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PRESENTATION ON SURGICAL SUTURES

PRESENTATION ON SURGICAL SUTURES. HISTORY OF SUTURES. Earliest Reference EDWIN SMITH PAPYRUS 1600 BC. Kangaroo Tendons Silver Cotton Acacia Thorns Cautery. Driver Ants Bark Fibre Linen Gold Animal Intestinal Tissue Synthetic Absorbable. WOUND CLOSURE THROUGH HISTORY.

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PRESENTATION ON SURGICAL SUTURES

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  1. PRESENTATION ON SURGICAL SUTURES

  2. HISTORY OF SUTURES Earliest Reference EDWIN SMITH PAPYRUS 1600 BC

  3. Kangaroo Tendons Silver Cotton Acacia Thorns Cautery Driver Ants Bark Fibre Linen Gold Animal Intestinal Tissue Synthetic Absorbable WOUND CLOSURE THROUGH HISTORY

  4. How the Surgeon Uses Suture Materials • Ligating • Suturing • Transfixing

  5. THE IDEAL SUTUREMoynihan 1912 • Monofilament • Use for any procedure • Easy to Handle • Minimal Tissue Reaction • High Breaking Strength • Holds Knot Securely • Absorbable • Predictable Absorption • Sterile

  6. CLASSIFICATION OF SUTURES

  7. ABSORBABALE ADVANTAGE • Broken down by body • No Foreign body left DISADVANTAGE • Time of Wound Support

  8. NONABSORBABALE ADVANTAGE • Permanent Wound Support DISADVANTAGE • Foreign body left • Suture Sinus • Suture Extrusion

  9. MONOFILAMENT ADVANTAGE • Smooth Surface • Low Friction • Less Tissue Drag • Less Tissue Trauma • No Bacterial Harbours

  10. MONOFILAMENT DISADVANTAGE • Handling and Knotting • Ends/Knot Burial • Stretch

  11. BRAIDED ADVANTAGE • Strength • Soft and Pliable • Good Handling

  12. BRAIDED DISADVANTAGE • Bacterial Harbours • Tissue Trauma • Tissue Drag

  13. SYNTHETIC ADVANTAGE • Resemble Natural Substances • Absorption by Hydrolysis • Predictable Absorption • Strong DISADVANTAGE Monofilament Handling

  14. NATURAL ADVANTAGE • Handling and Knotting • Economical DISADVANTAGE • Absorption by Enzymatic Action • Tissue Reactions • Unpredictable Absorption

  15. ABSORPTION TERMINOLOGY(Absorbable Sutures) • LOSS OF TENSILE STRENGTH • ABSORPTION OF MASS

  16. LOSS OF TENSILE STRENGTH DEFENITION • Tensile Strength retention refers to the amount of strength “INVIVO” that a suture material has retained. • This can be measured in days and as a percentage of original strength • Loss of Tensile strength can take place without any visible loss of suture bulk

  17. ABSORPTION OF MASS DEFENITION • Absorption is the loss of mass of the material in tissue as measured in days. • There may be mass of Suture in the wound and zero tensile strength retention. • Mass absorption is important as even when mechanical wound support is no longer needed, potential adverse reactions can continue as long as the suture is present.

  18. ABSORBABLESUTURES

  19. HICON CATGUT SUTURES

  20. HICON – CHROMIC GUT • Made from Sub Mucosa of Sheep Intestine • Cleaned and Purified for high Collagen Purity • Individual ribbons are twisted and dried • Chromicising done to ensure tensile strength • Polished to controlled diameter • Result in Virtual Monofilament • Packed wet to keep supple

  21. CATGUT ABSORPTION

  22. CATGUT ABSORPTION • Absorption by Enzymatic action • Absorption is unpredictable • Tissue reaction can occur

  23. CATGUT SUMMARY • ABSORBABLE – No Foreign body left • MONOFILAMENT – Minimal Tissue Trauma • 98 % PURE COLLAGEN – Minimises Tissue Reactions • PACKED WET – Pliable, Good Handling & Knotting

  24. SYNTHETIC ABSORBABLE

  25. SYNTHETIC ABSORBABLE HINCRYL SUTURES HICRYL

  26. COATED HICRYLTENSILE STRENGTH RETENTION

  27. COATED HINCRYL • WOUND SUPPORT : 28 – 32 DAYS • MASS ABSORPTION : 90 – 110 DAYS

  28. COATED HINCRYL • Imported Raw Material • ISO certified Manufacturing Facility • More than 40 suture Needle Combinations • Secure Knotting Characteristics

  29. Braided Synthetic Absorbable Coating on Hicryl Strong Good Knotting and handling Properties Few Tissue Reaction Predictable Absorption No Foreign body left Minimising problems of multifilament Knot slides down easily Minimal Tissue Reaction HINCRYL SUMMARY

  30. NON ABSORBABLE • HISIL • HILON • HINSURG

  31. HISIL BRAIDED BLACK SILK SUTURES

  32. HISIL • Easy handling • Manufactured from imported raw silk • Uniform diameter and smooth surface • Assured excellent knot security • Available in sizes 6/0 to 1 USP • On reels (Non sterile) of 25 mts length • Sterile Needled sutures

  33. HISIL • Very Good Handling • Very Good Knotting • Standard for many years

  34. HILON • SYNTHETIC • NONABSORBABLE • MONOFILAMENT

  35. HILON • First Synthetic Monofilament Non absorbable • Replaced Monofilament Silk • Used mainly in Skin and Abdominal Closure

  36. HILON • Smooth, Easy passage through tissue • No Bacterial harbours or Capillarity • Strong, Controlled Elasticity allows Ultra Fine Gauges • Provided Long term Wound Support

  37. HINSURG – POLYPROPELENE NONABSORBABLE SUTURES

  38. HINSURG • Monofilament to replace Nylon • Better Control of Stretching Properties • More Pliable for handling and knotting • Smoothest Suture Surface ever

  39. HINSURG • Extends upto 30% before Breaking • Indefinite Tensile Strength • Excellent Handling • Secured Knotting • Sterilised by EO • Inert and Non-Biodegradable

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