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PRESENTATION ON SURGICAL SUTURES

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PRESENTATION ON SURGICAL SUTURES - PowerPoint PPT Presentation


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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 Transcript
history of sutures

HISTORY OF SUTURES

Earliest Reference

EDWIN SMITH PAPYRUS 1600 BC

wound closure through history
Kangaroo Tendons

Silver

Cotton

Acacia Thorns

Cautery

Driver Ants

Bark Fibre

Linen

Gold

Animal Intestinal Tissue

Synthetic Absorbable

WOUND CLOSURE THROUGH HISTORY
how the surgeon uses suture materials
How the Surgeon Uses Suture Materials
  • Ligating
  • Suturing
  • Transfixing
the ideal suture moynihan 1912
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
absorbabale
ABSORBABALE

ADVANTAGE

  • Broken down by body
  • No Foreign body left

DISADVANTAGE

  • Time of Wound Support
nonabsorbabale
NONABSORBABALE

ADVANTAGE

  • Permanent Wound Support

DISADVANTAGE

  • Foreign body left
  • Suture Sinus
  • Suture Extrusion
monofilament
MONOFILAMENT

ADVANTAGE

  • Smooth Surface
  • Low Friction
  • Less Tissue Drag
  • Less Tissue Trauma
  • No Bacterial Harbours
monofilament10
MONOFILAMENT

DISADVANTAGE

  • Handling and Knotting
  • Ends/Knot Burial
  • Stretch
braided
BRAIDED

ADVANTAGE

  • Strength
  • Soft and Pliable
  • Good Handling
braided12
BRAIDED

DISADVANTAGE

  • Bacterial Harbours
  • Tissue Trauma
  • Tissue Drag
synthetic
SYNTHETIC

ADVANTAGE

  • Resemble Natural Substances
  • Absorption by Hydrolysis
  • Predictable Absorption
  • Strong

DISADVANTAGE

Monofilament Handling

natural
NATURAL

ADVANTAGE

  • Handling and Knotting
  • Economical

DISADVANTAGE

  • Absorption by Enzymatic Action
  • Tissue Reactions
  • Unpredictable Absorption
absorption terminology absorbable sutures
ABSORPTION TERMINOLOGY(Absorbable Sutures)
  • LOSS OF TENSILE STRENGTH
  • ABSORPTION OF MASS
loss of tensile strength defenition
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
absorption of mass defenition
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.
hicon chromic gut
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
catgut absorption22
CATGUT ABSORPTION
  • Absorption by Enzymatic action
  • Absorption is unpredictable
  • Tissue reaction can occur
catgut summary
CATGUT SUMMARY
  • ABSORBABLE – No Foreign body left
  • MONOFILAMENT – Minimal Tissue Trauma
  • 98 % PURE COLLAGEN – Minimises Tissue Reactions
  • PACKED WET – Pliable, Good Handling & Knotting
coated hincryl
COATED HINCRYL
  • WOUND SUPPORT : 28 – 32 DAYS
  • MASS ABSORPTION : 90 – 110 DAYS
coated hincryl28
COATED HINCRYL
  • Imported Raw Material
  • ISO certified Manufacturing Facility
  • More than 40 suture Needle Combinations
  • Secure Knotting Characteristics
hincryl summary
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
non absorbable
NON ABSORBABLE
  • HISIL
  • HILON
  • HINSURG
hisil
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
hisil33
HISIL
  • Very Good Handling
  • Very Good Knotting
  • Standard for many years
hilon
HILON
  • SYNTHETIC
  • NONABSORBABLE
  • MONOFILAMENT
hilon35
HILON
  • First Synthetic Monofilament Non absorbable
  • Replaced Monofilament Silk
  • Used mainly in Skin and Abdominal Closure
hilon36
HILON
  • Smooth, Easy passage through tissue
  • No Bacterial harbours or Capillarity
  • Strong, Controlled Elasticity allows Ultra Fine Gauges
  • Provided Long term Wound Support
hinsurg
HINSURG
  • Monofilament to replace Nylon
  • Better Control of Stretching Properties
  • More Pliable for handling and knotting
  • Smoothest Suture Surface ever
hinsurg39
HINSURG
  • Extends upto 30% before Breaking
  • Indefinite Tensile Strength
  • Excellent Handling
  • Secured Knotting
  • Sterilised by EO
  • Inert and Non-Biodegradable