Manual of Surgical Sutures and LigaturesPDF电子书下载

SECTION 1 How to Prepare Sutures for the Operating Room 1

SUTURES 1

Absorbable 1

Non-Absorbable 2

LIGATURES 2

ARRANGEMENT OF TUBES AND BOXES 2

For General Surgery 2

For Surgical Specialties 3

HOW TO STORE SUTURES 3

ASEPTICIZING EXTERIOR OF TUBES 4

Boilable Sutures 4

Non-Boilable Sutures 6

STORING ASEPTICIZED SUTURE TUBES 10

SILK SUTURES 12

STAY OR TENSION SUTURES 14

SPECIAL SUTURES 15

STERILIZATION OF NON-TUBED SUTURES 15

RESTERILIZATION OF SUTURES 17

SECTION 2 Preparation of Sutures at the Operating Table 21

SURGEON＇S CHOICE OF SUTURE MATERIALS 21

STERILITY OF THE SUTURE AS IT COMES FROM THE TUBE 22

TECHNIC OF HANDLING BOILABLE SUTURES 22

Opening the Tubes 22

Unwinding the Sutures 24

The Pliability or Suppleness of the Suture 24

Providing Maximal Pliability to Boilable Sutures 24

Satisfactory Methods for Restoring Pliability 25

1．Immersion in 70% Alcohol 25

2．Exposure to Towel Saturated with 70% Alcohol 26

3．Immersion in Saline Solution 28

4．Exposure to Towel Saturated with Saline Solution 29

How to Unwind Boilable Sutures after Maximal Pliability is Obtained 29

TECHNIC OF HANDLING NON-BOILABLE SUTURES 31

Opening the Tubes 31

How to Unwind Non-Boilable Sutures 31

Pliability of Non-Boilable Sutures 33

1．Exposure to Towel Saturated with 95% Alcohol 33

2．Immersion in Saline Solution 34

THE LIGATURE 34

TYPES OF SUTURES 36

LENGTH OF THE SUTURE 36

SELECTION OF NEEDLES 37

Types of Needles 37

Reese Snap-on Needle 38

Atraumatic Needle 39

Size of Needle as Related to Size of Suture 41

Number of Needles Required 42

SECTION 3 What the Surgeon Expects of Sutures 45

PHYSICAL PROPERTIES OF SUTURES 45

Size and Tensile Strength 45

1．Catgut Sutures，U．S．P 45

2．Surgical Silk 47

Duration in the Tissues 47

USE OF THE LIGATURE 48

To Arrest Hemorrhage and Form Thrombus 48

To Control Hemorrhage in Special Organs 49

To Prevent Secondary Hemorrhage by Transfixion 49

USE OF THE SUTURE 49

To Hold Tissues Together Until They Heal 49

Methods of Suturing 50

1．For All Tissues 50

2．For Special Tissues 51

3．Primary Suture Line 53

4．Secondary Suture Line 54

STAY OR TENSION SUTURES 54

SUTURES IN RELATION TO WOUND HEALING 57

POSTOPERATIVE WOUND INFECTIONS 59

SUTURES USUALLY ARE ABSORBED OR BECOME INNOCUOUS 63

USE OF SUTURES TO HOLD A DRAIN IN PLACE 64

SECTION 4 Suture Technic 69

IMPORTANCE OF A STANDARDIZED TECHNIC 69

THE HOSPITAL BACTERIOLOGIST 70

THE STERILITY OF SURGICAL SUTURES 72

ADVANTAGES OF FINE SIZE SUTURES 72

HOW TO CARE FOR THE SHORT END OF THE SUTURE 74

CARE OF THE LONG END OF THE SUTURE 76

PROTECTION OF SUTURES FROM EXPOSED SKIN 76

PROTECTION FROM CONTAMINATED LAPAROTOMY SPONGES 76

Protecting Sutures from Contaminating Discharges 78

Cutting After Knotting 79

Silk Sutures 79

Speed of Operation with Continuous and Interrupted Sutures 80

How to Develop Speed with Interrupted Sutures 80

SECTION 5 Complications and Contra-Indications 85

SIGNS OF TOO MUCH TENSION 85

SIGNS OF DISRUPTION 86

What Happened to the Sutures？ 86

CONTRA-INDICATIONS TO THE USE OF CATGUT 87

CONTRA-INDICATIONS TO THE USE OF SILK 87

SECTION 6 Sutures for Various Tissues 91

CATGUT SUTURES IN THE SKTN 91

GENERAL GUIDE FOR D＆G SUTURES 92

SECTION 7 Varieties of Suture Materials 101

SURGICAL CATGUT 101

Source 102

Types 102

Tanning Process 102

RIBBON GUT 104

KANGAROO TENDONS 105

KANGAROO BANDS 106

SURGICAL SILK 107

SPECIALLY TREATED SILK 109

SILKWORM GUT 109

NYLON 110

LINEN 111

HORSEHAIR 111

WIRE 111