Medical surgical sutures are sterile threads used for wound suturing, tissue ligation and fixation, and have been widely used in various surgical procedures. It plays an important role in the initial healing of wounds as well as in later recovery. With the rapid development of modern medicine, the increasing improvement of surgical technology, and the increasing demand for rejuvenation, the renewal and development of biomaterials science is more rapid.
The ideal medical surgical suture should have the following characteristics: (1) easy to dye, disinfect, sterilization and other treatments; (2) have certain mechanical properties, such as sufficient mechanical strength, appropriate ductility, retraction, good flexibility, elasticity, certain wetness and friction coefficient; (3) suture, knotting operation is convenient, good knotting performance; (4) there is a certain adaptability to body tissues, not caused by foreign body reactions and inflammation; (5) non-toxic, irritating, teratogenic and carcinogenic, with certain antimicrobial properties, and can promote wound healing ;(6) The product quality is stable, reliable and easy to prepare.
There are several classifications of medical surgical sutures. According to the biodegradable performance, it can be divided into two types:
One is non-absorbable sutures (non-absorbable sutures), which do not change the physicochemical properties over time, that is, they cannot be degraded in vivo, usually need to be removed by surgery, otherwise they will remain in the tissue as a foreign body; the other is absorbable sutures (absorbable sutures), which can be degraded into soluble products in the body tissue, usually implanted for 2 to 6 months, the wire can be gradually degraded and absorbed. According to the presence or absence of barbs, surgical sutures can be divided into barb sutures and barb-free sutures. At present, barb sutures are often used clinically for facial rejuvenation and body shaping treatment.
The following will introduce the application history and current status of non-absorbable sutures, absorbable sutures and barb sutures.
First, do not absorb the suture
Non-absorbable sutures are single or multi-strand sutures prepared by weaving and weaving from metal, natural materials or synthetic materials. With the advancement of materials and manufacturing processes and the requirements of clinical applications, it is mainly divided into the following generations:
The first generation does not absorb sutures
The first generation of non-absorbable sutures mainly include natural suture materials such as linen thread, cotton thread and silk thread, as well as metal suture materials. Flax thread and cotton thread are mainly used for gastrointestinal suture surgery, compared with other synthetic sutures, cellulose material is more reactive to tissue, the strength is also low, so it is rarely used.
The second generation does not absorb sutures
Compared with the silk thread, the second-generation synthetic non-absorbable suture has a long maintenance time in the body tissue, high tension strength, low tissue reactivity, and good operability; the disadvantage is that it is easy to dislocate, and it must be knotted many times to ensure the safety of the knot.
The early synthesis of non-absorbable sutures mainly include: (1) nylon sutures, the basic characteristics include good elasticity, sufficient tension, inertness, low tissue reactivity, no capillary effect, high tissue biocompatibility, especially suitable for tissue attenosis suture and skin suture. Although classified as non-absorbable, it loses about 30% of its initial tensile strength in 2 years after implantation. The disadvantages are that the knot buckle is difficult, the knot holding is poor, it is easier to dislocate, and it is often necessary to do 5 to 6 re-knots and leave a tail line at least 3 mm long. (2) Polyester thread, that is, polyester thread. The line has two kinds of braided lines, two kinds of strands and single strands. It is characterized by strong thread, strength second only to steel wire, low tissue reactivity, suitable for soft tissue suture and /or ligation, such as applied to cardiovascular surgery, neurosurgery and so on. In clinical practice, braided multi-stranded threads are more commonly used, such as ethibond, which is not absorbable sutures, but its surface friction coefficient is high and the knot resistance is large, which also limits its application in surgery. (3) Polypropylene thread, which is characterized by high tensile strength, low specific gravity, non-absorbent water, acid and alkali resistance, not easy to be degraded by enzymes, autoclaving resistance, strength retention ability second only to stainless steel wire and polyester wire, smooth surface, small trauma, low tissue reactivity, strong anti-infectivity, good adaptability in later periods, etc. This thread has been widely used in surgical sutures in general surgery, cardiovascular surgery and plastic surgery, such as prolene, which is not absorbable sutures. The disadvantages are low friction, poor flexibility, and slightly difficult knotting, especially when blood stained or wet.
The third generation does not absorb sutures
Gore-tex and polybutylene sutures (novafil1) are representative of the third generation of synthetic non-absorbable sutures
Gore-tex is a monofilament made of extruded PTFE, also known as extruded PTFE thread. The tensile strength of the line is higher than that of polypropylene and polyester thread, which is inert and is not easily absorbed and hydrolyzed in the implanted body. It has the characteristics of porous and chain structure, containing about 50% of the holes in the thread body, so that its reverse fold can also withstand long-term tension, and can be connected to the same thickness of stitches into a "non-invasive thread". This line is particularly suitable for vascular anastomosis and can significantly reduce the amount of bleeding at the eye of the needle. The disadvantages are low friction, poor knot holding, and the need for multiple knots. In addition, when tying, make sure that the suture line on the knot is slightly deformed (the air in the thread hole is discharged), and reserve a long enough tail line to prevent the knot from falling off.
Polybutylene suture (novafil) is composed of polybutene and polytetramethylene copolymer, characterized by low tissue reactivity, high elasticity, good operability and safe binding. It is suitable for delayed healing of expected wounds, as well as repair of tendons and other tissues, especially for early wound healing.
In addition, ultra-high molecular weight polyethylene sutures (nesplon) are currently the strongest twisted braided sutures. The line has the characteristics of high strength, smooth surface, low friction coefficient, not easy to raise hair, stable nature, etc., and is mainly used for sutures with high strength requirements such as bone fixation, but its cohesiveness is poor.
Of course, today, facial thread lifting surgery does not require the use of non-absorbable sutures. We use absorbable wire.
Absorbable wire has been continuously iteratively updated through technology, and has now reached the "latest generation of long-term absorbable sutures" and "barb sutures".
Face thread lifting
Face thread lift + face fat addition or subtraction
For the "absorbable wire" that we will definitely use for facial thread lifting, sisters who are ready to do thread lifting can consult in detail or type what you want to know below, and I will reply to you.
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