Surgical surgical sutures and suture needles are remarkably small, with a magnifying glass. "Needle-thin hold depends on the needle to use. Surgical sutures than head hair was thin, almost invisible to the naked eye.
2013年7月16日星期二
2013年7月10日星期三
Surgical sutures and surgical needles should be how to choose
Surgical needles: triangle needle is to suture the skin. Round pin is used to stitch the intestinal tract, etc. Surgical suture: 1 is stitched joint capsule and muscles. 2 is the subcutaneous tissue. 4 is to suture the skin. 5 are stitched epidural.
Optimal surgical needles requirements: 1. Use high quality stainless steel material. 2. In does not affect the strength of the premise, as far as possible thin. 3. By the needle detector prod-ucts. 4. Guide the suture through tissue damage to the limit. 5. The resistance of the sharp degree to at least down through the organization. 6. Bending, can not be broken. The choice of the surgical suture line: absorption line: normal gut absorption, starting about 7 days can be used for ligation and sewing leather; Chromic catgut. 14-21 days gradually quilt absorb, for closing a deep tissue. The gut is mainly used for internal organs like the stomach, intestines, bladder, ureter, biliary tract, mucosal layer suture. General use 1-0\3-0 chromic catgut. Coarser 0-2 catgut chromic system commonly used in deep tissue inflammatory peritoneal. An absorption line: (0-3) - 0 for commonly used fine silk, applicable to the general ligation and stitching. (5-0) - (7-0) to the fine line wire, used for vascular nerve suture; 1-4, often said in the thread, usually for suturing peritoneum, and fascia, etc.; No. 4 above for coarse yarn, is often used in ligature large blood vessels, reducing a suture. Don't absorption lines include, cotton silk, stainless steel wire, chemical fiber wire, etc. Stainless steel wire bone with more!
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Optimal surgical needles requirements: 1. Use high quality stainless steel material. 2. In does not affect the strength of the premise, as far as possible thin. 3. By the needle detector prod-ucts. 4. Guide the suture through tissue damage to the limit. 5. The resistance of the sharp degree to at least down through the organization. 6. Bending, can not be broken. The choice of the surgical suture line: absorption line: normal gut absorption, starting about 7 days can be used for ligation and sewing leather; Chromic catgut. 14-21 days gradually quilt absorb, for closing a deep tissue. The gut is mainly used for internal organs like the stomach, intestines, bladder, ureter, biliary tract, mucosal layer suture. General use 1-0\3-0 chromic catgut. Coarser 0-2 catgut chromic system commonly used in deep tissue inflammatory peritoneal. An absorption line: (0-3) - 0 for commonly used fine silk, applicable to the general ligation and stitching. (5-0) - (7-0) to the fine line wire, used for vascular nerve suture; 1-4, often said in the thread, usually for suturing peritoneum, and fascia, etc.; No. 4 above for coarse yarn, is often used in ligature large blood vessels, reducing a suture. Don't absorption lines include, cotton silk, stainless steel wire, chemical fiber wire, etc. Stainless steel wire bone with more!
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2013年6月23日星期日
Cosmetic surgical sutures to buy separately?
Q: do the earlobe keloid resection surgery, a total of 6. Operation and anesthesia fee or something, were given out. The doctor says surgery depends on how much line, collect money again. I want to ask, do surgery with surgical sutures should be separate charge?
A: used in dressing, all in the cost of raw materials including! ~ temporary plus, plus
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A: used in dressing, all in the cost of raw materials including! ~ temporary plus, plus
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Technology of victory! 3 d printing to save bronchial soften baby
Recently because the 3 d printing technology is used in the manufacture of guns, and the media to the forefront. But you don't forget, 3 d printing also can be used to save lives.
A baby boy in the Ohio Kaiba Gionfriddo, in six weeks was diagnosed with congenital tracheal bronchus softening, cause collapse of trachea, oxygen cannot smoothly into the lungs, always run the risk of suffocation. Before operation, a baby can only rely on inserted into the trachea to maintain ventilation.
In securing baby permission from parents as well as the relevant institutions of the university of Michigan, Michigan, school of medicine, using 3 d printers, according to the patients with chest CT images, print out the shape of the trachea and a piece of plywood. Then, the doctor put the plywood in patients with chest, supporting airway collapse, so that the air flowing. Operation is completed, the baby use 21 days of breathing machine, and then recovered discharged from hospital. Today more than a year of time has passed, the child can already spontaneous breathing, and plywood has not any different.
This 3 d printing plywood only takes up a day, compared to the previous hand made more fast, cost only a third. And it USES is poly (ethyl acetate material, belongs to the biodegradable plastic, also be used to make surgical sutures. This piece of plywood about degradation will be in 3 years later, but at that time in patients with respiratory function has been fully mature, can out of plywood.
The baby was lucky, it is the first 3 d printer application of clinical cases. The medical achievement are published in the New England journal of medicine, the author thinks "high-definition images, the 3 d print combination of computer and biological materials, can be specified for patients, to promote creating implantable devices." Similarly, using 3 d printers to produce bone, teeth, and already is considered a possible direction.
Currently bioprinting pioneer Organovo, calif., company has been successful use of 3 d printing to create "mini liver", and it can survive more than five days; Cornell university with the aid of mouse tail and decorative, print out the human ear. Believe farther in the future, have the vitality of organs can be printed.
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A baby boy in the Ohio Kaiba Gionfriddo, in six weeks was diagnosed with congenital tracheal bronchus softening, cause collapse of trachea, oxygen cannot smoothly into the lungs, always run the risk of suffocation. Before operation, a baby can only rely on inserted into the trachea to maintain ventilation.
In securing baby permission from parents as well as the relevant institutions of the university of Michigan, Michigan, school of medicine, using 3 d printers, according to the patients with chest CT images, print out the shape of the trachea and a piece of plywood. Then, the doctor put the plywood in patients with chest, supporting airway collapse, so that the air flowing. Operation is completed, the baby use 21 days of breathing machine, and then recovered discharged from hospital. Today more than a year of time has passed, the child can already spontaneous breathing, and plywood has not any different.
This 3 d printing plywood only takes up a day, compared to the previous hand made more fast, cost only a third. And it USES is poly (ethyl acetate material, belongs to the biodegradable plastic, also be used to make surgical sutures. This piece of plywood about degradation will be in 3 years later, but at that time in patients with respiratory function has been fully mature, can out of plywood.
The baby was lucky, it is the first 3 d printer application of clinical cases. The medical achievement are published in the New England journal of medicine, the author thinks "high-definition images, the 3 d print combination of computer and biological materials, can be specified for patients, to promote creating implantable devices." Similarly, using 3 d printers to produce bone, teeth, and already is considered a possible direction.
Currently bioprinting pioneer Organovo, calif., company has been successful use of 3 d printing to create "mini liver", and it can survive more than five days; Cornell university with the aid of mouse tail and decorative, print out the human ear. Believe farther in the future, have the vitality of organs can be printed.
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Rat tail do surgical sutures, raise rats can also make money!
Refers to those special animals have been domesticated successfully, not yet widely used in the production, countries have yet to be identified as poultry, livestock, insect and the, remains to be domesticated wild animals under domestication.
You can make money a rat
Mice as a kind of special animal has now been raised some people a lot, its prospect is also favored by the industry. At the mention of rats, people instinctively will generate resentment, and rat meat more can not be accepted. According to understanding, keeping rodents is in recent years began to popular business, this kind of business are bred mice is not our common or for people viewing pet rat, but is given priority to with musk rat and nutria.
They have certain commercial value, but also diversified sales, both in the field of cosmetics and can be widely used in the field of consumption. But reporters from shenyang shenyang pet animal health supervision bureau and chamber of commerce, there is currently no person do such business in shenyang.
Annual revenue of more than 800
Breeding mice how much business opportunities, where business value, feeding rats really can eat meat?
Musk rat breeding base in China Marketing Department ms dai told reporters, they do business of raising desman company started in 2007, so far, breeding base has reached 12000 square meters, the types of mouse has more than three thousand pairs, efficiency can reach more than 800, ten thousand yuan a year.
According to Ms. Dai, musk rat "whole body is treasure," musk rat can do mink fur, manure production of mosquito coil incense is the natural raw material, the meat is edible, beard can do senior toothpicks, musk, produced by male mice can do cosmetics. Desman in addition to the widely used, are very strong ability to reproduce. In the south of the musk rat can produce 2-3 times a year, each breeding populations in 8-12 only, the survival rate can reach more than 90%, if the reproduction rate is to cut some in the north.
Desman besides strong reproductive capacity and wide scope of application, its profit is also very considerable. According to understand, desman peacetime eat some corn noodles and vegetables can, keeping costs low. Every male rats 10-15 g musk yearly, and the musky market price in 100 yuan per gram, can bring 1000 yuan to entrepreneur's profit; And females may give birth to more than 20 chicks every year, every cub market value in 250 yuan, a year can also have more than 5000 yuan of profits. In addition, musk rat fur according to their different sizes the market price also have high and low, at present to the market price of each skin in about 120 yuan, and rat meat prices in the 60-80 yuan/jins, mainly popular in some southern coastal cities.
Tail can be used as surgical sutures Breeding of musk rat profitable, raising the prospect of the nutria? Chibi south forest farms, head of the nutria He Xing engaged in aquaculture has been a few years time, he said, the rats of aquaculture is a special industry, the market gap is larger. Nutria purpose similar to musk rat, but it won't produce musk. For now, the market price of the nutria skins and is not very good, but its tail is can do sutures after extraction.
What the factory director said that at present some special door to door to buy nutria tail, the price is 118 yuan/article, if food prices in 20-25 yuan/kg. It is worth mentioning that for this rat survival temperature to control the temperature of 0 degrees Celsius above zero. If the north winter temperature is too low, the nutria breed and can influence the survival rate of baby mice. This is why few northern breeding.
Investment tips
Special animal faces regulatory difficult
For entrepreneurs, choosing the appropriate mouse species, can be raised in shenyang?
Shenyang animal health supervision bureau of disease control at Yang Qingmin tell reporter, at present there are no farms in shenyang special feeding rats, the country has no special laws and regulations to clear such animal breeding, but if someone do such business, in addition to need to pass for examination and approval of relevant industry and commerce, taxation, and to examine its epidemic, after the inspection will be awarded merchants for animal epidemic prevention certificate.
He Xingze tells a reporter, regional rules for feeding rats enterprises may also have differences, but their own farms in addition to deal with relevant business license, has dealt with wild animals domestication and breeding licenses, license and wild animals.
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2013年6月21日星期五
Hello: I just finished my mammary gland fibroma surgery, postoperative wound infection, surgery has been more than 3 months now, sutures not to come out, now what can I do?
Q: illness description (onset time, main symptoms) : hello, I just after mammary gland fibroma operation and postoperative wound infection, surgery has been more than 3 months now, surgical sutures not to come out, now what can I do? Hello: I just finished my mammary gland fibroma surgery, postoperative wound infection, already change medicine anti-inflammatory treatment, surgery has been more than 3 months now, surgical sutures not to come out now, blade have small pustules, like the appearance of small blisters, how to do? What method can quickly eliminate surgical suture? Want how to help: what should I do now? Suture was too slow to come out! Has been more than three months, came out, the doctor said let me go home waiting, but time is too long, used to treat conditions and whether there is allergic, genetic history: second liver now what should I do? Suture was too slow to come out! Has been more than three months, came out, the doctor said let me go home waiting, but time is too long.
Answer: in front of you have said; Postoperative wound infection, the infection is likely to be surgical sutures in the body, make body in produce rejection, and the blade have small pustules, prove have inflammatory liquid inside, need to go to the hospital to clean, if more, may need to draw out.
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Answer: in front of you have said; Postoperative wound infection, the infection is likely to be surgical sutures in the body, make body in produce rejection, and the blade have small pustules, prove have inflammatory liquid inside, need to go to the hospital to clean, if more, may need to draw out.
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Surgical suture didn't clean up to do!
Q: I was about a month ago the prepuce operation, the wound is completely healed! Today I take a shower of the time, found that the wound that place take place a little bit not clean surgical sutures after surgery! I tried to pull it out, but very painful very pain! Must be already with meat a long! But can you tell me whether the influence is not big, should be drawn or go to the hospital!
A: go to the hospital to take out. In order to avoid future trouble. When should you use absorbable surgical sutures. Why the province that a few money? Otherwise there won't be upset now
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A: go to the hospital to take out. In order to avoid future trouble. When should you use absorbable surgical sutures. Why the province that a few money? Otherwise there won't be upset now
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After surgery, surgical sutures allergic reaction?
Ask: I in June this year cut bilateral thyroid all surgery, now sometimes from the surgical scar of a blister, doctor check to the hospital, surgical sutures and my skin do not absorb, the blister after the break, there will appear some suture threads, after the doctor remove the thread, and gave me a dressing process, also had some anti-inflammatory drugs. Now, my neck on the right side of a lump, reddish, feels a little pain, could you tell me what causes lumps appear, should be how to deal with the method of traditional Chinese medicine has tonic?
Answer: wound healing after the thrum reaction won't have any big effect, just wait it out inflammation after exposed some trival, health of people, coupled with the thread size is different, there will be someone, someone can't, pick up a little, not inflamed the thrum of the rail can be permanently retained in the body, don't need to use Chinese traditional medicine recuperates the.
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Answer: wound healing after the thrum reaction won't have any big effect, just wait it out inflammation after exposed some trival, health of people, coupled with the thread size is different, there will be someone, someone can't, pick up a little, not inflamed the thrum of the rail can be permanently retained in the body, don't need to use Chinese traditional medicine recuperates the.
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Prepuce operation after surgical suture off, crossing cracked?
Q: I finished wrapping operation has been 22 days, about 16 days or so, surgical sutures have been off, below the glans penis coronary ditch the blade began as a small mouth, and have now cut 1 cm long, today morning he was still bleeding! Do you need any stitches?
A: penile erectile drug control.
Generally do not need to suture, dressing.
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A: penile erectile drug control.
Generally do not need to suture, dressing.
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A variety of surgical suture useful purposes
Q: the surgical sutures subcutaneous tissue must use a line can be absorbed, if not, does not remove, it would not remain in the body you say 0000 - line 10, which is what material? Stainless steel? Cotton? Or chemical fiber?
Answer: surgical suture operation silk thread from 0000-10, 0000 is generally stitched eyes. 1 -- 4 4 suture the skin. Subcutaneous tissue suture muscles. 8-10 and catgut suture appendix stump, you don't have to remove the gut can be absorbed by tissues. Intraperitoneal thread bad absorption. Yes, subcutaneous tissue and muscle tissue. Take out stitches are not. Generally can absorb. Abdominal cavity is bad absorption. Now, don't need this thread already. Are endoscope without these lines with burning, laser, such as methods. Surgical operation is silk. Silk line.
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Answer: surgical suture operation silk thread from 0000-10, 0000 is generally stitched eyes. 1 -- 4 4 suture the skin. Subcutaneous tissue suture muscles. 8-10 and catgut suture appendix stump, you don't have to remove the gut can be absorbed by tissues. Intraperitoneal thread bad absorption. Yes, subcutaneous tissue and muscle tissue. Take out stitches are not. Generally can absorb. Abdominal cavity is bad absorption. Now, don't need this thread already. Are endoscope without these lines with burning, laser, such as methods. Surgical operation is silk. Silk line.
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2013年6月20日星期四
A cesarean section, surgical sutures remain the abdomen
Question: caesarean section palace, surgical sutures remain
Disease: caesarean operation suture suspected misuse unsolvable sutures
Hello, doctor! I am in Canada hospital appointment of cesarean section in November 2009. Have a problem want to ask you.
Illness description (onset time, main symptoms) :
Three months after the caesarean operation found abdominal incision suture outside the unsolvable, extract with the dark blue line suture incision length also 16 cm. Asked operation the doctor whether to remove an aid at discharge, and was told that used are soluble in the line, don't have to remove. 6 weeks postpartum review and ask him to check the thread (1 cm in seal end), the defendant still ZhiYong is soluble in line, don't have to deal with. Thus there are doubts whether internal unsolvable suture of incision is the misuse of the same.
Once treatment and result:
Back to normal after the operation, there is no discomfort. Incision outside there was a thin scar, anodyne.
Want how to help:
Could you tell me if you have any methods or equipment check to internal (uterus) suture of incision type? If the misuse of the unsolvable sutures, will have any health problems? What should I do?
Uterine incision should not use wrong sutures, if misused the unsolvable sutures, there will be a foreign body reaction, regular check colour to exceed it.
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Disease: caesarean operation suture suspected misuse unsolvable sutures
Hello, doctor! I am in Canada hospital appointment of cesarean section in November 2009. Have a problem want to ask you.
Illness description (onset time, main symptoms) :
Three months after the caesarean operation found abdominal incision suture outside the unsolvable, extract with the dark blue line suture incision length also 16 cm. Asked operation the doctor whether to remove an aid at discharge, and was told that used are soluble in the line, don't have to remove. 6 weeks postpartum review and ask him to check the thread (1 cm in seal end), the defendant still ZhiYong is soluble in line, don't have to deal with. Thus there are doubts whether internal unsolvable suture of incision is the misuse of the same.
Once treatment and result:
Back to normal after the operation, there is no discomfort. Incision outside there was a thin scar, anodyne.
Want how to help:
Could you tell me if you have any methods or equipment check to internal (uterus) suture of incision type? If the misuse of the unsolvable sutures, will have any health problems? What should I do?
Uterine incision should not use wrong sutures, if misused the unsolvable sutures, there will be a foreign body reaction, regular check colour to exceed it.
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The research progress of absorbable surgical sutures
Study on absorbable suture of biomaterials
HE Liping，LI Wenping，LUO Guoliang,et al.
(College of Animal Science and Technology,HuNan Agricultural University,Changsha 410128,China)
Abstract： Absorbable suture has been widely used in medicine and veterinary medicine,which is one of the most active do mains on biomedicine macromolecule research. This paper gave a general review about their absorbability,degradation and research status.
Key words: biomaterial; surgical suture; biological degradation
Medical absorbable surgical suture is a kind of biological materials, it is mainly used in general surgery and plastic surgery need to suture surgery. It can provide the body with temporary bracket or barrier, can through the absorption and degradation to avoid rejection, non-infectious inflammation in the body and other adverse effects, and reduce the chances of the second operation [1], and so on medicine and animal medicine, it has obvious advantages compared with other surgical sutures, widely clinical application, is a highly development potential of absorbable implant material. With the development of science and technology, people more and more research on absorbable surgical sutures. Many scholars think [2], the ideal surgical sutures should satisfy the following conditions: (1) can be a thorough disinfection sterilization; (2) has certain mechanical properties, such as proper mechanical strength, about 20% of the extension, has certain flexibility and elastic recovery, have certain wet strength and friction coefficient; (3) when suture knot, convenient operation, concludes the knot after good performance; (4) the suture line intensity is constant within a certain time in the body; (5) adaptability to human tissue, not because of foreign body reaction and inflammation; (6) the product quality is stable and reliable, easy, cheap.
The absorbable sutures can be divided into natural absorbable sutures and synthetic absorbable sutures. The former mainly have gut, collagen can be absorbed sutures, chitin and chitosan absorbable surgical suture line, etc., which has poly glycolide sutures, poly lactic acid can be absorbed sutures, get together on two heterocyclic oxygen already ketone suture line, etc.
1 natural absorbable sutures
1.1 gut in all natural absorbable sutures, gut is one of the most traditional, starting from the earliest medical records, the surgery that has been used in the gut, it is taken from the gut mucosa in the submucosa. In the body of the degradation and absorption give energy to macrophages activity depends mainly on the existence of the cathepsin. Gut suture materials are still commonly, because its source is wide and relatively simple production process, low cost. But it has poor flexibility, response, infection of digestive juices and tensile strength under the environment of fast loss of faults. To solve these shortcomings, people made laced with crosslinking agent chromium and chromic catgut made of iodine iodine gut, the tensile strength and extension of the former can increase the gut to maintain stress time, which has the potential to reduce incision infection rate, but both cannot completely avoid the disadvantage of the gut [2].
1.2 collagen fiber absorbable sutures in collagen from animal bones, fascia, soaking boiling, extracted multi-channel processes such as hydrolysis, and then through twisting and the effect of crosslinking agent and made. Collagen surgical sutures, lies in the nature of the collagen [3, 4]. Stress - strain test showed that the natural collagen show the elastic and viscoelastic states the mechanical behavior of two phases; And collagen antigenicity is quite low, have natural biodegradable properties, and can promote the cell growth. Collagen these properties make it can be successfully used for the preparation of medical surgical sutures. Absorbable sutures made with collagen fiber has the following advantages: (1) good plasticity, can be processed into various shapes; (2) into a fiber performance is good, after extrusion forming by tensile strength to some degree; (3) the products have good histocompatibility, no bad reaction after implantation in the human body, non-toxic, can be absorbed by human body. But, according to a report in the Zheng Shufen etc. [5] the collagen has the defects of the absorption rate is easy to change. WenYongTang collagen absorbable sutures are investigated in [6], such as production, he according to the principle of combination of glutaraldehyde and collagen protein, using it as a crosslinking agent, and to explore the surgical sutures made the intensity and the concentration of glutaraldehyde and glutaraldehyde and collagen reaction pH, time, relationship, this provides reference for later people to develop new surgical sutures. Collagen absorption rate is related to its strength, to get a higher intensity of sutures, since 1990, Guo Zhenyou etc. [7] started to mixed collagen and amino glucan and other natural materials as raw material to make a suture line, he had developed at the suture line not only retains the original collagen suture the good plasticity, fibre performance is good, good histocompatibility, into non-toxic characteristics, its strength is greatly higher than that of collagen suture line, knot strength also reach and exceed target set by the United States pharmacopoeia.
1.3 of chitin, chitosan can be absorbed sutures in chitin as raw material to produce absorbable sutures in the 1970 s, Japan studies in the field in the world, famous "sonjica company has several patents and products come out [8]. Domestic related research began in the 90 s. Currently, chitin suture line has a mature production technology, generally USES the wet spinning process, the raw material is high purity of chitin powder, more commonly used six fluoride solvent acetone, six fluorine isopropyl alcohol, trichloroacetic acid, etc. Concreting by choosing different solvents, and improve the spinning and processing technology, the preparation of a variety of models and can meet the different needs of absorbable chitin suture.
According to the test of scholars [9] chitin suture has many unique advantages: (1) the body well tolerated; (2) has certain antibacterial anti-inflammatory effects, can promote wound healing, scar small; (3) the strength and flexibility in the moderate, surface friction coefficient is small, easy to suture and knot; (4) for regular disinfection, dyeing, anti-corrosion and other special processing; (5) absorption evenly after the intensity attenuation rate is moderate, can satisfy the requirement of wound healing process of sutures strength; (6) the wide raw material sources, simple processing, low cost. Goosen etc. [10] the study showed that chitin suture of digestive enzymes, infected tissue and urine tolerance is better than gut and PGA. Hou Chunlin etc. [11] also by testing animals fully shows that the performance of chitin suture is superior to gut. But at the moment, chitin suture in clinic is not widespread use, the main problem is that the tensile strength, there is still a gap compared with the PGA class sutures, still cannot meet the needs of high strength and suture; And under the condition of the gastric juice acidity such as rapid strength loss; Animal experiments show that the use of chitin suture in the middle of the wound healing will appear unexplained mild inflammation. To solve the problems in actual use, has been reported literature [12] the preparation of chitin derivatives suture line, at the same time, using some of the new spinning technology, such as increasing chitin strength of liquid crystal spinning, etc., can get better effect.
Su Xiurong etc. [13] reported extract preparation of chitosan from shrimp crab shells medical surgical absorbable surgical sutures, and the suture with gut suture experiment has been carried out in mice, by tissue slice, scanning electron microscope observation, proved that the absorption of the surgical suture line of chitosan in the body is superior to the gut; And through the experiment proves that the surgical suture line of chitosan is non-toxic, harmless, without any side effects, easy to knot, easily absorbed by the body of the medicinal materials.
Humans found chitin and chitosan have been 100 years of history, but it used to make medical sutures or nearly 30 years. From the existing research results of chitin and chitosan have good application prospects. But currently in clinical use of chitin and chitosan implant materials are very limited, the main reason is facing three major difficulties: (1) the limitation of preparation technology, besides its in certain solvents, currently there is no more effective processing methods; (2) products in total after implantation inevitably brings the different response of the organism that for unknown reasons; (3) the degradation rate of products is influenced by many factors (mainly), out of control.
Since then, there is a kind of brown seaweed as raw material of seaweed fiber, the algae salt is made from roses uronic acid dew and long chain of uronic acid copolymer, as a fine serrated belt, the molecule structure of alginate fiber provides good performance, has the high absorbent, check blood and tissue tropism etc. [14]. Properties of the fiber and the development and utilization of seaweed are under study.
To sum up, in the natural absorbable sutures, because gut production technology is relatively simple, and used for a long time, although there are many shortcomings, but now, especially in our country, the use of the gut proportion occupy the bigger market still; And collagen fiber absorbable sutures, although low antigenicity, but absorb period length of the work to be thorough; And at present, chitin, chitosan research is a hot spot, its production technology is mature, and has the advantages of it fixed, therefore its research prospect is broad. The author thinks that, if the chitin, chitosan to processed into better sutures, its production process and antigenicity, degradation rate must be more in-depth research.
2 synthetic absorbable sutures
Nearly two hundred and thirty years, according to people in order to get a higher flexibility, higher strength, and to meet different surgical requirements needed for the different degradation performance of new sutures, people made a further research, obtained has the excellent properties of absorbable surgical sutures. These sutures overcomes the gut and collagen line faults, high fracture strength, tissue reaction and the absorption effect is good wait for an advantage, that result in the people's great attention. At present, mainly has the following several synthetic suture line approved by the FDA, can be listed, so they are more widely research and application.
2.1 gather glycolide (poly (glycolic acid) a variety of commercialization of suture line this is the earliest. Is relatively easy to hydrolysis and degradation products glycolic acid is the intermediate metabolism of the body. Making it in the development of absorbable sutures are preferred in the study, and in 1962 by the United States American Cyanamial company development, commodity called Dexon. Du Chun foot [15], its tensile strength than bowel line, cotton thread, similar to polyester line, but the response is smaller than it. Dexon absorbed time to start with the implanted tissue of different and different, generally between 30 ~ 60 days is absorbed. Reports [16] that Dexon mechanical strength in the wastage of the body faster, degradation rate is big, usually only suitable for 2 ~ 4 weeks of surgery. The suture line has the uniformity, stability and inertia, non-toxic, no antigenicity, no carcinogenicity, resistant to acid stomach enzymes and infection, minimal tissue reaction. In recent 10 years, as absorbable biomaterials in vivo, poly glycolide molecular engineering progress is mainly manifested in the following three aspects: (1) by mu oxygen bridge double metal ring opening polymerization of alkyl oxide catalyst activity, the successful synthesis of the poly (glycolic acid ester/polylactic acid ester (PGA/PLA) embedded copolymer, thus expanding the scope of this kind of material; (2) materials to improve the flexibility and suitable for manufacture monofilament surgical sutures; (3) development in PGA, PLA, poly (ethylene oxide (PEO) as soft segment of the block copolymer.
2.2 poly lactic acid (poly (lactide) absorbable sutures polylactic acid (PLA) is a kind of good biocompatible and biodegradable polymer, approved by the us food and drug administration (FDA) can be used as medical sutures. Li Xiaogong etc. [17] reported: PLA in the body metabolism is the final product of CO2 and H2O, the intermediate product of lactic acid and normal glucose metabolism in vivo, so it couldn't have gathered in vital organs. Polylactide and its copolymers as surgical sutures, due to its biodegradability, automatically degradation and absorption after wound healing, without secondary surgery, so favored by the doctor [18]. In 1975, PLGA (LA/GA = 90/10) began as a surgical suture line on the market. At present, the absorbable surgical suture in production of polylactide and its copolymers of study, there are still many problems still need to solve. Among them, looking for a suitable catalyst is an important topic of the research. [19] In recent years, studies have focused on the following aspects: (1) increase mechanical strength of sutures, synthesis of high molecular weight PLA, improve the stitching process; (2) the optical activity of polymer synthesis. Semicrystalline PDLA and PLLA than amorphous PDLLA has high mechanical strength, large tensile ratio and low shrinkage [20], more suitable for surgical suture; (3) the multi-functional sutures. The suture line, for example, adding anti-inflammatory drug to inhibit local inflammation and foreign body rejection. At the same time, how to make polymer degradation rate and wound healing time match better, how the sutures adding anti-inflammatory drug to inhibit local inflammation and foreign body rejection of work remains to be further [21].
2.3 poly 2 oxygen heterocycle already ketone sutures after this matter is Dexon and polylactic acid acetic acid of another kind of absorbable suture, referred to as "PDS. Ether chain due to its molecular chain, the molecular chain of flexible, so it can be made into different sizes of monofilament sutures. PDS tissue reaction induced by small, monofilament tensile strength than polypropylene, polyamide and PDS in biological tissues strength retention, stitching for healing the wound is particularly useful for a longer time [15], but for the wound heal faster, sutures when losing support function becomes encumbrance of the organization.
Was developed in the mid - 80 - s, ETHICON company for oxygen heterocycle already ketone and glycolide sutures crystal block copolymer, the suture line not only possesses the advantages of monofilament suture line structure, and shorten the suture absorption, increased flexibility, to expand the use of poly for the dioxolane ring already ketone. Its soft and absorbent were superior to the dioxolane ring already ketone homopolymer. Some people think that [22], so far, it is the best absorbable sutures. But look from literature [23] and block copolymerization difficult operation, process complex, is not easy to industrial production. Improved block copolymerization, therefore, operating technology development, will greatly make up for the inadequacy of ring already ketone sutures for oxygen, make its become outstanding in the absorbable suture.
2.4 glycolide - sanya methyl carbonate copolymer sutures by glycolide and carbonic acid trimethyl made by copolymerization of surgical suture has been developed in abroad, also called Maxon surgical sutures. It is made of 32.5% of the sanya base carbonate and glycolide polymerization, can be made into monofilament sutures [23]. The sutures is higher than pp and nylon nodules intensity peace straight tensile strength and its response to a small. Maxon in the body, according to the [24] blayne intensity decreased slowly, in 28 days, Maxon can still maintain the original strength of 59%, and can be fully absorbed in 6 ~ 7 months. In order to improve the operating performance of sutures, reduce tissue frictional resistance and so on, can the suture surface coating and impregnation, the sutures in the human body the absorption speed and not significantly affect the tensile strength retention. [25]
Above several is currently listed has been approved by the FDA sutures, now to experiment and to approve and polyester amide, poly ethylene propylene ester, etc.
Anyhow, synthetic sutures research will promote the development of absorbable sutures to study. Although these synthetic materials is better than that of natural absorbable sutures, because they are in the body through the hydrolytic degradation become non-toxic products, and eventually absorbed by the organization. But because of the synthetic technology is higher, and there are their respective shortcomings respectively (described above), its application is limited, especially in our country, its ability to mass production is still very low. But with the development of science and technology, especially the rapid development of biotechnology, believe their faults can be solved, so as to make them more widely application in clinic.
3 the absorbable surgical suture research status in our country
In the research has been started in our country, the research work mainly focused on poly glycolide, material such as polylactic acid synthesis and in vitro degradation and animal experiment. But so far, most of these research work only at the laboratory stage, there are many key technologies need to be resolved. At present domestic hospitals use mainly by gut. For the development and utilization of collagen fibers, has already started in our country, there are mass production, but there are still many problems unsolved, such as collagen fiber premature suture absorption shortcomings. Source of chitosan, chitin suture materials, the author thinks, our country coast is longer, shrimp, crab and other resources rich in chitin chitin resources, used for processing into surgical sutures and other biological products, has a great advantage, but due to the limitation of production technology, the development and utilization of chitin in China also is not very perfect. And the study of synthetic absorbable sutures, although some reports,21,22 [19], but the actual production of the quality of the product compared with foreign advanced level, there is still a certain gap, mainly is the quality is not stable, high grade of absorbable suture line can't production, so the use of synthetic absorbable surgical suture is limited by a lot of. Investigate its reason, main is facing three major difficulties in the study: (1) the limitation of preparation technology, products mechanical performance is not satisfied; (2) more advanced absorbable sutures are expensive; (3) to improve the strength of the polymer and solve the problem of late implant reaction and complications must be in-depth study. In order to solve the above problem, in our country vigorously in the research is very necessary. At present, we can use all kinds of methods, such as derivatives or consider using natural biological materials for the chemical modification and surface treatment to solving the problems of antigenicity. In our country, medical absorbable surgical suture line of research are increasingly brought to the attention of the general research scholars, its research field is also growing, people are now looking for new high performance materials, improve production technology, in order to make their research more and more closer to the world's advanced level. To speed up the related research and development work has important economic and social benefits. With the development of science and technology and the constantly find and application of new materials, medical absorbable sutures will become a full of vitality and hope research field.
HE Liping，LI Wenping，LUO Guoliang,et al.
(College of Animal Science and Technology,HuNan Agricultural University,Changsha 410128,China)
Abstract： Absorbable suture has been widely used in medicine and veterinary medicine,which is one of the most active do mains on biomedicine macromolecule research. This paper gave a general review about their absorbability,degradation and research status.
Key words: biomaterial; surgical suture; biological degradation
Medical absorbable surgical suture is a kind of biological materials, it is mainly used in general surgery and plastic surgery need to suture surgery. It can provide the body with temporary bracket or barrier, can through the absorption and degradation to avoid rejection, non-infectious inflammation in the body and other adverse effects, and reduce the chances of the second operation [1], and so on medicine and animal medicine, it has obvious advantages compared with other surgical sutures, widely clinical application, is a highly development potential of absorbable implant material. With the development of science and technology, people more and more research on absorbable surgical sutures. Many scholars think [2], the ideal surgical sutures should satisfy the following conditions: (1) can be a thorough disinfection sterilization; (2) has certain mechanical properties, such as proper mechanical strength, about 20% of the extension, has certain flexibility and elastic recovery, have certain wet strength and friction coefficient; (3) when suture knot, convenient operation, concludes the knot after good performance; (4) the suture line intensity is constant within a certain time in the body; (5) adaptability to human tissue, not because of foreign body reaction and inflammation; (6) the product quality is stable and reliable, easy, cheap.
The absorbable sutures can be divided into natural absorbable sutures and synthetic absorbable sutures. The former mainly have gut, collagen can be absorbed sutures, chitin and chitosan absorbable surgical suture line, etc., which has poly glycolide sutures, poly lactic acid can be absorbed sutures, get together on two heterocyclic oxygen already ketone suture line, etc.
1 natural absorbable sutures
1.1 gut in all natural absorbable sutures, gut is one of the most traditional, starting from the earliest medical records, the surgery that has been used in the gut, it is taken from the gut mucosa in the submucosa. In the body of the degradation and absorption give energy to macrophages activity depends mainly on the existence of the cathepsin. Gut suture materials are still commonly, because its source is wide and relatively simple production process, low cost. But it has poor flexibility, response, infection of digestive juices and tensile strength under the environment of fast loss of faults. To solve these shortcomings, people made laced with crosslinking agent chromium and chromic catgut made of iodine iodine gut, the tensile strength and extension of the former can increase the gut to maintain stress time, which has the potential to reduce incision infection rate, but both cannot completely avoid the disadvantage of the gut [2].
1.2 collagen fiber absorbable sutures in collagen from animal bones, fascia, soaking boiling, extracted multi-channel processes such as hydrolysis, and then through twisting and the effect of crosslinking agent and made. Collagen surgical sutures, lies in the nature of the collagen [3, 4]. Stress - strain test showed that the natural collagen show the elastic and viscoelastic states the mechanical behavior of two phases; And collagen antigenicity is quite low, have natural biodegradable properties, and can promote the cell growth. Collagen these properties make it can be successfully used for the preparation of medical surgical sutures. Absorbable sutures made with collagen fiber has the following advantages: (1) good plasticity, can be processed into various shapes; (2) into a fiber performance is good, after extrusion forming by tensile strength to some degree; (3) the products have good histocompatibility, no bad reaction after implantation in the human body, non-toxic, can be absorbed by human body. But, according to a report in the Zheng Shufen etc. [5] the collagen has the defects of the absorption rate is easy to change. WenYongTang collagen absorbable sutures are investigated in [6], such as production, he according to the principle of combination of glutaraldehyde and collagen protein, using it as a crosslinking agent, and to explore the surgical sutures made the intensity and the concentration of glutaraldehyde and glutaraldehyde and collagen reaction pH, time, relationship, this provides reference for later people to develop new surgical sutures. Collagen absorption rate is related to its strength, to get a higher intensity of sutures, since 1990, Guo Zhenyou etc. [7] started to mixed collagen and amino glucan and other natural materials as raw material to make a suture line, he had developed at the suture line not only retains the original collagen suture the good plasticity, fibre performance is good, good histocompatibility, into non-toxic characteristics, its strength is greatly higher than that of collagen suture line, knot strength also reach and exceed target set by the United States pharmacopoeia.
1.3 of chitin, chitosan can be absorbed sutures in chitin as raw material to produce absorbable sutures in the 1970 s, Japan studies in the field in the world, famous "sonjica company has several patents and products come out [8]. Domestic related research began in the 90 s. Currently, chitin suture line has a mature production technology, generally USES the wet spinning process, the raw material is high purity of chitin powder, more commonly used six fluoride solvent acetone, six fluorine isopropyl alcohol, trichloroacetic acid, etc. Concreting by choosing different solvents, and improve the spinning and processing technology, the preparation of a variety of models and can meet the different needs of absorbable chitin suture.
According to the test of scholars [9] chitin suture has many unique advantages: (1) the body well tolerated; (2) has certain antibacterial anti-inflammatory effects, can promote wound healing, scar small; (3) the strength and flexibility in the moderate, surface friction coefficient is small, easy to suture and knot; (4) for regular disinfection, dyeing, anti-corrosion and other special processing; (5) absorption evenly after the intensity attenuation rate is moderate, can satisfy the requirement of wound healing process of sutures strength; (6) the wide raw material sources, simple processing, low cost. Goosen etc. [10] the study showed that chitin suture of digestive enzymes, infected tissue and urine tolerance is better than gut and PGA. Hou Chunlin etc. [11] also by testing animals fully shows that the performance of chitin suture is superior to gut. But at the moment, chitin suture in clinic is not widespread use, the main problem is that the tensile strength, there is still a gap compared with the PGA class sutures, still cannot meet the needs of high strength and suture; And under the condition of the gastric juice acidity such as rapid strength loss; Animal experiments show that the use of chitin suture in the middle of the wound healing will appear unexplained mild inflammation. To solve the problems in actual use, has been reported literature [12] the preparation of chitin derivatives suture line, at the same time, using some of the new spinning technology, such as increasing chitin strength of liquid crystal spinning, etc., can get better effect.
Su Xiurong etc. [13] reported extract preparation of chitosan from shrimp crab shells medical surgical absorbable surgical sutures, and the suture with gut suture experiment has been carried out in mice, by tissue slice, scanning electron microscope observation, proved that the absorption of the surgical suture line of chitosan in the body is superior to the gut; And through the experiment proves that the surgical suture line of chitosan is non-toxic, harmless, without any side effects, easy to knot, easily absorbed by the body of the medicinal materials.
Humans found chitin and chitosan have been 100 years of history, but it used to make medical sutures or nearly 30 years. From the existing research results of chitin and chitosan have good application prospects. But currently in clinical use of chitin and chitosan implant materials are very limited, the main reason is facing three major difficulties: (1) the limitation of preparation technology, besides its in certain solvents, currently there is no more effective processing methods; (2) products in total after implantation inevitably brings the different response of the organism that for unknown reasons; (3) the degradation rate of products is influenced by many factors (mainly), out of control.
Since then, there is a kind of brown seaweed as raw material of seaweed fiber, the algae salt is made from roses uronic acid dew and long chain of uronic acid copolymer, as a fine serrated belt, the molecule structure of alginate fiber provides good performance, has the high absorbent, check blood and tissue tropism etc. [14]. Properties of the fiber and the development and utilization of seaweed are under study.
To sum up, in the natural absorbable sutures, because gut production technology is relatively simple, and used for a long time, although there are many shortcomings, but now, especially in our country, the use of the gut proportion occupy the bigger market still; And collagen fiber absorbable sutures, although low antigenicity, but absorb period length of the work to be thorough; And at present, chitin, chitosan research is a hot spot, its production technology is mature, and has the advantages of it fixed, therefore its research prospect is broad. The author thinks that, if the chitin, chitosan to processed into better sutures, its production process and antigenicity, degradation rate must be more in-depth research.
2 synthetic absorbable sutures
Nearly two hundred and thirty years, according to people in order to get a higher flexibility, higher strength, and to meet different surgical requirements needed for the different degradation performance of new sutures, people made a further research, obtained has the excellent properties of absorbable surgical sutures. These sutures overcomes the gut and collagen line faults, high fracture strength, tissue reaction and the absorption effect is good wait for an advantage, that result in the people's great attention. At present, mainly has the following several synthetic suture line approved by the FDA, can be listed, so they are more widely research and application.
2.1 gather glycolide (poly (glycolic acid) a variety of commercialization of suture line this is the earliest. Is relatively easy to hydrolysis and degradation products glycolic acid is the intermediate metabolism of the body. Making it in the development of absorbable sutures are preferred in the study, and in 1962 by the United States American Cyanamial company development, commodity called Dexon. Du Chun foot [15], its tensile strength than bowel line, cotton thread, similar to polyester line, but the response is smaller than it. Dexon absorbed time to start with the implanted tissue of different and different, generally between 30 ~ 60 days is absorbed. Reports [16] that Dexon mechanical strength in the wastage of the body faster, degradation rate is big, usually only suitable for 2 ~ 4 weeks of surgery. The suture line has the uniformity, stability and inertia, non-toxic, no antigenicity, no carcinogenicity, resistant to acid stomach enzymes and infection, minimal tissue reaction. In recent 10 years, as absorbable biomaterials in vivo, poly glycolide molecular engineering progress is mainly manifested in the following three aspects: (1) by mu oxygen bridge double metal ring opening polymerization of alkyl oxide catalyst activity, the successful synthesis of the poly (glycolic acid ester/polylactic acid ester (PGA/PLA) embedded copolymer, thus expanding the scope of this kind of material; (2) materials to improve the flexibility and suitable for manufacture monofilament surgical sutures; (3) development in PGA, PLA, poly (ethylene oxide (PEO) as soft segment of the block copolymer.
2.2 poly lactic acid (poly (lactide) absorbable sutures polylactic acid (PLA) is a kind of good biocompatible and biodegradable polymer, approved by the us food and drug administration (FDA) can be used as medical sutures. Li Xiaogong etc. [17] reported: PLA in the body metabolism is the final product of CO2 and H2O, the intermediate product of lactic acid and normal glucose metabolism in vivo, so it couldn't have gathered in vital organs. Polylactide and its copolymers as surgical sutures, due to its biodegradability, automatically degradation and absorption after wound healing, without secondary surgery, so favored by the doctor [18]. In 1975, PLGA (LA/GA = 90/10) began as a surgical suture line on the market. At present, the absorbable surgical suture in production of polylactide and its copolymers of study, there are still many problems still need to solve. Among them, looking for a suitable catalyst is an important topic of the research. [19] In recent years, studies have focused on the following aspects: (1) increase mechanical strength of sutures, synthesis of high molecular weight PLA, improve the stitching process; (2) the optical activity of polymer synthesis. Semicrystalline PDLA and PLLA than amorphous PDLLA has high mechanical strength, large tensile ratio and low shrinkage [20], more suitable for surgical suture; (3) the multi-functional sutures. The suture line, for example, adding anti-inflammatory drug to inhibit local inflammation and foreign body rejection. At the same time, how to make polymer degradation rate and wound healing time match better, how the sutures adding anti-inflammatory drug to inhibit local inflammation and foreign body rejection of work remains to be further [21].
2.3 poly 2 oxygen heterocycle already ketone sutures after this matter is Dexon and polylactic acid acetic acid of another kind of absorbable suture, referred to as "PDS. Ether chain due to its molecular chain, the molecular chain of flexible, so it can be made into different sizes of monofilament sutures. PDS tissue reaction induced by small, monofilament tensile strength than polypropylene, polyamide and PDS in biological tissues strength retention, stitching for healing the wound is particularly useful for a longer time [15], but for the wound heal faster, sutures when losing support function becomes encumbrance of the organization.
Was developed in the mid - 80 - s, ETHICON company for oxygen heterocycle already ketone and glycolide sutures crystal block copolymer, the suture line not only possesses the advantages of monofilament suture line structure, and shorten the suture absorption, increased flexibility, to expand the use of poly for the dioxolane ring already ketone. Its soft and absorbent were superior to the dioxolane ring already ketone homopolymer. Some people think that [22], so far, it is the best absorbable sutures. But look from literature [23] and block copolymerization difficult operation, process complex, is not easy to industrial production. Improved block copolymerization, therefore, operating technology development, will greatly make up for the inadequacy of ring already ketone sutures for oxygen, make its become outstanding in the absorbable suture.
2.4 glycolide - sanya methyl carbonate copolymer sutures by glycolide and carbonic acid trimethyl made by copolymerization of surgical suture has been developed in abroad, also called Maxon surgical sutures. It is made of 32.5% of the sanya base carbonate and glycolide polymerization, can be made into monofilament sutures [23]. The sutures is higher than pp and nylon nodules intensity peace straight tensile strength and its response to a small. Maxon in the body, according to the [24] blayne intensity decreased slowly, in 28 days, Maxon can still maintain the original strength of 59%, and can be fully absorbed in 6 ~ 7 months. In order to improve the operating performance of sutures, reduce tissue frictional resistance and so on, can the suture surface coating and impregnation, the sutures in the human body the absorption speed and not significantly affect the tensile strength retention. [25]
Above several is currently listed has been approved by the FDA sutures, now to experiment and to approve and polyester amide, poly ethylene propylene ester, etc.
Anyhow, synthetic sutures research will promote the development of absorbable sutures to study. Although these synthetic materials is better than that of natural absorbable sutures, because they are in the body through the hydrolytic degradation become non-toxic products, and eventually absorbed by the organization. But because of the synthetic technology is higher, and there are their respective shortcomings respectively (described above), its application is limited, especially in our country, its ability to mass production is still very low. But with the development of science and technology, especially the rapid development of biotechnology, believe their faults can be solved, so as to make them more widely application in clinic.
3 the absorbable surgical suture research status in our country
In the research has been started in our country, the research work mainly focused on poly glycolide, material such as polylactic acid synthesis and in vitro degradation and animal experiment. But so far, most of these research work only at the laboratory stage, there are many key technologies need to be resolved. At present domestic hospitals use mainly by gut. For the development and utilization of collagen fibers, has already started in our country, there are mass production, but there are still many problems unsolved, such as collagen fiber premature suture absorption shortcomings. Source of chitosan, chitin suture materials, the author thinks, our country coast is longer, shrimp, crab and other resources rich in chitin chitin resources, used for processing into surgical sutures and other biological products, has a great advantage, but due to the limitation of production technology, the development and utilization of chitin in China also is not very perfect. And the study of synthetic absorbable sutures, although some reports,21,22 [19], but the actual production of the quality of the product compared with foreign advanced level, there is still a certain gap, mainly is the quality is not stable, high grade of absorbable suture line can't production, so the use of synthetic absorbable surgical suture is limited by a lot of. Investigate its reason, main is facing three major difficulties in the study: (1) the limitation of preparation technology, products mechanical performance is not satisfied; (2) more advanced absorbable sutures are expensive; (3) to improve the strength of the polymer and solve the problem of late implant reaction and complications must be in-depth study. In order to solve the above problem, in our country vigorously in the research is very necessary. At present, we can use all kinds of methods, such as derivatives or consider using natural biological materials for the chemical modification and surface treatment to solving the problems of antigenicity. In our country, medical absorbable surgical suture line of research are increasingly brought to the attention of the general research scholars, its research field is also growing, people are now looking for new high performance materials, improve production technology, in order to make their research more and more closer to the world's advanced level. To speed up the related research and development work has important economic and social benefits. With the development of science and technology and the constantly find and application of new materials, medical absorbable sutures will become a full of vitality and hope research field.
Several surgical sutures have?
Surgical suture line refers to the surgery, or trauma treatment, used for ligation hemostasis, suture hemostasis and the special line of repair method.
Generally can be divided into absorbable surgical suture and an absorption surgical suture two broad categories:
Line can be absorbed
Absorbable surgical suture according to different material and absorption degree is divided into: gut line (PGA), chemical synthesis, natural collagen suture.
1, gut: originated from healthy animals out of sheep. Sheep, contains collagen ingredients, so don't need to remove stitches later. Medical gut points: normal gut and chromic catgut, all can be absorbed. Absorption of the length of time required, according to the thickness of gut and organization, can absorb 6 ~ 20 days commonly, but individual differences of patients with absorption process, and even do not absorb. The gut adopts disposable aseptic packaging, easy to use.
(1) normal gut: made of sheep or cows intestinal submucosa organization absorptive suture. Absorption of fast, but the response of catgut slightly larger. Used to heal more quickly or subcutaneous tissue, blood vessels and suture ligation of infected wounds, etc. Generally used in the uterus, bladder mucosal layer, etc.
(2) the chromic catgut: the gut of chromate treatment, can slow down the absorption rate, it caused less inflammatory response than normal gut. More commonly used in gynecology and urinary surgery, kidney and ureter surgery is often chosen stitches, because threads will promote stone formation. Use saline soak when using, after being to soften straight, in order to facilitate operation.
2, chemical synthetic line (PGA, PGLA, PLA) : USES the modern chemical technology made of a kind of linear polymer material, the suction line and coating, etc, generally 60 ￣ 90 days absorption, absorption of stability, participation due to the chemical composition, absorption is still incomplete.
3, pure natural collagen suture: otters raccoon dog tendon parts made from special animals, natural collagen content high, the production process without any chemical composition, has the characteristics of the collagen is due; As the fourth generation of sutures in the true sense. Has absorbed completely, high tensile strength, biocompatibility, promote cell growth, and so on. According to the thickness of line structures generally 8-50 days completely absorbed, and the absorption of stable and reliable, no obvious individual differences.
Do not absorb the surgical suturesThat cannot be absorbed sutures, so need to remove the after stitching. Take out stitches specific time due to the stitching part and differences among the wound and the patient's condition, when the abnormal situation such as good wound healing without infection: face and neck take out stitches 4 ~ 5 days; Lower abdomen, perineum 6 ~ 7; On the chest, abdomen, back, buttocks 7 ~ 9; Limbs 10 ~ 12, near joints may be extended for some minus 14 Japan can remove the stitches. To malnutrition, notch tension is bigger, special circumstances can consider to take out stitches, extend time. Teenagers take out stitches can shorten time, old age, diabetes, chronic diseases, can take out stitches delay time. Postoperative wound has obvious infection such as red, swollen, heat, pain, should take out stitches in advance. In case any of the following circumstance, take out stitches should be delayed:
1. The severe anemia, angular, mild cachexia.
2. The serious water loss or water electrolyte disorder has not been correct.
3. Older patients and infants and young children.
When there is no control 4. Cough, chest, abdomen incision take out stitches should be delayed.
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Generally can be divided into absorbable surgical suture and an absorption surgical suture two broad categories:
Line can be absorbed
Absorbable surgical suture according to different material and absorption degree is divided into: gut line (PGA), chemical synthesis, natural collagen suture.
1, gut: originated from healthy animals out of sheep. Sheep, contains collagen ingredients, so don't need to remove stitches later. Medical gut points: normal gut and chromic catgut, all can be absorbed. Absorption of the length of time required, according to the thickness of gut and organization, can absorb 6 ~ 20 days commonly, but individual differences of patients with absorption process, and even do not absorb. The gut adopts disposable aseptic packaging, easy to use.
(1) normal gut: made of sheep or cows intestinal submucosa organization absorptive suture. Absorption of fast, but the response of catgut slightly larger. Used to heal more quickly or subcutaneous tissue, blood vessels and suture ligation of infected wounds, etc. Generally used in the uterus, bladder mucosal layer, etc.
(2) the chromic catgut: the gut of chromate treatment, can slow down the absorption rate, it caused less inflammatory response than normal gut. More commonly used in gynecology and urinary surgery, kidney and ureter surgery is often chosen stitches, because threads will promote stone formation. Use saline soak when using, after being to soften straight, in order to facilitate operation.
2, chemical synthetic line (PGA, PGLA, PLA) : USES the modern chemical technology made of a kind of linear polymer material, the suction line and coating, etc, generally 60 ￣ 90 days absorption, absorption of stability, participation due to the chemical composition, absorption is still incomplete.
3, pure natural collagen suture: otters raccoon dog tendon parts made from special animals, natural collagen content high, the production process without any chemical composition, has the characteristics of the collagen is due; As the fourth generation of sutures in the true sense. Has absorbed completely, high tensile strength, biocompatibility, promote cell growth, and so on. According to the thickness of line structures generally 8-50 days completely absorbed, and the absorption of stable and reliable, no obvious individual differences.
Do not absorb the surgical suturesThat cannot be absorbed sutures, so need to remove the after stitching. Take out stitches specific time due to the stitching part and differences among the wound and the patient's condition, when the abnormal situation such as good wound healing without infection: face and neck take out stitches 4 ~ 5 days; Lower abdomen, perineum 6 ~ 7; On the chest, abdomen, back, buttocks 7 ~ 9; Limbs 10 ~ 12, near joints may be extended for some minus 14 Japan can remove the stitches. To malnutrition, notch tension is bigger, special circumstances can consider to take out stitches, extend time. Teenagers take out stitches can shorten time, old age, diabetes, chronic diseases, can take out stitches delay time. Postoperative wound has obvious infection such as red, swollen, heat, pain, should take out stitches in advance. In case any of the following circumstance, take out stitches should be delayed:
1. The severe anemia, angular, mild cachexia.
2. The serious water loss or water electrolyte disorder has not been correct.
3. Older patients and infants and young children.
When there is no control 4. Cough, chest, abdomen incision take out stitches should be delayed.
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