Four stages of development: Medical surgical sutures

Medical sutures are common thread materials, which are widely used in various surgical operations to suture wounds and connect tissues. With the continuous advancement of science and technology, suture materials have gone through four generations of development; the first generation is silk thread, the second generation is catgut suture, the third generation is chemically synthesized absorbable suture (PGA, PGLA, PLA), and the fourth Substitute collagen to absorb sutures.

First generation

Non-absorbable; as early as 3500 BC, the ancient Egyptians used cotton fiber and horsehair to suture wounds; ancient Chinese history books also have records of linen, hair, pig palm, and grass fiber used for suture; ancient Indians There is also a record of suturing the wound with the head of a big ant; it is the original application of various suture materials under the conditions of the time.

In 1930, the clinic began to use modern silk thread. The silk thread was made of silk, which contained silk protein, and the patient’s body tissue rejected it. Modern medicine is mostly used in blood vessel ligation and intermittent skin suture.

In 1938, non-absorbent chemical synthetic threads such as chemical nylon threads and polyester threads began to appear; at the same time, micro-traumatic suture needles began to be used;

Second generation

Absorbability; around 1800 AD, a wire made of a new type of material-catgut appeared, but it was not used in medical applications, but only used for tennis racket nets. This is the founding record of catgut. .

In 1860, the British doctor Joseph Lister started modern suture with sterilized sheep gut; from then on, there was the most primitive absorbable suture made of sheep mesentery. The characteristic is that it is relatively hard and needs to be soaked in salt water during use. It must be preserved in a protective liquid during the validity period (once the protection of the protective liquid is lost, the tension of the gut is not guaranteed), the tension is low, and the absorption time after implantation in the human body is not long. It is confirmed that there is a serious tissue rejection reaction. Modern medical catgut is divided into chromium catgut and flat catgut. Chromium catgut is a catgut made of raw sheep casings immersed in a chromate solution, which is green due to the chromium content. Plain catgut is the catgut made of raw sheep casing without chromium treatment; chromium catgut and flat catgut are not stained.

Third Generation

Absorbability; In 1960, the Americans invented chemically synthesized absorbable sutures; including PGA and PLA, artificially synthesized absorbable sutures, raw materials: artificial metabolites (glycolic acid, lactic acid) polymerized, the production process is It is made by spinning, stretching, coating and other processes, and the absorption method is hydrolysis; it has convenient operation and predictable absorption time; its absorption time is closely related to the water content of the suture, high water content means short absorption time and low water content The absorption time is long, so the production and storage environment requirements are higher; until now, because the main components are chemical substances and contain chemical coatings, there are still incomplete absorption and slight tissue rejection.

The United States began to implement the suture approval system in 1970; the suture patent protection period is 14 years.

Fourth Generation

Absorbability: In 1995, Professor Zeng Jiaxiu from Xinhua County, Hunan Province, China, after years of research, first invented a pure natural absorbable collagen suture[1]. This material was tested by the National Medical Polymer Product Quality Inspection Center. Collagen It accounts for 93%, elastin accounts for 3%, and fat accounts for 4%. It is a natural molding material. It is made of biological principles and does not contain any chemical components during the production process. It is an original ecological protein material. Since the main component is type I collagen, it can provide sufficient nutrition for wound healing after being used for wound suture. After clinical trials and scientific tests, it has no trace of absorption, convenient use, good biocompatibility, and no tissue drainage. Excellent characteristics of abnormal reaction and suitable absorption time; and obtained the Torch Program Certificate of the Ministry of Science and Technology in 2000, which is the earliest known absorbable suture torch program project recognized by the country, and it also established Xinhua County as a pure natural collagen. The foundation of the origin of the suture. The disadvantage is that the thread is not long enough, and a few sutures have uneven thickness; the length is between 10-35cm, but it can meet the needs of most operations. The uneven phenomenon just illustrates the fact that the material has not been processed by modern molding technology ( Nowadays, with science and technology, it is not difficult to coat the surface of the suture. This can increase the aesthetics of the thread, but this introduces chemicals and loses the properties of pure natural collagen; and after clinical application , The uneven thickness has no effect on the clinical effect. Since then, the history of human suture began to have a pure natural collagen suture, which is the most ideal suture material so far, and it has also made Professor Zeng Jiaxiu won an unprecedented glory. Its absorption time is closely related to the thickness of the suture. The thicker the suture, the longer the absorption time, and the thinner the suture, the shorter the absorption time; the general absorption period is 8-60 days, which requires a higher production environment.

In addition, there are also products that promote the fourth generation of collagen sutures using new gut sutures. However, due to the purification, bonding, drawing, polishing, coating and other processes in the production, the original ecological molecular structure has been destroyed, and there are many interruptions when used. , There are still catgut features such as tissue reaction.

The most basic characteristics of pure natural collagen sutures in the true sense are: strong tensile strength, good absorption effect, enzymatic absorption, no drawing, no spinning, non-woven, no coating.