Surgical thread: name, thickness, dimensions

Any average person one way or another during his life at least once faced with serious wounds or operations. In both cases, the damage is sewn up by the doctors to speed up the healing process. What is the difference between a surgical thread and the most common one?

When seams are needed

Deep cuts and wounds, cavitary operations, other injuries - most people in one way or another are faced with having to sew up their tissues for better and faster healing. For a long time this problem along with effective anesthesia was the main obstacle for the further development of surgery.

Throughout history, there have been several periods of the rise and fall of this discipline. So, in ancient Rome, surgery experienced an unprecedented development, with every gladiator school there was a doctor who treated the wounds of fighters after unsuccessful performances. In the Middle Ages, medicine as a whole fell into disgrace, and all knowledge of the past was forgotten to be restored in the Renaissance and New Times.

There was never a need to heal wounds, because throughout the history of human history wars have been constantly waged, and even in peacetime, a sterile surgical thread has saved many lives. How did it come about?

History

Science has a sufficiently large number of evidence that the first operations, including rather complex ones, were carried out long before the emergence of special tools and profound knowledge of human anatomy.

The first documented use of suture material took place 2000 years before our era. The use of threads and needles in healing wounds was described in the Chinese treatise on medicine. In those days, the skin was sewn with horsehair, animal tendons, cotton fibers, trees and other plants. In 175 BC, Galen first mentions catgut, which was made from the connective tissue of livestock. Until the 20th century, it remained practically the only suture material. However, in 1924, the material was invented, which was later called nylon. It is considered the first synthetic thread, suitable for stitching wounds. A little later, there appeared lavsan and kapron, which were almost immediately used in surgery. In the middle of the century polypropylene was invented, and in the 70's - artificial absorbable fibers.

At the same time as the surgical thread changed, metamorphoses and needles underwent metamorphosis. If earlier they did not differ in anything from ordinary ones, they were reusable and themselves injured tissues, then later they acquired a modern curved shape, they became thinner and smoother. Modern disposable needles are atraumatic, on their surface the microroughness is filled with silicone.

Modern suture material

In the surgery of the XXI century, threads of various origin and properties are used. They can be both natural and synthetic. There are also some who after a while after the operation resolve themselves, when the need for them disappears. With their help, often sew internal tissues, while external can be used and the usual, which you want to later remove. The final decision is made by the doctor depending on various factors, the nature of the wound and the condition of the patient. He also estimates the size of surgical threads, choosing a suitable thickness to support the tissues, but not to injure them once again.

Requirements

There are a number of properties that a modern surgical thread should possess. These requirements for suture material were formulated in 1965. However, they are still relevant today:

• Simple sterilization;
• Hypoallergenicity;
• low cost;
• Inertness;
• strength;
• Resistance to infection;
• Resorption;
• Versatility for any fabric;
• Plasticity, convenience in hand, lack of memory thread;
• Lack of electronic activity;
• Reliability of the node.

Modern natural and synthetic surgical threads somehow meet most of these requirements. Most often, with the right treatment, even the most serious wounds can be cured. And thanks to this, surgery could successfully develop to the modern level, when both micro-level operations and complex manipulations with such important organs as the heart and the brain are carried out, and often the patients recover in a relatively short time.

Thickness

Of course, over several thousand years, the surgical thread has undergone major changes and can not be compared to what the doctors were compelled to use at that time.

Today, doctors have a wide arsenal of very different suture material, suitable for a variety of body tissues. The most understandable characteristic for a layman is the thickness of surgical threads. It determines the strength and trauma of the joint and, accordingly, the healing time of the wound.

There are about two dozen threads, differing only in thickness. And the values vary from 0.01 to 0.9 millimeters. Thus, the very first in a row of these threads is thinner than a human hair approximately 8 times!

Varieties

Initially, two types of suture material are distinguished:

• Monofilament surgical thread;
• Multifilament, which, in turn, can be twisted or woven.

Each of these species has its advantages, disadvantages and peculiarities. Thus, monofilament has such advantages:

1. Smoothness. The structure of this type is less traumatic, which avoids greater bleeding.
2. Ease in manipulation. Monofilament is often used for intradermal sutures, as it does not grow into tissues and is easily removed if necessary.
3. No wick effect. This phenomenon consists in the fact that when the fibers are loosely adhered to each other, micro-voids are formed between them, which fill with the contents of the wound, increasing the risk of infection. In monofilament, there is no such danger.
4. Inertness. A single-fiber thread is less irritating to the skin, with its use lower chance of inflammation of the wound.

Moreover, monophilametric suture material has one significant drawback. Relatively small strength. Requirements for modern threads are such that there should be a minimum number of nodes - they irritate tissues and slow healing. Since the monofilament has a smoother surface, it does not hold up complex designs very well. When using this type of material, you have to use more knots to keep the seam better.

To improve the properties of threads, they are coated with different compositions to reduce the risk of infections, increase smoothness and biocompatibility. In addition, there is a constant work on new fibers and materials, so that surgery does not stand still.

Catgut and cellulosic materials

As already mentioned, the surgical thread, whose name originated from the word cattle gut , was one of the first. Today, the technology of its production is much more perfect than before, there is a suture material with chromium-plated, increasing strength and resorption time.

It is still a very popular type of thread, even though its use in some cases is equivalent to organ transplantation and can cause an appropriate immune response. Nevertheless, catgut is very suitable if the seam is needed for a short time, because after 10 days it can dissolve by half, and after 2 months it completely collapses after fulfilling its purpose.

Of the cellulose fibers, a polytite called ocelone and kacelone is made. They also have a relatively short resorption time, which makes them irreplaceable in urology, plastic and pediatric surgery. At the same time, they have an important advantage - they are not rejected by the body as foreign tissues.

The remaining absorbable

Other surgical threads have a longer lead-out period, which is useful in general, thoracic and oncosurgery. The most long-lived solution of polydiaksanone - it completely disappears 6-7 months.

The advantage of artificial fibers is that they contribute to a faster and more clean wound healing, reduce the risk of any complications and inflammations. That is why the catgut is gradually abandoned, finding safer analogs.

Silk and nylon

Two of these types are surgical threads, which are absorbed conditionally. In practice this means that it takes several years to remove them from the body. Silk for a long time was considered a gold standard, fascinating versatility in the application. However, due to the fact that its fibers are of natural origin, seams with its use often become inflamed and require more attention. But while it is very elastic, durable and soft, which earned the love of surgeons.

The nylon thread also often causes an inflammatory reaction. Nevertheless, it is often used for stitching of tendons and in ophthalmology.

Non-absorbable

The surgical threads, which later have to be removed manually, also differ in sufficient variety. Some of them have excellent manipulative properties, but are reactogenic. Others are inert and safe, but inconvenient to work and have little strength. Nevertheless, almost all of them are widely used both in general and in specialized surgery.

There are the following groups:

• Polyolefins - splen, polypropylene. Despite the fact that such seams are almost never inflated, convenience in work leaves much to be desired, and also it is necessary to tie a lot of nodules.
• Polyesters are nylon and lavsan. They are mainly used to support stretched tissues and endoscopic operations.
• Fluoropolymers. The most perfect group - have good handling properties and sufficient strength. Do not require a large number of nodes.

Steel and titanium

This may seem strange, but metal is still used in surgery in the form of both wire-thread and staples for a special apparatus. Serious drawback - injury to surrounding tissues. Nevertheless, in some cases, in orthopedics and bone surgery, you can not replace a metal with anything.

So, there are a lot of varieties of suture material. They are used for different purposes, and it is very important, which ultimately will be chosen surgical thread. The name, of course, does not play any role here, but the doctor always takes into account many factors, deciding what will be better for the patient.