Research of physical and mechanical characteristics of suture material in experiment in operations on liver

V. A. Lipatov, D. A. Severinov, A. A. Denisov, S. V. Lazarenko, N. N. Grigor’yev
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引用次数: 1

Abstract

Taking into account the peculiarities of the blood supply to the liver and the structure of its parenchyma, and, as a result, considerable difficulties in providing reliable hemostasis without additional traumatization, a surgeon needs to be careful when performing a surgical manipulation. Despite a large number of modern methods for stopping parenchymal bleeding, many practi-tioners give preference to classic methods of hemostasis, including ligation of bleeding vessels in the bulk of the organ using specialized sutures. One of the most serious complications of the use of suture material is cutting of organ tissue, which leads to enhanced bleeding and expansion of the area of damage. At the moment, the tactics of choosing suture material for surgical procedures is empirical. In this context, the aim of this study was to assess the physico-mechanical properties of suture material regarding its structure, and to develop a criterion for choosing surgical sutures for surgical procedures. For the study, the liver was removed out of corpses of males of 35 to 40 years of age, after which separate sections of 7.5×7×4 cm in size were obtained from it. Then a wound 3 cm long and 2 cm deep was made. The wound was sutured with a simple interrupted suture without tightening, but with application of one simple half-node. For suturing, catgut, twisted capron and polyglycolide thread were used. Attention was paid to the maximal force applied at the moment of cutting (Fmax) and the degree of pulling the thread at the moment of cutting (Lu). The analysis of the data was based on comparison of Fmax and Lu parameters. This method permits to refuse from the empirical approach to the choice of suture material for operations on the liver, and to develop a criterion for choosing surgical sutures.
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肝脏手术实验中缝合材料物理力学特性的研究
考虑到肝脏血液供应及其实质结构的特殊性,以及因此在不造成额外创伤的情况下提供可靠止血的相当大的困难,外科医生在进行手术操作时需要小心。尽管有大量的现代方法来阻止实质出血,但许多医生还是倾向于传统的止血方法,包括使用专门的缝合线来结扎器官中大部分的出血血管。使用缝合材料最严重的并发症之一是切割器官组织,这会导致出血加剧和损伤区域扩大。目前,外科手术中选择缝合材料的策略是经验性的。在这种情况下,本研究的目的是评估缝合材料的物理力学性能及其结构,并制定外科手术选择手术缝合线的标准。在这项研究中,从35至40岁的男性尸体中取出肝脏,然后从中获得7.5×7×4厘米大小的独立切片。然后做了一个3厘米长,2厘米深的伤口。伤口采用简单的间断缝合,不收紧,但应用一个简单的半结。缝合时采用羊线、双绞线和聚乙二醇酯线。注意在切割时刻施加的最大力(Fmax)和在切割时刻拉螺纹的程度(Lu)。数据的分析是基于Fmax和Lu参数的比较。该方法摒弃了以往经验方法对肝脏手术缝线材料的选择,并为手术缝线的选择制定了一套标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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