ligation material. The advantage of less tissue reaction and maintain the tensile strength is longer; The disadvantage of a longer-term memory in the organization can contribute to contamination development of infections, surgical site infection and significantly contaminated and therefore does not apply. Cotton organizational memory in time may be longer than silk. Cotton threads of the same thickness smaller than the thread tension strength, and relatively easy to loose.
Silk and cotton cut into the larger organization. Therefore, in the tension of the wound or more vulnerable organizations, as a last resort and with a coarse thread. However, residual lint also increases the formation of larger foreign bodies nodules; may start by postoperative shallow discharge from the wound scar, sometimes fistula formation.
2. The catgut composition of the collagen fibers, taken from the small intestine of sheep or cattle; there is a line of the same nature, made with bovine tendon processing. The catgut points two kinds of ordinary catgut and chromic catgut. Ordinary catgut about 72 hours within the organization that lost about a week to be absorbed. The chromic catgut collagen fiber bonding is more compact, and can keep for 5 days, 2 to 3 weeks to be absorbed within the organization. The duration of its existence and the environment related to contact with the digestive juices or bacterial infection can be faster useless.
The organization has a strong gut reaction; current suture similar reaction, but lighter. Initially the reaction, lymphocytes, exudation of neutrophils and fibroblasts proliferation of other organizations. Absorption dominated, monocytes, macrophages, fibroblasts gradient into fiber cells. Acute reaction to the strong neutrophil; slower absorption formation of granulation tissue around the suture.
Catgut (many with chromic catgut) applicable to expected rapid absorption and infection may occur suture ligation. For example: for ureter or bile duct suture (anastomosis), to avoid stone composition deposited on the suture; heavier purulent peritonitis, peritoneal catgut suture can also be used. Applied when soaked in warm water to make use of catgut flexibility is moderate, or ligation is often due to tight or easy to break.
3. Wire alloy, its tensile strength over other types of sutures, apply to the bone engaging and great tension wound closure. Tissue reaction is minor and does not procure the contaminated wound becomes infected wounds. Wire is not entirely within the organization can not afford to change, but the change is very slow, so long there. If it is near the surface and palpable, makes the patient feel unwell. In addition, the alloy wire also difficult to operate, cutting tissue may suture breakage or kinking operation may stabbed surgeon spread disease and other shortcomings.
4. Non-absorbent and absorbent two types of synthetic fibers.
(1) does not absorbent synthetic fibers: nylon 6.6, nylon (nylon 6), polyester the Pu Luolun (Prolene), have a greater tensile strength, slight tissue reaction, can maintain its performance within the organization for a long time. With silk, the advantages of the synthetic fibers: (1) can be made a considerable strength and small diameter thin line, it applies not only to general surgery, microsurgery; ② surface is very smooth, the tissue damage is very small (can be made without damage to the suture), tissue reaction than with the thread; ③ contaminated wound is very small, such as nylon, hydrolysis may also have an antibacterial effect. The disadvantage is slightly harder texture, knotted easier to release their own, the need to increase the number of knot (3 to 5 buckle) ligation.
(2) an absorbent synthetic fibers: Dexon (PGA, polyglycolic acid), protection Vicryl Vicryl (polyglactin 910, poly-lactic acid-glycolic acid), PDS (polydioxanone, poly-dioxo-heterocyclic cyclohexanone) and PVA (polyvinyl acetate Pooh Lun). Compared with chromic catgut, the advantage of this type of synthetic fiber: ① no natural suture antigenicity, less tissue reaction; (2) tensile strength and absorption time, such as Vicryl maintained within the organization for more than 35 days; (3) may have an antibacterial effect, such as glycolic acid hydrolysis of Dexon and Vicryl bacteriostatic effect, the suture for sterile environment. Synthetic suture through the tissue and smooth, accurate positioning knotted smooth ligation tensile strength, small tissue reaction, can be made of 10-0 Narrow sutures, good absorption performance, able to maintain the wound for up to 3 to 6 weeks, 56 to 70 days is substantially absorbed, there is a trend to replace the natural sutures and silk, the drawback is that the price is more expensive. Use of absorbable suture ligation, needed Triassic knot, thread left in the cut line should be longer, so that the knot loose. Avoid held with a needle or the vascular clamp extra virgin suture or line kink or even rupture. In pancreatic surgery, not catgut ligature and suture, catgut susceptible to trypsin digestion and absorption can occur secondary to bleeding and anastomotic leakage; synthetic absorbable suture is caused by the decomposition of the polymer chains by hydrolysis is absorbed, and therefore fewer limitations on their use.
The synthetic fiber is developed in order to achieve the aforementioned ideal suture material conditions. In addition, in view of the suture as a foreign body may be contaminated tissue infection rate increased, conducted a survey of the relationship between synthetic sutures and bacteria. Found that the physical configuration of the suture material chemical structure of bacterial adhesion, monofilament suture and coating (such as silicon package) with more silk suture and uncoated, less adhesion of bacteria; hydrophilic group (ester group) more easily adhere to bacteria. Types of bacteria on the distribution of the suture, such as Staphylococcus aureus easier than E. coli adhesion to the suture, the former often clustered adhesion, which scattered. The research in this area to contribute to the development of new suture, the suture is more suitable for the surgery of contamination and infection.