Chapter 2555 [2555] Tension
I remember that for a while, I don't know where it started to blow up a clinical malpractice. Some patients are terribly afraid of sutures, no matter how big or small they are, they insist on telling the doctor that you have to give me good sutures, which can be absorbed in the human body. This group of people is afraid of leaving foreign objects in their bodies. I don't know where I heard the rumor that if these sutures are left in the body, people will die.
I also know that this statement cannot be established. Absorbable sutures were invented later. According to this statement, the previous operation patients were all killed by non-absorbable sutures.
When considering what kind of suture to use in medicine, the first step that doctors should consider 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 it since the first operation with a retractor. After anesthesia, as long as the living tissue is moving, there will always be contraction tension.
Medically, sutures are used to close wounds, the purpose is to pull the two ends of the opening together to allow the wound to heal. If the suture is not strong enough in tension, it is not strong enough to resist the contraction tension of human tissue. In this way, when the human tissues on both sides of the anastomosis repeatedly contract, the tension can easily break the thread directly, causing the wound to re-open, resulting in failure of the suture.
How terrible is the failed suture, and if the incision is opened again, isn't this going to cause massive bleeding? Or is it a leak? The wound never healed, the anastomosis leaked, repeated infections, systemic sepsis, it was really tossing to death - all the doctors could think about were these more terrifying things.
Some patients are afraid of the so-called rumors that if the sutures stay in the body, they will die. 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, there are also absorbable sutures. Absorbable sutures are not absorbed by the body immediately after being stitched, and it becomes meaningless to suture. They have to wait for the wound to heal before being absorbed by the body. This process can be as short as a few days or as long as more than a month.
In fact, these patients should be afraid of the rejection of sutures. The problem is that the current medical technology has already developed to the point that there are strict regulations on the use of various surgical materials, which are not allowed to stay, and which can be left in the human body for a long time are clearly marked. All materials that can stay in the human body must be tested and studied for compatibility with human tissue, and can only be used clinically after passing the review. This point has been mentioned in orthopedic materials science. Complex materials in orthopedics can do this, and small sutures have already crossed this threshold.
Having said that, it can be seen that the concerns of these people are nonsense.
Indeed, it can be seen clinically that some doctors will ask patients whether to use absorbable sutures before surgery. Where is this patient-selectable suture typically used? The innocuous layer of skin that has little to do with the patient's life. After all, some patients are financially constrained and can pay limited medical expenses. Back then, this absorbable suture was called cosmetic thread, which was very expensive and had to be paid by oneself.
It is impossible for a doctor to hand over this professional thing to a patient who does not understand medicine to choose a suture that is related to the patient's life. It is equivalent to handing someone a knife to commit suicide.
Speaking of polypropylene thread, the most commonly used place is in blood vessels.
The advantage of single-strand thread of this material 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 has a low rejection reaction when it stays in the human body for a long time.