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Classification and development history of Surgical Sutures

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Classification and development history of Surgical Sutures

Surgical Suture refers to special threads used for ligation and hemostasis and suture hemostasis and tissue suture in surgical operations or trauma treatment. Surgical Sutures can be divided into absorbable lines and non-absorbable lines, which are mainly used in hospitals and clinics. Next, let's take a look at the classification and development history of Surgical Sutures.

Here is the content list:

  • Classification of Surgical Sutures.

  • History of Surgical Sutures.

Classification of Surgical Sutures.

Surgical Suture can generally be divided into two categories: absorbable lines and non-absorbable lines. Absorbable Surgical Sutures are divided into catgut, chemical synthetic thread (PGA), and pure natural collagen Surgical Sutures according to different materials and degrees of absorption. Non-absorbable sutures are Surgical Sutures that cannot be absorbed by tissue, so they need to be removed after sutures. The specific suture removal time varies depending on the suture site, wound, and the patient's condition. When the wound heals well without infection and other abnormalities: 4 to 5 days for the face and neck to be removed; 6 to 7 days for the lower abdomen and perineum; Chest, upper abdomen, back, buttocks 7 to 9 days; limbs 10 to 12 days, the near joints can be extended, and the tension reduction sutures can be removed on 14 days. In special cases such as malnutrition and high incision tension, an appropriate extension of suture removal time can be considered. Adolescents can shorten the stitch removal time, and elderly people, diabetics, and those with chronic diseases can delay stitch removal time. If there is an obvious infection such as redness, swelling, heat, pain, etc. after the wound, the sutures should be removed in advance. In the following cases, suture removal should be delayed: severe anemia, weight loss, mild cachexia; severe dehydration or uncorrected water-electrolyte imbalance; elderly patients and infants; chest and abdominal incisions should be delayed when the cough is not controlled.

History of Surgical Sutures.

Absorbability refers to the ability to be degraded by the body over time. Therefore, Surgical Sutures can be divided into absorbable lines and non-absorbable lines. Absorbable thread is often used to refer to sutures that can lose most of their tensile strength within 60 days of entering the body. Absorption of the Surgical Suture is achieved through tissue response to sutures. Sutures that need to be buried inside the body and deep in the wound are generally absorbable threads, while non-absorbable threads are used to suture the outer layer of the wound and will eventually be removed. In rare cases, where tensile strength is to be maintained in deep tissue for extended periods, non-absorbable threads are also used.

Different materials of Surgical Sutures have been used and debated, but largely unchanged for thousands of years. Needles are made of bone or metal (such as silver, copper, aluminum bronze wire). Sutures are made from plant material (linen, hemp, and cotton) or animal material (hair, tendons, arteries, muscle strips or nerves, silk, and catgut). African cultures use thorns, while others use ants for sutures, tricking bugs into biting both sides of the wound and twisting their heads.

The earliest records of surgical sutures date back to 3000 BC in ancient Egypt, and the oldest known sutures are on mummies from 1100 BC. The first detailed written account of wound suturing and the use of suture material comes from the Indian sage and physician Sushruta in 500 BC. The Greek "father of medicine" Hippocrates and later Roman Aulus Cornelius Celsus described basic suture techniques. The first description of intestinal sutures was by the Roman physician Galen in the 2nd century and is also believed to be by the 10th-century Andalusian surgeon Zaheravi. Dhahrawirut's strings were recorded to have been swallowed by a monkey, who discovered the absorbable properties of the gut. Since then, medical catgut has been manufactured. Joseph Lister introduced a sea change in suturing technology, and he advocated routine disinfection of all Surgical Sutures. In the 1860s, he first tried to sterilize "carbolic acid catgut", and twenty years later he sterilized chrome catgut. In 1906, sterile iodine-treated catgut was produced.

The next big leap occurred in the 20th century. With the development of the chemical industry, the first synthetic thread was made in the 1930s, and numerous absorbing and non-absorbing synthetic threads were rapidly developed. The first synthetic thread was made of polyvinyl alcohol in 1931. The polyester thread was developed in the 1950s, and later radiation sterilization for catgut and polyester was developed. Polyglycolic acid was discovered in the 60s, and it was used in the manufacture of Surgical Sutures in the 70s. Most Surgical Sutures are made from polymer fibers. Of the ancient materials, only silk and gut are still in use though not very often. In Europe and Japan, catgut is banned for bovine spongiform encephalopathy, while silk is sometimes used in vascular and ENT procedures.

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