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¡¾2555¡¿Tension

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    I remember that for a while, I don¡¯t know where a clinical evil trend started.  Some patients are so afraid of sutures that they insist on telling the doctor before any operation, big or small, that they must give me good sutures that can be absorbed by the human body.  These people are afraid of leaving foreign objects in their bodies.  I don¡¯t know where I heard the rumor that people would die if these sutures were left in the body.

    I also know that this statement is impossible to establish.  Absorbable sutures were invented later.  According to this statement, wouldn¡¯t it be true that all previous surgical patients were killed by non-absorbable sutures?

    When considering what kind of suture to use in medicine, the first step that doctors have to consider is not whether the suture can be absorbed by the human body, but the tensile strength of the suture material.

    Regarding the tension of human tissue, we have said it since the first operation with a retractor. After anesthesia, as long as the living tissue is moving, there will always be contraction tension.

    In medicine, sutures are used to sew wounds. The purpose is to pull the two ends of the opening together to allow the wound to heal.  If the suture tension is not strong enough, it will not be able to resist the contraction tension of human tissue.  As a result, when the human tissue on both sides of the anastomosis repeatedly shrinks, the tension can easily pull the thread directly, causing the wound to reopen and the suture to fail.

    How terrible is a failed suture? If the opening is reopened, wouldn't it lead to massive bleeding?  Otherwise, is it a leak?  The wound never healed, the anastomosis leaked, there were repeated infections, and systemic sepsis was really going to kill people. All the doctors could think about were these more terrifying things.

    Some patients are afraid of the rumor that if sutures are left in the body, they will die. If it refers to suture infection, all sutures now have been strictly disinfected, and the incidence rate is too low.  And if there is a risk of infection with non-absorbable sutures, absorbable sutures are also available.  Absorbable sutures are not immediately absorbed by the human body as soon as they are sewed, which means there is no point in suturing them. They have to wait for the wound to grow well before being absorbed by the human body. This process can take as short as a few days or as long as more than a month.

    ¡°What these patients are actually afraid of is the rejection of the sutures.  The problem is that current medical technology has developed to the point where various surgical materials have strict usage regulations. Which ones cannot be left in and which ones can be left in the human body for a long time are clearly marked.  All materials that can be left in the human body must be tested for compatibility with human tissue, and can be used clinically only after passing the review.  This was discussed in Orthopedic Materials Science.  Complex orthopedic materials can do this, and small sutures have already crossed this threshold.

    Having said this, it can be seen that these people¡¯s concerns are nonsense.

    It is indeed seen in clinical practice that some doctors will ask patients whether to use absorbable sutures before surgery.  Where are patient-selectable sutures typically used?  An innocuous layer of skin that has little bearing on the patient¡¯s life.  After all, some patients have limited financial resources and can only afford medical treatment. In those days, absorbable sutures, called cosmetic threads, were very expensive and had to be paid for out of pocket.

    "The choice of sutures is a matter of concern for the patient's life. It is impossible for doctors to leave this professional thing to patients who do not understand medicine to choose randomly. That is equivalent to handing a knife to someone to commit suicide."

    Speaking of polypropylene threads, the most commonly used place is in blood vessels.

    The advantage of a single-strand thread of this material is that it is less susceptible to infection than multi-strand threads. Its smooth performance allows it to cause less damage when passing through human tissue, and it has a low rejection reaction when it stays in the human body for a long time.

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