Chapter 2556： 【2556】Pediatric Features

Chapter 2556 [2556] Pediatric Features

The most important thing is that its high elasticity makes it excellent for vascular sutures.

In simple terms, blood in the blood vessels is the peaks and valleys that fluctuate with blood pressure. When the fluid in the blood vessel is full, it pulls the anastomosis, which can be stretched like a rubber band and not easily broken like an inflexible rope. When the amount of fluid in the blood vessels is at a low point, it can contract back well to encourage the opening to heal.

The unique advantage of    polypropylene thread is undoubtedly very suitable for the anastomosis of the heart, the largest blood pump in the human body, into and out of the great vessels.

In adult heart transplants, it is true that polypropylene sutures are enough.

Pediatrics are not the same.

In pediatrics, pediatric surgeons need to focus on the characteristics of children's growth and development. In pediatric orthopedics, it is the same as in other pediatric surgeries. In the anastomosis of large blood vessels in pediatric cardiac surgery, pediatricians need to consider that children's blood vessels will grow again, and on the other hand, they can focus on considering that children's vigorous metabolism is an advantage compared to adults.

Comprehensive measure, doctors can use absorbable sutures to match non-absorbable sutures in this place, giving the patient's own human tissue more self-repair fault tolerance at the anastomosis.

is equivalent to saying that in this operation, the doctor sews a vascular anastomosis, and can use half of the non-absorbable sutures and half of the absorbable sutures.

How to choose absorbable sutures. Remember that absorbable sutures are absorbed by the body. Therefore, what the doctor has to do is to ensure that the absorbable suture is not absorbed by the body before the wound heals, otherwise, the thread disappears before the wound heals, which also means that the suture fails.

There are many kinds of absorbable sutures on the market, some degrade fast and some degrade slowly, which refers to the disappearance time of sutures in the human body. Is it okay to choose slow-degrading sutures for slow-healing human tissue?

No, some absorbable sutures degrade slowly, but the tension support time provided by it is shorter, only a few days, which is not as good as the degradation of fast tension support time sutures. Therefore, special attention should be paid to choosing this kind of suture. The human tissue you suture needs no strong tension support. A factor that must be considered, if required, is the time to be placed on the tension support.

For example, peritoneal suture, such as the current vascular suture, all have special requirements for tension support, so this point needs to be considered. For this reason, the commonly used absorbable sutures in pediatrics are PDS sutures. In this case, can this line be placed in the adult great blood vessels? no. Compared to polypropylene wire, it is still a little worse.

The above just shows once again that medicine is an engineering discipline.

The choice of the suture material by the doctor and how to use it well is also a technical issue. The polypropylene line or the PDS line has one thing in common, which is too slippery. If it is slippery, it is convenient and less harmful to pass through human tissues. On the other hand, the pain point is that it is easy to end up and slip out. Use these two kinds of threads on the knot, other materials to tie a knot, the doctor needs to tie several knots to them. Too many knots are not good either. In the way of suture, it is not suitable to use interrupted suture, and continuous suture is used.

Before suturing, determine the next six anastomotic sutures again, and do a sequence. The left pulmonary vein group was selected first, because the location here belongs to the posterior wall of the heart.

(end of this chapter)