-基础手术指切口缝合.pptVIP

* 李翊嘉 * 可吸收线优点：自行吸收无需拆线，特别适合儿童使用避免拆线 可吸收线缺点：吸收过程中有炎症反应；如患者对缝线过敏或缝线反应大，无法拆除 不可吸收线优点：不可吸收，适合某些特定部位，特别是血管吻合提供永久支持；缝合表皮方便拆线； 不可吸收线缺点：不可吸收，需要拆线 Monofilament sutures, such as Prolene, are smooth and pass easily through tissue. They cause the least tissue reactivity and trauma and are more difficult for bacterial adhesion. The drawback is that they are difficult to handle compared to multifilament sutures such as silk. In addition, knot security, which is proportional to the coefficient of friction of the suture, is usually greater in multifilament sutures, especially those that are braided. The lower the knot security, the more throws are required to create a secure knot. 单股缝线：组织损伤小、不易感染；摩擦力小、不易操作、需要打较多的结 多股/编织缝线：组织损伤相对较大；多股编织线有空隙容易存留细菌导致感染；摩擦力大、容易操作、打结较少 * 李翊嘉 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 polig