How long does it take for catgut sutures to dissolve? Surgical sutures: how surgical sutures are applied. Surgeon consultation

As a rule, having given birth to a baby, a new parent feels incredible relief on the one hand, but on the other hand, she almost immediately becomes immersed in new worries associated with the newborn, and quite often forgets about herself. It’s good if the birth took place without complications, and the young mother can immediately begin her duties. It is much more difficult for those whose health is after important event requires long-term treatment and recovery. So, after caesarean section The woman will face a lot of hassle related to caring for the sutures, and it will take a lot of time to recover after the operation. Having already arrived home from the maternity hospital, the parent is faced with many questions that she did not have time to get answers to, being under the constant supervision of specialists. Among the important and popular ones: when do threads dissolve after childbirth?

In fact, every second woman has to be stitched up after childbirth, and we are not talking about a caesarean section at all. Very often, during labor, ruptures or cuts of the perineum, vagina or cervix of varying degrees of severity occur. It is clear that after childbirth it is necessary to return everything to its place, and it is necessary to apply stitches to connect the torn tissues. How does this happen (under general anesthesia or under local), which suture the doctor will make will depend on many factors (as well as the choice of suture material for this procedure). IN lately Fortunately, they almost always use self-absorbable threads, which do not require removal but disappear on their own.

Timing of thread resorption after childbirth

Before you get acquainted with the resorption times of threads, you need to know what they are, what they are made of and, in fact, how they dissolve. Absorbable threads are made from natural or synthetic material, and they can disintegrate and be eliminated from the body by the action of enzymes (a kind of digestion occurs) or water ( chemical reaction called hydrolysis). Most often, after childbirth, catgut, maxon, vicryl are used:

• Catgut is a suture material of a protein nature, which is made from purified connective tissue obtained from the layers of the intestines of cattle or sheep. Catgut sutures dissolve completely within a month, the first “detachments” of the threads are observed already on the 7th day. After birth tears and incisions, catgut is most often used to connect both internal and external tissues.
• Vicryl- a modern suture material of synthetic origin, which is most often used during caesarean section. Complete resorption of the threads occurs after 60-90 days.
• Maxon (PDS)- a synthetic thread with a high durability, which is used to connect tendons (including after cesarean section). The threads dissolve completely only by the 210th day.

Possible complications

Postpartum sutures with self-absorbing threads do not require special care or removal. It is enough just to comply general rules personal hygiene, special attention pay attention to hygiene when suturing the perineum:

• wash yourself after every trip to the toilet;
• dry the perineum with a towel;
• treat seams with antiseptic agents;
• change sanitary pads every 2 hours;
• wear only loose underwear;
• Wear shapewear only after the scars have completely healed.

Among the possible complications, if the doctor’s recommendations are not followed correctly, the following may occur:

• suture divergence requiring re-application;
• inflammation of the sutures, which provokes the development of various infections.

Increased pain at the suture site, as well as bleeding and increased body temperature are serious reasons to immediately consult a doctor. To avoid trouble, you should refrain from sexual intercourse for the first two months after giving birth when sutures are applied, and you are also not allowed to sit down for 2-3 weeks. A woman can only lie or stand (occasionally a half-sitting position is allowed).

Please also note that the resorption of the threads and the healing of the wound itself have different periods. So, the threads are already weakening, but the wound will still heal for some time. Normally, internal sutures do not cause any discomfort to a woman, but external sutures are often accompanied by painful sensations for the first 2-3 days. It is necessary to follow the instructions of the attending physician, then postpartum period It will fly by quickly, unnoticed, and most importantly - without complications.

One stitch, two stitches, it will be fun! - the obstetrician said with a needle at the feet of the happy woman in labor. For some, this black humor becomes an unfunny reality and causes a lot of trouble and trouble. We'll talk about situations that inspire obstetricians to take up the needle, ways to quickly heal and relieve pain.

When to apply stitches and causes of ruptures

Childbirth does not always go smoothly, and sometimes you have to pay for the happiness of having children with birth injuries - tears and cuts in the genital tract, which are covered with external and internal sutures after childbirth. Injuries can be internal - ruptures in the cervix and vagina, and external - ruptures and cuts in the perineum.

After a natural birth, the obstetrician must check for ruptures and, if detected, they are sutured. Otherwise, if suturing is not carried out, the postpartum period threatens to end in a hospital bed due to bleeding in the injured tissues and the addition of infection to them, and in the future even provoke prolapse internal organs and urinary and fecal incontinence.

The process of applying external and internal seams lasts a long time and requires high qualifications of the doctor, and in the case of ruptures in the cervix that extend to the vagina and uterus, and some virtuosity due to inaccessibility and the danger of damage to the nearby bladder and ureters.

Internal sutures after childbirth on the cervix, vagina and uterus itself are applied using absorbable threads made of biological or semi-synthetic material. If only the cervix is ​​affected, then anesthesia is usually not required - after childbirth it is insensitive. In all other cases, local or general anesthesia is used - anesthesia or epidural anesthesia.

The muscle layers in case of ruptures and cuts of the perineum are also sutured with absorbable threads, and the skin is often made of non-absorbable silk, nylon and other materials, which are removed in the maternity hospital or in the antenatal clinic, usually 3-7 days after childbirth, when the suture is scarred. The procedure is quite painful and therefore anesthesia is required.

The reasons for ruptures can be different. This includes not following the advice of the obstetrician during the pushing period, and the presence of scars from sutures placed in previous births (the scar consists of inelastic connective tissue), rapid, prolonged, premature and instrumental births (application of forceps), anatomical features of the pelvic structure, a large head in a child, breech presentation, low skin elasticity at the time of birth.

How long does it take for a scar to heal after a cesarean section?

Obstetricians have different attitudes toward episiotomy—dissection of the perineum. For some, this is a routine procedure that is performed en masse to avoid the risk of perineal rupture. Other doctors strive for the most natural course of the birth process, intervening when it is already quite obvious that a rupture cannot be avoided. If instrumental delivery is performed with forceps or a vacuum extractor, then preliminary dissection of the perineum is recommended.

Episiotomy does not help prevent third-degree tears when the anal sphincter is involved in the violation of the integrity of the perineum and may even contribute to such injury. Still, surgical dissection has a number of advantages over rupture. Dissected tissues are technically easier to repair than torn ones. The resulting wound has smooth edges, healing occurs faster and a more aesthetic scar is formed.

Healing and treatment of sutures

As unfortunate as it may be, what happened happened, and as a result, after giving birth, you needed stitches. At internal seams If the suturing procedure is performed correctly and carefully, it will hurt for about 2 days. They do not require special care and do not need to be removed, since they are made of absorbable thread.

Self-absorbing sutures after childbirth made from natural material - catgut - completely dissolve in about a month, and from synthetic ones - after 2-3 months. Internal ones heal faster and can diverge in extremely rare and exceptional cases.

The outer crotch seams are a completely different matter. With such a postpartum reward, it’s painful to move, it’s difficult to go to the toilet, and you can’t sit down at all because the stitches can come apart.

The ban on sitting remains in effect for two weeks, after which you can gradually try to sit on hard surfaces.

If catgut sutures were placed on the perineum, then do not be alarmed if after a week pieces of threads appear that have fallen off - during this period the material loses its strength and breaks. The seams will no longer come apart, unless, of course, you start dancing. How long it will take for the material to dissolve depends on the speed of metabolic processes in the body. Sometimes there are cases when the catgut does not dissolve even six months after suturing.

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Non-absorbable thread sutures from the perineum are removed 3–7 days after birth. If this was not done in the maternity hospital, then the sutures are removed by a gynecologist in the antenatal clinic. During the removal procedure itself, it is a little unpleasant, but in most cases it does not hurt, or the pain is quite tolerable.

How long it takes for sutures to heal after childbirth is influenced by the individual healing rate of damage received by the body - both from minor scratches and from more serious injuries.

Usually this process does not take more than a month, but on average is 2 weeks.

Both before and after removal of sutures, it is necessary to regularly treat them. This is especially important, since postpartum discharge and the constantly moist environment of the perineum contribute to the proliferation of various microorganisms on the wound surface. As a result, the sutures may fester and healing will be delayed indefinitely.

How and with what to treat stitches after childbirth at home? Just like in the maternity hospital, you need to treat two to three times a day with antiseptic solutions and/or antibacterial ointments that suppress the uncontrolled growth of inflammation-causing bacilli. The most accessible means are the well-known brilliant green, hydrogen peroxide, potassium permanganate, chlorhexidine, etc. Ointments include levomekol and others. Treatment should be carried out avoiding a sitting position.

If you provide air access to the perineum, healing will go much faster. To do this, you need to use “breathable” pads made of natural materials and refrain from wearing tight underwear. The ideal option is to provide “ventilation” during sleep, when you can completely abandon underwear and sleep on a special absorbent diaper, or an oilcloth with a regular fabric diaper.

To speed up regeneration, you also need good nutrition that supplies building material to the site of injury. From folk remedies tea tree oil and sea buckthorn oil accelerate healing. And of course, hygiene rules and maintaining cleanliness are welcome on the path to rapid healing.

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How to relieve pain

During the healing process of the sutures, tissue contraction occurs - the wound surfaces contract and the wound is closed with a scar. Therefore, it is quite normal that the sutures hurt after childbirth, like any other injuries that violate the integrity of muscle and epithelial tissue. Discomfort – pain and itching in the perineum may be experienced up to 6 weeks after birth.

If the pain is of a different nature, and even more so when the sutures begin to fester, you need to consult a doctor.

If the pain is severe, which happens in the first days after childbirth, then applying cold to the perineum and painkillers can help cope with it. In the maternity hospital they give injections, at home you can take ibuprofen (Nurofen), which is not contraindicated for breastfeeding and has an anti-inflammatory effect. To feel less pain during urination, you can try urinating while standing in the bathroom with your legs apart.

What to do if the seams come apart

It is rare, but it happens that the seams partially or completely come apart. This can happen due to heavy lifting, early onset of sexual relations after childbirth, sudden sitting down and other awkward sudden movements, increased pressure on the genitals due to constipation.

The birth process often occurs with ruptures of the uterus or vagina. Subsequently, scarring problems arise. To prevent them, you need to know how long it takes for sutures to dissolve after childbirth and how to remove them correctly.

When a woman's tissue is damaged, an external rupture occurs. External sutures after childbirth are necessary when suturing the perineum. The manipulation is carried out using a material that does not dissolve: silk or polypropylene. When fusion has occurred, the threads are removed. Rupture of the cervix and vagina leads to the application of internal threads; materials of this type are used so that the sutures dissolve on their own.

When the perineum is damaged, damage occurs to the skin, muscles, and tissues up to the walls of the rectum. Doctors select various material, the choice is influenced by the type and extent of the gap.

Types of threads:

1. nylon;
2. silk;
3. absorbable.

The suture after a cesarean section can be interrupted or cosmetic intradermal, depending on how the longitudinal and transverse incision was made. Both types are painful, however, internal or absorbable sutures after childbirth are more aesthetically pleasing. Regardless of the type chosen, antibiotic therapy is mandatory. After a week, scars are formed, at the same time the silk external sutures are removed. The threads come out within a month after childbirth.

You can prevent adhesions with an active lifestyle; it normalizes blood circulation and restores the body. It is recommended to get out of bed as soon as your doctor allows. This is independent of pain in the area of ​​the commissure.

Stitches are applied in layers. First, internal damage is removed, then they move on to the muscles, and the skin is sewn last. For it, materials are taken that do not dissolve. The threads are impregnated with antibiotics to reduce the risk of inflammation. Superficial sutures are removed before discharge from the hospital; internal sutures fall off on their own.

When performing a caesarean section, abdominal surgery is used, in which several layers of tissue are cut. Most often, an incision is made into the uterus to minimize blood loss and help wounds heal quickly. After stitching, the threads dissolve within a month. It is important to lead a healthy lifestyle and follow medical recommendations.

Deadlines

Most often, catgut sutures are used for suturing the perineum, ruptures in the vagina or cervix during natural process. Cosmetic stitches will be needed after childbirth if a caesarean section was performed. The type of tear and size affects what drug the doctor will prescribe. Pain sensations differ when stitching the vagina or perineum. Internal adhesions on the uterus are less noticeable.

When do self-absorbable sutures dissolve after childbirth? It will take about three months. In this case, the woman in labor does not experience any discomfort.

Sutures are applied using the main types of threads:

• Catgut is a self-absorbing material, the remnants of which come out by the end of the week after stitching. Self-absorbing sutures heal within a month after childbirth;
• Vicryl. Used during caesarean section. Dissolves in 8-9 weeks;
• Maxon. Resorption occurs after three months.

The material is applied in the perineum, on the cervix, and in the vagina. Absorbable sutures are used after childbirth, the procedure is carried out with tissue treatment with Novocaine or with the introduction of intravenous anesthesia. Painkillers are chosen depending on the rupture and its size. The sensitivity threshold for suturing in the vagina or perineum differs.

How long does it take for external sutures to dissolve after childbirth? Doctors estimate a period of five to seven days when using absorbable material. Staples and threads are removed after 3–7 days. Complete healing will occur within two weeks to one month. Discomfort and pain are felt for about six weeks. The scar hurts, like after surgery.

Removing stitches is a procedure that causes discomfort, not pain. The woman experiences pinpoint and sharp tingling sensations. The manipulation takes about 10 minutes, including preparation and treatment of scars. At this time, a burning sensation and a slight tingling sensation are felt.

Care

External sutures can provoke inflammation, suppuration, and infection. To prevent this, you need to know the rules of care. The healing time varies depending on how much the woman takes care of herself. Incisions and tears heal quickly if the woman rests, abstains from sexual activity, and treats the wounds with antiseptics.

Discharge from the uterus increases the healing time and acts as a foci for the development of infection. Stitches dissolve quickly after childbirth if a woman maintains hygiene.

To prevent bacteria from entering, the mother must:

• change the gasket frequently;
• treat scars with antiseptics;
• wipe the perineum with sterile wipes;
• do not sit down for ten days to prevent the seams from coming apart;
• do not eat foods that cause constipation;
• use natural underwear or disposable panties;
• Take a shower more often and wash your genitals with soap.

If catgut is used, the sutures will dissolve within five days. Only in some cases do they have to be removed. Treatment is carried out in a maternity hospital, antenatal clinic or at home. The hospital uses brilliant green and potassium permanganate. The obstetrician will tell you what to use at home after examining the condition of the adhesions. It is recommended to use Levomekol, Chlorhexidine, Hydrogen Peroxide. With proper treatment, sutures dissolve quickly after childbirth. Note absence negative consequences and cosmetic defects.

You should not be afraid of the process of defecation; if you skip it, it creates additional stress on the muscles and increases pain. To facilitate the process, the use of glycerin suppositories is allowed so as not to injure the perineum. If stitches were placed on it, you cannot sit down for the period from 7 to 14 days. You are allowed to go to the toilet on the first day after birth. After a week, you can sit on the buttock, which is located on the opposite side from the one where the damage was.

Complications

Postpartum stitches often lead to discomfort. It is important to respond to pain in a timely manner to prevent complications. When a woman is in satisfactory condition, she should not lift weights. The usual way of life will return when six months have passed after suturing; the use of physiotherapy at home helps.

The following problems are noted during rehabilitation:

• pain;
• scar divergence;
• suppuration.

Pain. Appears after childbirth, so the use of special ointments and dry warming will be required. Strong medications should not be used if the newborn is breastfed.

Discrepancy. Most often this happens if the seams are located on the perineum. The cause is early sexual activity, infection, sudden movements. The woman observes swelling, increased temperature, and the wound is bleeding.

Suture dehiscence is most often noted when performing mama physical exercise, sudden movements. It is recommended to call a doctor if blood is oozing from the wound. The condition is dangerous because an infection enters the muscle tissue, which leads to inflammation, fever, and increased temperature.

Itching. Indicates the elimination of pathology or infection in the wound. The severity is reduced by washing with warm water. Medicines are not used.

Suppuration of the wound leads to fever, weakness, unpleasant smell, fever and pain. Treatment occurs after examination using ointments and antibiotics.

How long does it take for tears to heal after childbirth? Within a month. In order for the wound to heal successfully, you need to maintain hygiene, use antiseptics and get plenty of rest. Be sure to follow a diet for proper operation intestines. Treatment is practiced for a month.

For quick healing of sutures, you must adhere to simple rules and recommendations. For six months after giving birth, a woman needs to take care of personal hygiene, take care of herself, care for scars and wait until the body has fully recovered.

This feels like a painful lump that runs almost from the commissure of the labia, often to the side and back, rarely exceeding 2-3 cm in length. In the first days they rub a lot, causing a lot of suffering, after removing them you will feel relief. Sometimes a cosmetic intradermal suture is applied; it is not felt and is easier to tolerate.

Why do my stitches hurt after childbirth?

Because this is a sutured wound that appears as a result of a rupture or incision in the perineum. In a week it will be much easier for you, but you will fully recover in about 8 weeks, or even six months...

Let's figure out what types of suturings there are, how they are applied and how the woman is subsequently treated.

Internal - applied to tears in the cervix and vagina, they usually do not hurt and do not require any special care. They are applied from absorbable materials, there is no need to remove them, there is no need to process them in any way, there is no need to smear or douche, you just need to ensure complete sexual rest for at least 2 months, because here they are in far from ideal conditions.

In order for the wound to heal well, it needs rest and asepsis. Neither one nor the other can be fully provided; the mother will still have to get up to the child, she will have to walk. It is impossible to apply any bandage in this area, and postpartum discharge creates a breeding ground for microbes, which is why it is quite common for the sewn areas to diverge.

You can sew up the perineum using different methods and materials, however, these are almost always removable options (they will need to be eliminated within 5-7 days). Most often, if everything goes well, they are removed in the maternity hospital, before discharge.

The treatment of stitched areas in the maternity hospital is carried out by a midwife. This can be done either on the examination chair or right in the ward. Usually treated with brilliant green 2 times a day. In the first two weeks, the pain is very pronounced, it is difficult to walk, and sitting is prohibited; mothers feed while lying down, eat either standing or lying down.

After the surgical threads are removed and discharged from the maternity hospital, the woman will not be able to sit normally for almost another month. At first you can only sit sideways on something hard, and even from the maternity hospital you will have to return reclining, in the back seat of the car.

How long does it take for stitches to heal after childbirth?

You will feel discomfort in the area where the perineum was torn for at least 6 weeks. Yes, and care at first will have to be very thorough.

Caring for stitches after childbirth

- Self-absorbing options in the vagina and cervix area do not require special care.

External threads require careful care. Their application is most often done in layers, using removable material.

After applying them, you will have to wash yourself after each visit to the toilet. clean water with the addition of potassium permanganate, and thoroughly dry the perineum with a clean towel.

The pads will need to be changed very often as the wound needs to be dry. While you are in the maternity hospital, the midwife will perform the treatment.

Removing the threads is a low-painful procedure that significantly relieves discomfort.

In the first days, it will be necessary to delay the first bowel movement as much as possible, especially with grade 3 ruptures; in the future, it will be induced using suppositories.

It will be necessary to abstain for some time from cereals and bread, vegetables and other stool-stimulating foods. This usually does not cause big problems since before childbirth a cleansing enema is performed, which in itself can delay stool.

Dehiscence of suturings most often occurs in the first days or immediately after their removal, rarely later. The cause may be early sitting down, sudden movements, as well as complications such as suppuration. This is not a common complication, which occurs with serious ruptures of the perineum, 2-3 degrees.

If there is inflammation, redness, sharp pain in the perineum, premature removal of the material restraining the perineal rupture before the wound has completely healed is not good, because this will form a rough scar. Your gynecologist will tell you how to treat the wound.

If early period went well, healing is proceeding without complications, after discharge from the hospital only hygienic measures will be required. Bepanten or another softening and healing ointment may be recommended.

When do sutures heal completely after childbirth?

On average, discomfort disappears after 2 weeks, but sex will be unpleasant for at least 2 months after the birth of the child. During healing, a scar is formed, which somewhat narrows the entrance to the vagina, making sex painful.

Choosing the most painless position, which is different for each couple, and using anti-scar ointments, for example, Contractubex, will most likely help you cope with this.

Strange sensations in the vaginal area can bother you for quite a long time, up to six months. However, later they completely resolve.

When you need to suspect that something is going wrong:

- If you have already been discharged home, and the stitched area is bleeding. Sometimes bleeding occurs as a result of wound dehiscence. You won’t be able to fully examine yourself on your own, so hurry back to the doctor.

If internal stitched wounds hurt. Normally, after suturing vaginal tears, there may be slight pain for 1-2 days, but it quickly passes. A feeling of heaviness, fullness, or pain in the perineum may indicate the accumulation of hematoma (blood) in the area of ​​injury. This usually happens in the first three days after giving birth, you will still be in the maternity hospital, tell your doctor about this feeling.

Sometimes suturings fester after discharge from the hospital. In this case, a painful swelling is felt in the wound area, the skin here is hot, and a high temperature may rise.

In all these cases, you should not think on your own what to apply to the wound; you should urgently consult a gynecologist.

Suture material– a necessary attribute and tool for any surgical intervention. Currently, there are a great variety of different suture materials in medicine, so there is a need for a clear classification of surgical threads and catgut. The development of medical technologies currently makes it possible to create truly perfect samples for more effective healing of surgical wounds.

Requirements for surgical suture material today

Back in 1965, A. Shchupinsky compiled a list of requirements for modern suture material in surgery:

1. The suture material must withstand sterilization.
2. Surgical threads and catgut should not react with other tissues and medications, not cause irritation, the material should be hypoallergenic.
3. Surgical threads and catgut must be quite strong and last until the surgical wound is completely healed.
4. The knot on the operating threads should be made without problems and held firmly.
5. Surgical suture material must be resistant to infection.
6. Surgical threads and catgut must be able to dissolve over time, without consequences for the human body.
7. A thread in surgery must have maneuverability, elasticity, plasticity, be soft, fit well in the surgeon’s hand, and have no “memory.”
8. Surgical sutures must be suitable for any type of surgical intervention.
9. Operating threads should not be electrified.
10. In the knot, the surgical thread must be no less strong than the thread itself.
11. The price of surgical sutures and catgut should not be prohibitively high.

Types of surgical threads, properties and purpose

• According to their structure, surgical threads are divided into monofilament and polyfilament.

1. Monofilament – a single-filament surgical thread that has a smooth surface and consists of a single fiber.
2. Shedding – multi-filament, or polyfilament, surgical thread, divided into twisted thread, braided thread.

Multifilament threads can be coated with a special compound, or regular, uncoated. Threads that are not covered with anything, when pulled, can injure tissue due to their cutting rough surface, as if “seeing through” the material. Uncoated threads are more difficult to pull through fabrics than coated threads. Moreover, they cause more bleeding of the wound.

Coated surgical sutures are called combined sutures. The scope of application of coated threads is much wider, due to better properties than uncoated threads.

Surgeons are well aware of the wicking effect of multi-fiber threads - this is when the microvoids between the fibers of the thread are filled with tissue fluid in the wound. This ability of polyfilaments to move fluid can cause the infection to move to healthy tissue, and, consequently, its spread.

Comparison of monofilaments and polyfilaments in surgery based on their main properties:

• Strength of threads.

Of course, braided suture material is more durable due to the complex structure of the fibers and weaving or twisting. Surgical monofilament is less strong in the knot.

In endoscopic surgery, the use of polyfilaments is predominant - this is due to the fact that the threads have to be tied with the help of equipment and instruments, and the monofilament can break at the site of a knot or compression.

• The ability of threads to perform various manipulations.

Since shedding is much more flexible, soft, has almost no “memory”, it is more convenient for it to work on small wounds, and it requires fewer knots than monofilament.

In turn, monofilament does not have the ability to adhere to tissue, and therefore it is more convenient for it to work, for example, on intradermal sutures - after the wound has healed, it is easily removed and does not additionally injure the tissue. Consequently, monofilament causes less irritation and inflammation of tissues.

• Based on the material from which surgical threads are made, suture material is divided into:

1. Organic natural- catgut, silk, flax, cellulose derivatives - cacelon, occelon, rimin.
2. Inorganic natural– metal thread made of steel, platinum, nichrome.
3. Artificial and synthetic polymers– homopolymers, polydioxanone derivatives, polyester threads, polyolefins, fluoropolymers, polybutesters.

• According to their ability to be absorbed in tissues, or biodegradable, surgical threads are divided into:

1. Completely absorbable.
2. Conditionally absorbable.
3. Non-absorbable.

• Absorbable surgical sutures:

1. Catgut.
2. Synthetic threads.

Catgut surgical can be plain or chrome plated. Catgut is made from the serous tissues of cows; it is a material made from natural raw materials.
The time it takes for catgut to be absorbed into human tissues can be different - for example, regular catgut remains strong for one week to 10 days, chrome-plated - from 15 to 20 days. Completely ordinary catgut dissolves in about two months - 70 days, chrome-plated - from 3 months to 100 days. Of course, in each specific organism, the rate of resorption of one or another type of catgut will be different - it depends on the condition of the person, his enzymes in the tissues, as well as on the properties of the brand of catgut.

Synthetic absorbable surgical sutures are made from polyglycaprone, polyglycolic acid or polydiaxonone.

It can also be monofilament or polyfilament, with different properties in terms of resorption time and tissue retention time.

• Synthetic threads, which quickly dissolve (they hold the wound for up to 10 days, completely dissolve in 40-45 days), most often they are made using the weaving method of polyglycolide or polyglycolic acid.

Most often, such threads are used in pediatric surgery. The advantages of these threads are that, due to the short period of resorption, gallstones and urinary stones do not have time to form on them.

• Synthetic threads that have an average resorption period – can be monofilament or braided.

The period of wound maintenance for this group of threads is up to 28 days, the period of complete resorption is from 60 to 90 days. Synthetic surgical sutures with an average resorption period are used in various fields of surgery. Monofilaments from this group have worse handling properties than polyfilaments; they can support a wound for up to 21 days, and completely dissolve in 90-120 days.

• Synthetic surgical sutures with a long resorption period made from polydiaxanone.

Retention of tissue on the wound surface for this group of threads is 40-50 days. These threads completely dissolve in the period from 180 to 210 days.

Long-term absorbable surgical sutures made of polymers are used in general surgery, traumatology, thoracic surgery, oncology, and maxillofacial surgery.

Compared to catgut, synthetic thread has an important advantage: it is not perceived by the human body as foreign tissue, and therefore is not rejected.

• Conditionally absorbable threads made from:

1. Silks.
2. Nylon or polyamide.
3. Polyurethane.

• Silk considered the gold standard in the field of surgical treatment. This material is durable, soft, elastic, and can be used to tie two knots. But this thread also has disadvantages - like catgut, it is an organic fiber, therefore, wounds sewn up with silk become inflamed and suppurate more often. Silk has a rate of resorption in tissues from six months to a year, so it is undesirable to use it for prosthetics.
• Polyamide surgical threads, or nylon , have a resorption period in tissues of up to 2-5 years. They have many disadvantages - they are reactogenic, tissues react to them with inflammation. The most favorable areas of application for these threads are surgical ophthalmology, suturing of blood vessels, bronchi, aponeurosis, and tendons.
• Polyurethane ester monofilament has the best manipulation properties in comparison with all other groups. Polyurethane is very soft and flexible, has no “memory”, and can be tied with three knots. This thread does not cause inflammation; it does not cut through tissue even when there is swelling in the wound area. This thread is often produced with special devices - balls, which allow the surgeon to do without tying knots. Polyurethane thread is used in surgical gynecology, plastic surgery, in traumatology, vascular surgery.

• Non-absorbable threads:

1. Made from polyester fibers (lavsan or polyester).
2. Made from polypropylene (polyolefins).
3. From fluoropolymers.
4. Made of steel or titanium.

• Polyester threads have advantages over polyamide ones - they are less reactive in tissues. Basically, these threads are braided and have a very large margin of strength. Today, these threads are not used so widely in surgery - mainly in cases where it is necessary to stitch tissues that will be in tension after surgery, as well as in endoscopic operations. The areas of surgery where this thread is still used are traumatology, cardiac surgery, orthopedics, and general surgery.

• Polypropylene (polyolefin) threads – exclusively in the form of monofilaments.

Advantages of polypropylene threads

They are inert in the tissues of the body, they do not provoke inflammation and suppuration. These threads never cause the formation of ligature fistulas.

Disadvantages of polypropylene threads

They do not dissolve, and also have poor handling properties; they must be tied with a large number of knots.

Polypropylene threads are used in general surgery, oncology surgery, cardiovascular surgery, traumatology and orthopedics, thoracic surgery, and operative ophthalmology.

• Fluoropolymer threads are the latest inventions in the field of medical materials. These surgical threads have great strength. They are elastic, flexible, soft. In terms of their strength, they are similar to polypropylene threads, and therefore are used in the same areas. But fluoropolymer threads have a small but advantage - they need to be tied with fewer knots.
• Steel and titanium threads They come in the form of monofilaments and in the form of braided threads. They are used in general surgery, orthopedics, and traumatology. In addition, braided steel thread is used to make an electrode (pacing) in cardiac surgery. This type of thread has great strength, but weak point– the junction of the thread and the needle. If a steel or titanium thread is inserted into the eye of a needle, in the old fashioned way, it will greatly injure the tissue and contribute to bleeding and inflammation in the wound. More modern use steel threads - when it is inserted directly into a surgical needle and crimped at the junction for strength.

• Division of surgical threads by thickness.

To indicate the size of threads in surgery, the metric size for each diameter of the threads, increased by 10 times, is used.