Chapter 2555 [2555] Tension

I remember for a while, I don’t know where a clinical evil spirit started to blow. Some patients are very afraid of sutures, no matter how big or small they have to wrap them before surgery and tell the doctor that you have to give me good sutures that can be absorbed in the human body. These people are afraid of leaving foreign bodies in their bodies. I don't know where I heard the rumor that these sutures in the body will kill people.

I want to know that this statement is impossible. Absorbable sutures were invented later. According to this statement, the previous surgical patients were all killed by non-absorbable sutures.

When considering what kind of suture to use in medicine, the first step for doctors to think about the absolute suture is not whether the suture can be absorbed by the human body, but the tensile strength of the suture material.

Regarding the tension of human tissue, we have said from the first surgical retractor that as long as the living tissue is active after anesthesia, there is always a tension of contraction.

Medically, sutures are used to close a wound. The purpose is to pull the two ends of the opening together to allow the wound to heal. If the tension resistance of the suture is not strong enough, it is not strong enough to resist the contraction tension of the human tissue. In this way, when the human tissue on both sides of the anastomosis is repeatedly contracted, the tension can easily directly break the thread, causing the wound to re-open and suture failure.

How terrible is the failed suture, and the incision is reopened, isn't this about bleeding? Or is it leaking? The wound never healed, the anastomotic leak, repeated infections, and systemic sepsis, it was really going to be a toss-up—all the more terrifying things the doctor could think about.

The so-called rumors that some patients are afraid of the so-called sutures left in the body will kill people. If it refers to suture infection, the current sutures are all strictly sterilized, and the incidence rate is too low. And if there is a risk of infection with non-absorbable sutures, the same is true of absorbable sutures. Absorbable sutures are not absorbed by the human body immediately after being sewn. It is meaningless to become sutured. It has to wait for the wound to grow well before being absorbed by the body. This process can be as short as a few days or more than a month.

These patients should actually be afraid of suture rejection. The problem is that medical technology has already developed to the point that various surgical materials have strict regulations on the use of them, and which ones cannot be left behind and which ones can stay in the human body for a long time are clearly marked. All materials that can remain in the human body must be tested and studied for compatibility with human tissue, and only after the approval can they be used in clinical practice. This has been discussed in orthopedic materials science. Complex materials in orthopaedics can do this, and small sutures have already crossed this threshold.

Having said that, it can be seen that these people’s concerns are nonsense.

It is true that some doctors will ask patients whether to use absorbable sutures before surgery. Where is this patient-selectable suture typically used? An innocuous layer of skin that has little to do with the patient's life. After all, some patients who are financially strapped can pay limited medical expenses. In those days, the absorbable sutures were called cosmetic sutures, which were very expensive and had to be paid for by themselves.

The choice of sutures is a matter of concern for the lives of patients. It is impossible for doctors to give this professional thing to patients who do not understand medicine to choose randomly. It is equivalent to handing a knife to someone to commit suicide.

Speaking of polypropylene threads, the most commonly used place is in blood vessels.

The advantage of this material single-strand thread is that it is less susceptible to infection than multi-strand thread, and its smooth performance makes it less harmful when passing through human tissue, and it stays in the human body for a long time with low rejection.

(end of this chapter)