必威体育精装版 基础手术指切口缝合教学课件.ppt

2021/7/9 减小张力：皮下游离 减小张力：皮下缝合 减小张力：皮下缝合 减小张力：皮下缝合二分之一原则沿鼻唇沟 垂直褥式 水平褥式 皮内缝合 两边不一样平 三角/四角缝合 Sutures Absorbable vs. non-absorbable Synthetic vs. natural Braided vs. monofilament 不可吸收缝线的特点 可吸收缝线的特点 Catgut羊肠线 Catgut is derived from the submucosal layer of sheep intestine. It elicits a significant inflammatory response. Its absorption is unpredictable. It loses its strength by 8–9 days. It is absorbed by 1 month. A decreased rate of absorption occurs if the suture is chromatized (chromic catgut). Clinically catgut is usually used as: A mucosal suture A dermal suture in the face A skin suture in children. Polyglycolic acid聚羟乙酸 Dexon is a synthetic suture composed of polyglycolic acid. It is degraded by hydrolization. It loses its strength by 21 days and is absorbed by 90 days. Polyglactin 910 聚糖乳酸910 Vicryl （薇乔）is a braided synthetic suture composed of polyglactin 910. It loses its strength by 21 days and is absorbed by 90 days. Its braided nature may make it more prone to bacterial colonization than monofilament alternatives. (Vicryl Plus) It may provoke a significant inflammatory reaction and some recommend that it is not used as a dermal suture in the face. Poliglecaprone 25 聚糖乙内酰胺 Monocryl （单乔/玻璃丝）is a monofilament synthetic suture composed of poliglecaprone 25. It has similar absorption characteristics to vicryl. Its monofilament composition may make it less prone to bacterial colonization Polydioxanone 聚二氧六环酰胺 PDS（普迪思） is a monofilament synthetic suture composed of polydioxone. It is absorbed more slowly than either vicryl, monocryl or dexon. It loses its strength by 3 months and is absorbed by 6 months. It is primarily used as a dermal suture in areas prone to developing stretched scars. Non-absorbable sutures Cutaneous stitches which will need to be removed. Deep stitches to provide permanent tissue fixation. Non-absorbable sutures Natural Silk丝线 Synthetic Polyamide Nylon尼龙线 So-named because it was developed jointly in New York and LONdon Polypropylene (P