Suture: Difference between revisions
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In [[medicine]], '''sutures''' are "materials used in closing a surgical or traumatic wound."<ref>{{MeSH}}</ref> | In [[medicine]], '''sutures''' are "materials used in closing a surgical or traumatic wound."<ref>{{MeSH}}</ref> They may be made of treated natural material, synthetic plastic, or wire, and come in a variety of thicknesses, attached or nonattached needles, and other mechanical forms. | ||
Especially for use inside wounds, sutures may be nonabsorbable and permanent, or absorbable and indended to be replaced by healthy issues. In some procedures, it eventually may be part of the plan to remove nonabsorbable sutures. | |||
Sutures, traditionally, have been thread-like and applied with a needle and sewing technique. Some suture materials, however, are used to form a constricting loop (e.g., to close off a blood vessel or surgical stump), either simply knotted or sewn with a "purse-string" technique that allows them to tightened. | |||
Especially with microsurgical and endoscopic procedures, mechanical clips, often requiring special tools to apply, have replaced traditional sutures. | |||
==Roles in medicine== | ==Roles in medicine== | ||
===Simple skin lacerations=== | ===Simple skin lacerations=== | ||
Tissue adhesive may be better than sutures for simple skin lacerations.<ref name="pmid18440668">{{cite journal |author=Man SY, Wong EM, Ng YC, ''et al'' |title=Cost-consequence analysis comparing 2-octyl cyanoacrylate tissue adhesive and suture for closure of simple lacerations: a randomized controlled trial |journal=Ann Emerg Med |volume=53 |issue=2 |pages=189–97 |year=2009 |month=February |pmid=18440668 |doi=10.1016/j.annemergmed.2008.03.003 |url=http://linkinghub.elsevier.com/retrieve/pii/S0196-0644(08)00568-4 |issn=}}</ref> | Tissue adhesive may be better than sutures for simple skin lacerations.<ref name="pmid18440668">{{cite journal |author=Man SY, Wong EM, Ng YC, ''et al'' |title=Cost-consequence analysis comparing 2-octyl cyanoacrylate tissue adhesive and suture for closure of simple lacerations: a randomized controlled trial |journal=Ann Emerg Med |volume=53 |issue=2 |pages=189–97 |year=2009 |month=February |pmid=18440668 |doi=10.1016/j.annemergmed.2008.03.003 |url=http://linkinghub.elsevier.com/retrieve/pii/S0196-0644(08)00568-4 |issn=}}</ref> | ||
Also, in some case where the skin is not under tension, various kinds of natural or sythetic fiber strips can be used to approximate and repair the edges. An early type was the "butterfly", essentially a modified strip of adhesive tape with notches cut in the center where the strip would go over the broken skin; the narrow wound covering, on commercial butterfly strips, has no adhesive. A later type of external wound closure is a sterile strip of tape, witb a gentle and biodegradable adhesive. As the wound heals, these strips fall away. | |||
==Complications== | ==Complications== | ||
Revision as of 07:40, 20 February 2009
In medicine, sutures are "materials used in closing a surgical or traumatic wound."[1] They may be made of treated natural material, synthetic plastic, or wire, and come in a variety of thicknesses, attached or nonattached needles, and other mechanical forms.
Especially for use inside wounds, sutures may be nonabsorbable and permanent, or absorbable and indended to be replaced by healthy issues. In some procedures, it eventually may be part of the plan to remove nonabsorbable sutures.
Sutures, traditionally, have been thread-like and applied with a needle and sewing technique. Some suture materials, however, are used to form a constricting loop (e.g., to close off a blood vessel or surgical stump), either simply knotted or sewn with a "purse-string" technique that allows them to tightened.
Especially with microsurgical and endoscopic procedures, mechanical clips, often requiring special tools to apply, have replaced traditional sutures.
Roles in medicine
Simple skin lacerations
Tissue adhesive may be better than sutures for simple skin lacerations.[2]
Also, in some case where the skin is not under tension, various kinds of natural or sythetic fiber strips can be used to approximate and repair the edges. An early type was the "butterfly", essentially a modified strip of adhesive tape with notches cut in the center where the strip would go over the broken skin; the narrow wound covering, on commercial butterfly strips, has no adhesive. A later type of external wound closure is a sterile strip of tape, witb a gentle and biodegradable adhesive. As the wound heals, these strips fall away.
Complications
Infection
Infections may be reduced by topical chloramphenicol.[3] Getting sutures wet does not increase infections.[4]
References
- ↑ Anonymous (2024), Suture (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Man SY, Wong EM, Ng YC, et al (February 2009). "Cost-consequence analysis comparing 2-octyl cyanoacrylate tissue adhesive and suture for closure of simple lacerations: a randomized controlled trial". Ann Emerg Med 53 (2): 189–97. DOI:10.1016/j.annemergmed.2008.03.003. PMID 18440668. Research Blogging.
- ↑ Heal CF, Buettner PG, Cruickshank R, et al (2009). "Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial". BMJ 338: a2812. PMID 19147639. PMC 2628297. [e]
- ↑ Heal C, Buettner P, Raasch B, et al (May 2006). "Can sutures get wet? Prospective randomised controlled trial of wound management in general practice". BMJ 332 (7549): 1053–6. DOI:10.1136/bmj.38800.628704.AE. PMID 16636023. PMC 1458594. Research Blogging.