Gastrointestinal Surgical Techniques in Small Animals. Группа авторов

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in gastrointestinal surgery since they eventually are degraded and removed by the body over days to months. Nonabsorbable sutures do not lose significant strength over 60 days, and remain in the tissues to some degree for years. Monofilament sutures are composed of a single smooth strand, whereas multifilament sutures are braided or woven from multiple strands.

Suture is selected for a specific digestive organ wound repair considering the physical characteristics of the suture material (tensile strength and knot security, absorption rate, surface qualities, capillarity, tissue reactivity), and the environment and healing rate of the tissue involved in the repair. As a rule, more pliable and smaller diameter sutures have favorable handling properties in gastrointestinal surgery compared to larger, stiffer suture materials.

Table 2.1 Characteristics of suture materials used in digestive system procedures.

Absorbable Suture	Nonabsorbable Suture	Trade Name	Type	Degradation Process	Foreign Body Response	Tensile Strength Retention (%)	Relative Knot Security	Mass Absorption Time (days)	Comments
Chromic Catgut		Surgical gut; chromic gut	Rapid to Intermediate absorbable multifilament	Phagocytosis and proteolytic enzymes	Moderate	Unpredictable	Fair	Variable; 45–60 d or longer	Degradation and tissue reactivity related to where implanted; knots imbibe fluid and unravel if knot ears are cut short
Polyglactin 910		Vicryl Rapide	Rapid absorbable multifilament	Hydrolysis	Mild	50% after 5 d; 0% after 14 d	Fair to good	42	Irradiated to aid in dissolving
		Vicryl, Coated Vicryl Plus	Intermediate absorbable multifilament	Hydrolysis	Mild	75% after 14 d; 50% after 21 d	Fair to good	56–70	Plus designates triclosan (antibacterial) impregnated
Lactomer		Polysorb (coated)	Intermediate absorbable multifilament	Hydrolysis	Mild	80% after 14 d; 30% after 21 d	Fair to good	56–70	Improvements in braid construction and coating reduce drag and improve knot security
		Velosorb (coated)	Rapid absorbable multifilament	Hydrolysis	Mild	60% at 5 d; 0% at 14 d	Fair to good	40–50	Irradiated to aid in dissolving; similar to Vicryl Rapide
Polyglycolic Acid		Dexon S (uncoated), Dexon II (coated)	Intermediate absorbable multifilament	Hydrolysis	Mild	65% after 14 d; 35% after 21 d	Fair to good	60–90	Coated Dexon II helps reduce drag, but decreases knot security
Polyglytone 6211		Caprosyn	Rapid to intermediate absorbable monofilament	Hydrolysis	Minimal	60% after 5 d; 20–30% after 10 d	Fair	56	Knots have been known to untie spontaneously when incubated in serum; supple easy to handle for monofilament; fastest mass absorption of absorbable monofilaments
Polygliocaprone 25		Monocryl	Rapid to intermediate absorbable monofilament	Hydrolysis	Minimal	50–60% after 7 d; 20–30% after 14 d; 0% after 21 d	Good	91–119	Supple easy to handle for monofilament.
Polyglycolic Acid/Polycaprolactone		Quill Monoderm	Intermediate absorbable monofilament barbed	Hydrolysis	Slight	42–76% at 7 d; 36–52% at 14 d	N/A	90–120	Uni‐ and bidirectional barbed suture; choose one size larger due to strength loss from barbs. Slightly higher tissue reaction than V‐Loc 90.
		Stratafix PGA‐PCL Plus (barbed)	Rapid to intermediate absorbable monofilament barbed	Hydrolysis	Minimal	50–60% after 7 d; 20–30% after 14 d; 0% after 21 d	N/A	90–120	Stratafix Monocryl comes with spiral barbs; uni‐ or bidirectional. Plus – antibacterial
Glycomer 631		Biosyn	Intermediate absorbable monofilament	Hydrolysis	Minimal	75% after 14 d; 40% after 21 d	Average	110	Knots occasionally untie spontaneously
		V‐Loc 90	Intermediate absorbable monofilament barbed	Скачать книгу В начало < 9 10 11 12 13 14 15 16 17 18 > В конец e-mail: [email protected]