Qee qhov xwm txheej, piv txwv li, thaum lub sijhawm phais, nrog rau tom qab yug menyuam, yuav tsum tau nqus cov sutures. Rau qhov no, cov khoom siv tshwj xeeb yog siv. Muaj ntau ntau hom absorbable threads. Lub sijhawm kho ntawm cov qhov txhab zoo li no nyob ntawm ntau yam. Yog li ntev npaum li cas cov sutures absorbable?
hom seams
Txhawm rau teb cov lus nug no, nws yog qhov yuav tsum tau ua kom paub meej yam tseem ceeb ntawm cov seams muaj nyob. Feem ntau qhov no yog:
- Nyob hauv. Cov seams zoo sib xws yog superimposed ntawm kev raug mob los ntawm cov neeg kho tshuab kev nyuaj siab. Qee hom ntaub so ntswg yog siv los txuas cov ntaub so ntswg ntawm qhov chaw tawg. Xws li tus kheej-absorbable sutures kho tau sai heev. Feem ntau lawv siv rau cov poj niam tom qab yug me nyuam ntawm lub ncauj tsev menyuam. Hauv qhov no, tsis tas yuav tshuaj loog, vim qhov no ntawm qhov chaw mos ntawm lub cev tsis muaj qhov rhiab heev.
- Tawm sab nraum zoov. Lawv tuaj yeem siv tau los ntawm cov khoom siv absorbable. Tom qab yug me nyuam, xws li sutures yog ua ntawm rupture los yog thaum lub sij hawm dissection ntawm lub perineum, raws li zoo raws li tom qab ua hauj lwm. Yog ibCov khoom siv pa yog siv, nws yuav tsum tau muab tshem tawm 5-7 hnub tom qab kev phais.
Nco ntsoov tias kev nqus ntawm tus kheej tuaj yeem siv sijhawm ntau lub lis piam los kho. Nws tag nrho yog nyob ntawm hom khoom thiab nws muaj pes tsawg leeg.
Dab tsi yog nqus tau sutures
Tus kheej-absorbable sutures yuav luag txhua zaus siv. Nws yog qhov tsawg kawg nkaus rau kev kho qhov txhab kom siv cov khoom siv phais uas tiv taus hydrolysis. Absorbable sutures yog cov uas poob lawv lub zog thaum ntxov li 60 hnub. Muaj kev sib cais ntawm cov xov raws li qhov tshwm sim:
- Enzymes uas muaj nyob hauv cov ntaub so ntswg ntawm tib neeg lub cev. Hauv lwm lo lus, cov no yog cov proteins uas tswj thiab ua kom muaj tshuaj lom neeg.
- Dej. Cov tshuaj tiv thaiv no hu ua hydrolysis. Hauv qhov no, cov xov raug puas tsuaj los ntawm dej, uas muaj nyob hauv tib neeg lub cev.
Synthetic braided polyglycolide xov "MedPGA"
Analogues ntawm cov khoom siv phais xws li "Safil", "Polysorb", "Vikril".
Tus kheej-absorbable sutures tom qab phais lossis tom qab yug menyuam tuaj yeem siv tau siv MedPGA xov. Cov khoom siv phais no yog tsim los ntawm polyhydroxyacetic acid. Cov xov no yog coated nrog ib tug absorbable polymer. Qhov no yuav tsum tau txo qis wicking thiab capillarity, nrog rau txo cov nyhuv sawing uas tshwm sim thaum cov khoom dhau los ntawm cov ntaub so ntswg.
Yuav siv sijhawm ntev npaum li cas rau MedPGA xov kom yaj
Tus kheej-absorbable sutures thov nrog MedPHA xov undergo hydrolytic degradation, uas yog nruj me ntsis tswj. Nws yuav tsum tau muab sau tseg tias xws li cov khoom yog heev ruaj. Tom qab 18 hnub, cov xov khaws cia txog li 50% ntawm lawv cov khoom muaj zog.
Ua tiav resorption ntawm cov khoom siv phais tshwm sim tsuas yog tom qab 60-90 hnub. Tib lub sijhawm, cov tshuaj tiv thaiv ntawm lub cev cov ntaub so ntswg rau MedPGA threads yog qhov tsis tseem ceeb.
Nws tsim nyog sau cia tias cov khoom siv phais mob zoo li no tau siv dav rau suturing tag nrho cov ntaub so ntswg, tshwj tsis yog cov uas muaj kev ntxhov siab, thiab tsis zoo rau lub sijhawm ntev. Feem ntau, MedPGA threads yog siv nyob rau hauv thoracic thiab plab phais, gynecology, urology, yas phais thiab orthopedics. Txawm li cas los xij, nws tsis yog siv rau cov paj hlwb thiab cov hlab plawv.
Synthetic braided polyglycolide xov "MedPGA-R"
Analogues ntawm cov khoom siv phais yog Safil Quick, Vikril Rapid.
"MedPGA-R" yog cov xov hluavtaws ua los ntawm polyglyclactin-910. Xws li cov khoom siv phais yog them nrog tshwj xeeb absorbable polymer. Qhov no txo qis kev sib txhuam raws li cov xov dhau los ntawm cov ntaub so ntswg ntawm lub cev, thiab tseem txo cov wicking thiab capillarity. Ua tsaug rau cov khoom siv phais no, cov sutures nws tus kheej tuaj yeem siv tau.
Nws siv sijhawm ntev npaum li cas rau MedPGA-R xov kom yaj
"MedPGA-R" - cov khoom siv uas qiv nws tus kheej rau hydrolyticlwj. Cov xov zoo li no muaj zog heev. Tom qab tsib hnub, 50% ntawm lawv cov khoom muaj zog tau khaws cia. Ua tiav resorption tshwm sim tsuas yog rau 40-50 hnub. Nws yuav tsum raug sau tseg tias cov tshuaj tiv thaiv ntawm cov ntaub so ntswg rau MedPGA-R cov khoom siv phais yog qhov tsis tseem ceeb. Tsis tas li ntawd, cov xov tsis ua rau ua xua.
Cov khoom siv no yog siv rau suturing mucous daim nyias nyias, daim tawv nqaij, cov ntaub so ntswg mos, nrog rau cov xwm txheej uas xav tau kev txhawb nqa lub qhov txhab rau lub sijhawm luv. Txawm li cas los xij, muaj kev zam. Cov xov zoo li no tsis siv rau ntawm cov hlab ntsha thiab cov hlab plawv.
Synthetic braided polyglycolide xov "MedPGA-910"
Analogues ntawm cov khoom siv phais xws li "Safil", "Polysorb", "Vikril".
"MedPGA-910" yog cov xov uas nqus tau los ntawm polygliglactin-910. Cov khoom siv phais kuj tau kho nrog cov txheej tshwj xeeb, uas txo qhov "sawing" cov nyhuv thaum cov khoom dhau los ntawm cov ntaub so ntswg, nrog rau txo qis capillarity thiab wicking.
Resorption time for MedPGA-910
Yog li, thaum twg tus kheej-absorbable sutures thov nrog MedPGA-910 cov khoom siv phais yaj? Cov xov zoo li no muaj tus nqi siab ntawm lub zog. Txawm li cas los xij, lawv kuj tau txais hydrolytic degradation. Tom qab 18 hnub, cov khoom siv phais tuaj yeem khaws tau txog li 75% ntawm nws cov khoom muaj zog, tom qab 21 hnub - txog 50%, tom qab 30 hnub - txog 25%, thiab tom qab 70 hnub cov xov yog resorbed tag.
Cov khoom no yog siv rau kev suturingcov ntaub so ntswg mos uas tsis nyob hauv qhov nro, nrog rau cov uas kho tau sai, hauv kev phais yas, thoracic thiab plab, gynecology, urology thiab orthopedics. Tsis txhob siv "MedPGA-910" thaum suturing paj hlwb thiab hlab plawv.
Monofilament "PDO"
Tsis muaj ntau cov analogues ntawm cov khoom siv phais. Qhov no yog Biosyn, nrog rau PDS II. Cov xov zoo li no yog tus cwj pwm los ntawm tus nqi siab ntawm kev lom neeg tsis txaus ntseeg, tsis yog qhov tsis zoo thiab tsis yog capillary, hydrophobic, tsis txhob raug mob cov ntaub so ntswg thaum hla lawv, elastic, muaj zog txaus, haum zoo thiab tuav lub pob.
Yuav siv sijhawm ntev npaum li cas rau monofilaments kom yaj
PDO monofilaments yog amenable rau hydrolysis. Raws li qhov tshwm sim ntawm cov txheej txheem no, dihydroxyethoxyacetic acid yog tsim, uas yog tag nrho tawm ntawm lub cev. 2 lub lis piam tom qab suturing, cov khoom siv phais khaws cia txog li 75% lub zog. Kev ua tiav ntawm cov xov xwm tshwm sim hauv 180-210 hnub.
Raws li rau thaj tsam, PDO cov khoom siv phais yog siv rau suturing thiab txuas cov ntaub so ntswg mos ntawm txhua yam, suav nrog rau suturing cov hlab plawv cov ntaub so ntswg ntawm tus menyuam lub cev, uas yuav muaj kev loj hlob ntxiv. Txawm li cas los xij, kuj muaj kev zam. Monofilaments tsis haum rau suturing cov ntaub so ntswg uas yuav tsum tau kev txhawb nqa lub qhov txhab mus txog 6 lub lis piam, nrog rau cov uas raug hnyav loads. Sutures yuav tsum tsis txhob siv rau kev cog qoob loo, lub plawv li qub, lossis hluavtaws vascular prostheses.
Yuav muaj pes tsawgabsorbable sutures?
Tom ntej no, peb yuav txiav txim siab txhua yam hais txog dab tsi nws tus kheej nqus sutures tom qab yug menyuam yog: thaum lawv yaj, txawm lawv xav tau kev saib xyuas. Tsis txhob hnov qab tias ntau yam cuam tshuam rau lub sijhawm ntawm kev kho qhov txhab thiab kev ploj tag ntawm cov xov. Ua ntej ntawm tag nrho cov, koj yuav tsum paub dab tsi raw cov ntaub ntawv cov khoom siv phais yog ua los ntawm. Feem ntau, cov xov pib yaj 7-14 hnub tom qab suturing. Txhawm rau kom ceev cov txheej txheem, tom qab lub qhov txhab tau zoo lawm, tus neeg ua haujlwm noj qab haus huv yuav tshem tawm cov nodules. Txhawm rau txiav txim siab lub sijhawm ntawm resorption ntawm cov xov, koj yuav tsum tau nrog koj tus kws kho mob:
- Yuav ua li cas xaws.
- Cov khoom siv dab tsi yog cov xov ua los ntawm.
- Kwv yees lub sijhawm ntawm kev sib cais.
Tau kawg
Tus kheej-absorbable sutures feem ntau yog siv rau suturing phais qhov txhab uas nyob hauv cov ntaub so ntswg sib sib zog nqus, nrog rau ntawm daim tawv nqaij. Piv txwv li, hauv kev hloov khoom nruab nrog cev.
Cov khoom siv phais tib yam kuj yog siv los xaws cov qhov txhab thiab kua muag tau txais thaum yug menyuam. Lub sijhawm no, ntau qhov kev tshawb fawb tau ua tiav. Lawv cov txiaj ntsig tau pom tias polyglycolic acid sutures ploj lawm tom qab tsuas yog plaub lub hlis, thaum polyglactin-based sutures ploj tom qab peb. Nyob rau tib lub sijhawm, nws tus kheej-absorbable sutures yuav tuav cov npoo ntawm lub qhov txhab kom txog thaum nws zoo tag, thiab maj mam pib tawg. Yog tias cov xov txuas ntxiv mus ntev thiab ua rau tsis xis nyob, ceskoj yuav tsum nrhiav kev pab los ntawm kws phais lossis koj tus kws kho mob.
