タイトルまたは説明

Suture Characteristics Absorbable Sutures The absorbable surgical sutures are made from either "natural" or synthetic polymers. Natural Collagen: The collagen sutures are derived from the submucosal layer of ovine small intestine or the serosal layer bovine small intestine "gut." This collagenous tissue is treated with an aldehyde solution, which cross-links and strengthens the suture and makes it more resistant to enzymatic degradation. Suture materials treated in this way are called plain gut. Surgical gut, plain: Tensile strength is maintained for ***0 days postimplantation (variable with individual patient characteristics), and absorption is complete within *0 days. This type of suture is used for (1) repairing rapidly healing tissues that require minimal support and (2) ligating superficial blood vessels. Surgical gut, fast-absorbing: This type of suture is indicated for epidermal use (required only for **7 d) and is not recommended for internal use. Surgical gut, chromic (treated with chromium salt): o Tensile strength is maintained for ****4 days. The absorption rate is slowed by chromium salt (*0 d). Tissue reaction is due to the noncollagenous material present in these sutures. Also, patient factors affect rates of absorption and make tensile strength somewhat unpredictable. o Salthouse and colleagues demonstrated that the mechanism by which gut reabsorbs is the result of sequential attacks by lysosomal enzymes.3 Natural fiber absorbable sutures have several distinct disadvantages. First, these natural fiber absorbable sutures have a tendency to fray during knot construction. Second, there is considerably more variability in their retention of tensile strength than is found with the synthetic absorbable sutures. A search for a synthetic substitute for collagen sutures began in the ***0s. Soon, procedures were perfected for the synthesis of high molecular weight polyglycolic acid, which led to the development of the polyglycolic acid sutures.