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1463214243-SURGICALSUTURESANDLIGATURES1.ppt (Size: 249.5 KB / Downloads: 23)
SUTURES
A surgical suture is a specially prepared and sterilized thread which is used to sew the tissues together .
LIGATURES
A ligature is specially prepared and sterilized thread which is used to tie the blood vessels .
CLASSIFICATION OF SUTURES [A].(Based on absorbability)
1. Absorable:- Absorable sutures are absorbed by tissue in which they are implanted and the time taken for complete disappereance.
Eg:- Catgut, Kangaroo tendons, Brocafil .
2. Non-Absorable:- Non- Absorable sutures are not absorbed by tissue and unless they are on the surface, remain in the body after the wound has healed.
Eg:-Silk, Linen, Cotton, Nylon, Polyester, Horsehair, metals and alloys.
[B].(Based on their costruction)
1. Mono-filament-Eg.- Nylon ,catgut ,polypropylene,stainless steel suture etc.
2. Multi-filament-Eg.-silk ,polyester etc.
[C].(Based on their source)
1. Natural-Eg.- silk,catgut,collagen,kangaroo tendon .
2. Synthetic-Eg.- Nylon, polypropylene, polyester.
[D].(According to their usage)
Eg.-Cardiovascular suture, opthalmic suture, general suture, orthopaedic suture etc.
CHARACTERISTICS OF SUTURES
Ideal suture should be:
*Easy to handle.
*Have minimally reaction in tissue.
*Inhibits bacterial growth.
*Holds securely when knotted.
*Resist shrinking in tissue.
*Is noncapillary, nonallergenic, noncarcinogenic and nonferromagnetic.
*Absorbs with minimal reaction after tissue has healed.
[NOTE:Such an ideal suture does not exist].
1. ABSORBABLE SUTURE (PREPARATION OF CATGUT)
Raw Materials:- 7mt intestine collected and kept in cold storage.
Washing:- The instestines are washed thoroughly with water.
Splitting:-The gut is cut into smooth ribbons .
Removal of unwanted layers:-The layers of gut like the innermost mucosa and the outer muscularis and serosal layers are scrapped off by knife.
Chemical processing:- At this stage the ribbons may be tanned or hardened by soaking in solution of chromic salt.
Spinning:- ribbons are tied together at one end ,pulled and spin.
Drying:- are kept in a suitable heat and temperature condition under suitable tension.
Finishing- The dried strings are polished by mechanical means.The strings are rubbed against a abrasive surface to get smooth uniform string of circular section.
Sterilization:-The gut may be sterilized by chemicals, heat or ionizing radiations.
TYPES OF CATGUT - (BOILABLE AND NON -BOILABLE CATGUT)
If the tubing fluid is anhydrous the tubes may be boiled before opening it for use;this type of catgut is called “boilable catgut”.
If the tubing contains water the tubes of the caguts are labeled “non-boilable”.
CATGUT SUTURES ARE AVAILABLES IN THE FORM OF -
PLAIN CATGUT- It is usually having shorter absorption period and is absorbed more rapidly in infected areas.
CHROMIC CATGUT- It is treated with chromium salt solution to resist body enzymes and slowerthe absorption process thus supporting the wound for longer periods.
2.NON-ABSORBABLE SUTURES
SILK:- Silk consist of strands prepared from filamentsof the cocoon spun by the silk wormof the Bombyx family.
LINEN:- Linen consist of selected fibers made into a twisted strands from flax(Linum usitatissinum).
COTTON:- (from Gossypium sp.) .
HORSE HAIR:- (From tail hairs of the horse).
NYLON:-(formed by the polymerization reaction product of an acid and amine).
POLYESTER:-(Prepared by polymerizing the ester).
METAL AND ALLOYS