1. Circular suture needle: mainly used for soft and easily penetrated tissues, such as peritoneum, gastrointestinal tract, heart tissue, etc., with little damage when passing through.
2. Triangular sewing needle: suitable for tough tissues, the needle tip is triangular and the needle body is round.
3. Triangular angle needle: the point from the needle tip to the waist line is triangular, which is used to puncture tough and difficult tissues, such as fascia and skin.
4. Metal wallet: This kind of metal money is packed in a special nail box and clamped with a special clip, which is mostly used for skin suture and orthopedic surgery.
5. Non-invasive suture needle: This type of needle is attached to both ends of suture, which is mostly used for vascular anastomosis and tubular or annular structures, and also used for continuous suture, such as intestinal anastomosis and heart surgery. There are two types: curved and straight.
6. Lead needle: it has a handle, and the front end is a flat and blunt needle tip and needle body. It is used for vascular ligation of deep tissue, which is not easy to cut and easy to operate. It is often used in liver surgery.
The types of surgical needles are 5 X 12, 6 X 14, 7 X 17, 8 X 20, 9 X 24, 9 X 34, 1 1X 24, etc.
When selecting the sewing needles of the above types and models, needle holders of different sizes should be used for matching, so as to avoid improper matching, which will cause the needle body to bend or break and affect the operation.
Medical suture:
Various sutures are used to suture various tissues and organs in surgery until the surgical wound heals, and can also be used to ligate and suture blood vessels to stop bleeding. All sutures are foreign bodies in human tissues, which will cause adverse reactions, but the reaction size is different. The most basic principle of choosing suture is: try to use thin suture with high tension and minimal reaction to tissue. The thickness of various stitches is represented by numbers and zeros. The bigger the number, the thicker the stitches. Commonly used pins are 1#, 4#, 7# and 10 #. The more zeros, the thinner the stitches. Commonly used are1/0 ~10.
1. Medical silk thread: two kinds: divided silk thread and round silk thread. It is a suture widely and basically used in surgery. Apply both hard and soft, and the operation is simple. It is often used to suture various tissues, organs and blood vessels in the body. The reaction in the tissue is small, but it is not absorbed in the body to form foreign bodies, which will affect the wound healing after surgical infection. Generally, the suture is mostly black, which is easy to separate from the tissue during surgery. Commonly used wire models are "000", "0", "1", "4", "7" and "10", and the wire length is 60 cm or 70 cm. The model of assembly line is the same as that of plate line. At present, the group thread is less used in qualified hospitals and has been replaced by disposable medical board thread. Silk thread should not be disinfected repeatedly, so as not to affect the tension.
2. Non-destructive suture: there are two kinds of non-absorbable suture and absorbable suture.
(1) Non-absorbable threads include nylon thread (polyamide fiber thread), polyester knitted thread and polypropylene thread.
Nylon (polyamide fiber) thread: Polyphenolamine fiber suture thread, made of man-made fiber. The tensile strength and toughness are stronger than those of silk thread, and the reaction in tissue is small. The model is 6/0- 1 1/0, which is often used for vascular and nerve anastomosis and repair, and can also be used for tubal anastomosis.
Polyester knitting thread: polyester suture is the strongest suture except copper wire. Generally, it is woven from multiple strands and has high tensile strength. It is usually used for heart valve replacement, orthopedic muscle repair and microvascular anastomosis. Thick thread is 1 ~ 10, thin thread is 2/0 ~ 6/0, and tension reducing sewing is commonly used 10.
Polypropylene suture: also known as slip thread, is a non-inert suture made of propylene polymerization. Compared with polyamide fiber suture, it is easier to knot and has higher strength. It is mainly used to anastomose blood vessels and nerves. There are two kinds of imported and domestic products, and their models range from 2/0 to 6/0. When tying a knot with a slip thread, you must wet your hands to prevent them from breaking.
(2) Absorbable suture: it is an ideal suture at present, and its surface is coated with polyglycolic acid. It has the advantages of smooth surface, fast absorption, little damage and little tissue reaction. Its models are 0 ~ 9/0 and wide, with needles. Needles can be divided into large, small, round and triangular needles, which should be selected according to clinical use. It is often used to suture intestinal tract, biliary tract, muscle, joint capsule, uterus, peritoneum and other tissues and organs, and also used in ophthalmology and burn plastic surgery.
3. Medical catgut: It can be divided into ordinary catgut and chrome catgut, both of which can be absorbed. The length of absorption depends on the thickness of intestine and tissue, and it can be completely absorbed in 6 ~ 20 days. At present, the catgut adopts disposable aseptic packaging, which is convenient to use.
(1) Common catgut: an easily absorbable suture made of submucosa tissue of catgut or bovine gut. It is absorbed quickly, but the tissue has a slight reaction to the intestine. It is mainly used for ligating blood vessels and suturing infected wounds of subcutaneous tissue, and the healing speed is faster. Commonly used in the uterus, bladder and other mucous membranes.
(2) Chrome catgut: This catgut is made of chromic acid, which can slow down tissue absorption and has less inflammatory reaction than ordinary catgut. Generally, it is mostly used in gynecological and urinary system surgery, and it is often used in kidney and ureter surgery because silk thread will promote the formation of stones. When in use, it is soaked in salt water and straightened after softening, which is convenient for operation.
The models of medical catgut are 1#, 2#, 0#, 1/0, 2/0, 3/0, 4/0, 5/0, etc. At present, the use of medical catgut in large general hospitals is gradually decreasing, and it will be replaced by ideal absorbable suture.
4. Stainless steel wire: mainly used when strong tension suture is needed, such as tension suture of muscle repair team. Commonly used are thick (diameter 1. Omm), medium (5mm in diameter) and thin (6mm in diameter). Causing tissue reaction is the most difficult to sew, but it is not easy to knot, and the tip of steel wire is easy to puncture gloves. Several rubber tubes with a length of 1cm should be prepared for tension-reducing suture.
Suture is one of the most basic and important materials in surgery. The reasonable application of surgical suture is of great significance to accelerate wound healing, reduce postoperative complications and improve the quality of surgery. Therefore, as an operating room nurse, it is necessary to understand the clinical application of various sutures.
1. Single-strand non-absorbable non-invasive suture, such as Plolen suture, is often used in cardiovascular surgery, mainly because non-biological materials are incompatible with the original cardiovascular tissue of the body, so non-absorbable suture must be used in artificial valve replacement and artificial blood vessel bypass surgery. Studies have shown that absorbable sutures such as PDS and Banjarmasin can be used to anastomose the blood vessels of children's cardiovascular system, and the long-term patency rate is better than that of Proron suture.
2. Suture of various intestinal operations in contaminated sites. "3-0" absorbable suture can be used for ligation in intestinal cavity. Intestinal cavity contains a large number of bacteria, especially the distal end of colon and rectum. If silk thread is used, bacteria will accumulate and multiply in the micropores of braided thread, causing inflammatory reaction, tissue edema and anastomotic stenosis, and absorbable suture can avoid this kind of infection.
3. Hernia repair Hernia repair is to repair the weak part of the abdominal wall with its own tissue or synthetic materials. After suture, the tension between tissues is great, which requires the suture to maintain a strong tension for a long time. Therefore, 10 silk thread with high tensile strength and absorbable suture is selected.
4. Absorbable suture is commonly used in gynecological surgery to suture vaginal stump after hysterectomy, which not only reduces the occurrence of infection, but also reduces the postoperative discomfort of patients.
5. Thyroid surgery The incision of thyroid surgery is located in the neck, and the healing of the incision has a great influence on the patient's appearance. The absorbable or non-absorbable non-invasive suture used in chemical synthesis has little tissue trauma and is beneficial to wound healing. There is no need to remove the absorbable suture after operation, which can alleviate the pain of patients and shorten the hospitalization time.
6. Peritoneal suture, Dexon suture and Vicryl suture can all be used to suture peritoneum. At present, the latter two kinds of sutures are mostly used in our hospital. These two kinds of suture are 76cm long absorbable suture with needle, which can continuously suture peritoneum, speed up abdominal closure, shorten the exposure time of patients' internal organs, reduce foreign body reaction in tissues and reduce postoperative complications. It can save threading time for hand washing nurses, carefully check surgical instruments with visiting nurses and improve work efficiency.