Surgical dressings & sutures
These are composed of fibers that are characterized
by
Flexibility
Fineness
High ratio of length & thickness
Fibers may be defined as hair-like material directly obtained
from animlas, vegetables or minerals
These may also be defined as an agglomeration of cells in
which the diameter is negligible
Although nature provide a variety of fibrous materials e.g
Cellulose
Wood
Grains
Straws
But only a limited variety can be used for commercial and
industrial purposes
Classification of fibres
used in surgical dressings
Types of surgical dressings
A material used to protect a wound and to assist healing process
is called as surgical dressing.
It is used to remove wound exaudates , prevent infection,
provide physical protection and mechanical support to the
tissue.
Further classified as
Primary wound dressing
Absorbents
Bandages
Adhesive tapes
protectives
wool
Itis obtained from fleece of sheep (Ovis aries)
that belongs to family bovidae
Utilization
of wool for clothing and fabrics has
been reported since earliest civilizations.
Woolhas been considered as one of the major
commodities to generate revenue
Preparation
After removing Sheep hair and are separated into five
main types i.e.
Fleece
Pieces
Bellies
Crutching
locks
Preparation
It is then treated with certain detergents to remove dirt
and grease that contains lanolin.
After removing dirt and grease wool is bleached with
hydrogen peroxide
After bleaching it is spreaded on nets and dried with hot
air.
Characteristics
It is creamy white in colour but some species also
produce black, brown or grey colour wool (moorit)
Wool is smooth, elastic , slippery to touch and slightly
curly in appearence
Diameter varies from 15-40 µm
Wool is soluble in warm alkaline solution but insoluble
in dilute or strong acids
Composition
Wool is mainly composed of a Sulphur containing protein
known as “keratin”
Keratin also contain cysteine in Sulphur bridges which
gives elasticity to the fibre
Uses
Used as filtering aid and straining medium
Used to generate fine fibers for dressings
Silk
It is obtained from the cocoons from the larvae of
Bombayx mori that belongs to family
Bombycideae/Moraceae
The cocoon is made up of single continuous thread of
raw silk that may 300-900 meter long
The fibers are very fine and lustrous about 1/2500th of
an inch in diameter
Preparation
One gram of silk worm contains about 15000eggs which
are kept at 00C to overcome immature development
Silk worms eat mulberry leaves day and night to grow
fastly
When the colour of their head changes into darker that
indicates the stage of moulting
After one month of this stage they become fully mature
After this stage the colour of their body changes into
slightly yellow and reaches in a size of 4cm.
After this stage the silk worm eats a final meal of about
20-25times of its own weight and attains a size of 9cm
and thickness of 10 mm
The skin becomes tight and all these symptoms indicate
that worm is going to cover itself with cocoons
The process of spinning continues almost for 3 days
After 7-8 days larvae changes into chrysalides and
cocoons are collected by throwing them into hot water
This process kills the worms and makes the separation
of fibers easier.
Characteristics
Colour is yellow
Size ranges from 5-25 microns in diameter and 1200
meter in length
Appearance is fine, solid and smooth to touch
Soluble in dilute sulphuric acid
Hygroscopic in nature with good elasticity
Composed of a protein known as fibrion
Uses
Pharmaceutically used in preparation of sutures,
ligiatures and sieves
Infected larvae is used in the treatment of certain
traditional remedies
Animal fibres - different microscopically, differentiated by following chemical tests:
Cotton
It is obtained from the gossipium species i.e.
Gossypium herbacium
Gossypium hirsutum
Gossypium barbadense
Belongs to family Malvaceae
Preparation
After the collection of cotton bolls these are subjected
to the process of drying and ginning by which the
trichomes are removed from seed
Hair, short in length are known as “linters” used for low
grade cotton while long hair are used for cloth
preparation.
Raw cotton contain impurities, for making it more fine
it is subjected to further purification
By treating with dilute soda ash solution under pressure
for 15 hours
After this process it is bleached, washed and dried
After packing the cotton is sterilized by using radiations
Characteristics
It is white in colour, tasteless and odourless
Filaments are fine, hair like in texture, soft and unicellular
Size ranges between 2.2-4.6cm in length and 20-35 micron in
diameter
Chemically it is composed of 90% cellulose, 7-8% moisture,
0.5-2% wax, fat oil and cell contents
Purified cotton contains about 6-7% of moisture
Purified cotton has some impurities
As it is almost impossible to remove all the
impurities because process becomes too
expensive
BPC has limits
certain amount of shell & leaf material allowable
for surgical procedures it is discouraged to be
used in the body cavity to prevent going into the
body or it should be wrapped first in gauze to
prevent loose fibres
Regenerated fibres
Produced from
naturally occurring or semi-synthetic that
may have long chain molecules,isolated,
controlled and possibly modified
VISCOSE RAYON
viscose rayon, viscose, rayon, regenerated cellulose
It is a viscous orange red-aquoues solution of sodium cellulose
xanthogenate obtained by dissolving wood pulp cellulose&
linters in sodium hydroxide and by treating with carbon
disulphide
The material is delignified and packed in the form of white pulp
boards and forwarded to rayon manufacturers.
Thiswhite pulp contains cellulose about 80-90% and 7-8% of
hemicellulose
Hemicellulose is removed by treating with alkali solution, liquid
is removed by pressing and alkali-cellulose (Na Cellulosate) is
obtained
This is treated with carbon disulphide and sodium
hydroxide to give a viscous solution of sodium cellulose
xanthate
After filteration the material is immersed in dil.
sulphuric acid and sodium sulphate until the cellulose is
regenerated as continuous filaments.
Now the material is drawn from the solution and twisted
for strength, desulphurized , bleached and washed to
obtain a final product that contains 10% of moisture
contents.
Rayon is white fibre
Its tensile strength varies from two-third to 1 & a half
times than cotton
In wet conditions it looses about 60% of strength
Fibers prepared from it are water repellant e.g. cotton
crepe bandages
Chemistry & Uses
Viscose rayon is pure form of cellulose
The size of cellulose molecule is reduced
It is used in the manufacturing of surgical dressings,
absorbent wool and cellophene
Nylon
It is a thermostatic synthetic polymer prepared from
inorganic materials like coal, water and air, the units
are linked by peptide bonds.
Nylon is a copolymer formed by the condensation
reaction of equal parts of diamine and dicarboxylic acid
Terylene
Polyester fiber produced by the condensation of
ethylene glycol with teraphthalic acid
Prepared in the same way as nylon
Sutures & ligiature
Suture is a thread or material used for stitching or
sewing together the tissues, muscles and tendons with
the help of a needle.
Absorbable threads or fibers may be used to tie a blood
vessel during a surgical procedure without using a
needle as they are digested in the tissues e.g. catgut,
kangroo tendons
Non-absorbale sutures e.g. silk, cotton, nylon, polyester
fiber and stainless steel wires
Good quality suture may be non-irritant, sterilized with
good mechanical strength and have good absorption
capacity.
Absorbable suture
Surgical catgut arethe sterilized fiber or strands prepared
from collagen of connective tissues obtained from healthy
animals.
Generally submucosal layer of small intestine of freshly
killed animal is used for the preparation of catgut
About 7.5m long intestine of sheep is cleaned and split
longitudinally into ribbons
The inner most mucosa and two outer layers of submucosa,
muscularis and serosal layers are removed
Upto 6 ribbons are stretched and dried to form a
uniform strand.
These fibers are polished to get a smooth strings and
gauzed diameters.
These are then cut into suitable lengths and are
sterilized by placing them in glass tubes filled with
anhydrous high boiling liquids like toluene or xylene and
heating is carried out in an autoclave.
Final sterilization may be done by the radiations of
gamma rays from cobalt-60.
Kangroo tendons are used in hernia and bone repairs are
prepared from the tail of kangroo in the same way by
which the catgut is prepared.
Chromicized surgical catguts are prepared by soaking
the material in chromium salts for tanning the tissue so
catgut is not affected by the proteolytic enzymes and
stay longer in body
Non absorbable sutures
the examples include
Silk suture
Cotton suture
Linen suture
Nylon suture
Metallic sutures
