Absorbable suture policy
Absorbable suture refers to a new suture material that can be degraded and absorbed by human body after being implanted into human tissue during surgical suture, and it is unnecessary to remove stitches, thus avoiding the pain of removing stitches.

Chinese name

absorbable suture

Foreign name

absorbable suture

Management category

The third kind of medical devices

Classification name

Medical absorbable suture

quick

navigate by water/air

physical features

Specification structure

classify

Suture contrast

Extended reading

refer to

area of application

Can be widely used in gynecology, obstetrics, surgery, plastic surgery, urology, pediatrics, stomatology, otolaryngology, ophthalmology and other operations and suture of intradermal soft tissue. [ 1]

physical features

1. suture diameter. The diameter of the suture line is in millimeters, usually represented by several zeros. The thinner the suture, the more zeros there are, but the thickness of different suture materials is also different. Try to use thin suture with high tension and minimal reaction to tissue, and try to choose thin suture when it can withstand wound tension.

2. Tensile strength. The tensile strength of the same kind of suture after knotting is 1/3 when it is not knotted. Generally speaking, the tensile strength of tendon suture is the largest, followed by synthetic materials, and the catgut is the smallest.

3. structure. Single thread (monofilament) suture is not easy to cause infection, and it is suitable for sewing contaminated wounds, but it is not easy to operate. Multi-strand (braided thread) is easy to handle, but it will increase the chance of infection and tissue reaction.

4. Friction coefficient. Sutures with low friction coefficient can easily slide through tissues and are often used for intradermal suture. But the lower the friction coefficient, the smoother the stitch and the easier the knot is to loosen, so it is necessary to tie more knots.

5. Knot firmly. The greater the strength of the knot, the less likely the wound will split. The suture with high friction coefficient has good firmness, but it has great resistance when passing through the skin and is difficult to use.

6. flexibility. The elastic suture is not easy to cut the tissue when the tissue edema, and the wound is not easy to split after the edema subsides.

Specification structure

Divided into blue, natural color and blueprint interwoven color. The length of the thread varies from 45 cm to 90 cm. Sutures with special length can be customized according to clinical surgical requirements.

classify

According to the absorbability of suture materials, absorbable suture can be divided into catgut suture, polymer chemical synthetic suture and pure natural collagen suture.

1. gut

The catgut is made of collagen matrix in the submucosa of catgut. Medical catgut can be divided into ordinary catgut and chrome catgut.

The absorption time of common catgut is short, only 4-5 days, and the speed is fast, but the tissue reacts slightly to catgut. It is mostly used for ligating blood vessels and suturing infected wounds in tissues or subcutaneous tissues that heal quickly. It is generally used for mucous membranes such as uterus and bladder, but the catgut tension is poor and the tissue reaction is heavy.

Chromium catgut can increase the tensile strength of catgut and prolong the time of maintaining stress. Catgut takes a long time to absorb and needs 14-2 1 day, which is less than the inflammatory reaction caused by ordinary catgut. It is used for suturing deep tissues, mostly for gynecological and urinary system operations, and also for suturing mucous membranes such as stomach, intestine, bladder, ureter and biliary tract. Thick chrome catgut is usually used to suture deep tissues or inflamed peritoneum.

Both ordinary gut and chrome gut have some shortcomings, such as insufficient tension, difficulty in sewing and knotting, unsatisfactory absorption effect, rejection, unsatisfactory adaptability in vivo, and rapid loss of tensile strength in digestive juice and infected environment. [2]

2. Polymer chemical synthesis line (PGA polyethylene glycol acid)

PGA fiber has high strength, moderate elongation, low initial modulus, non-toxicity and good biocompatibility, so the suture has good uniformity, stability, non-toxicity, non-antigenicity, non-carcinogenicity, resistance to gastric acid, digestive enzymes and infection, and minimal tissue reaction. However, the absorption time is long, and it is completely stable within 60-90 days, which is easy to strangulate the new tissue of the incision and form a small amount of scars. [ 1]

Besides PGA polyglycolic acid, there are many other kinds of synthetic fiber threads, such as Banjarmasin (polyethylene glycol carbonate), VICRYL (polyethylene glycol 9 10), PLGA, PDS (polydioxanone, polyoxyhexanone) and PVA (polyvinyl acetate vinylon). [2]

3. Pure natural collagen suture (tendon)

Pure natural collagen suture, also called tendon suture, is taken from the tendon tissue of a special animal-otter and beaver. Pure natural collagen has high content, and the production process does not involve chemical components. It has many characteristics of collagen material. Compared with other sutures, it has tendon characteristics, good flexibility and strong tension. In addition, it has unique functions such as good absorption effect, good wound healing and good biocompatibility. It is the fourth generation suture in the true sense. According to the thread thickness, it is completely absorbed in 8- 15 days, and the absorption is stable and reliable, with no obvious individual difference.