~Teachingcenter的醫學筆記~

可吸收線(comparison of absorbable sutures)

= Surgical gut
--- (type) chromic
--- (material) collagen derived from healthy beef and sheep
--- (strength in vivo) individual patient characteristics can affect rate of tensile strength loss
--- (tissue reaction) moderate reaction

 

= Monocryl (poliglecaprone 25)
--- (type) monofilament
--- (material) copolymer of glycolide and epsilon-caprolactone
--- (strength in vivo) 50~60% (violet 60~70%) remains at 1 week; 20~30% (violet 30~40%) remains at 2 weeks; lost within 3 weeks (violet 4 weeks)
--- (tissue reaction) minimal acute inflammatory reaction

 

= Coated vicryl (polyglactin 910)
--- (type) braided or monofilament
--- (material) glycolide and L-lactide coated with a copolymer of lactide and calcium stearate
--- (strength in vivo) 75% remains at 2 weeks; 50% remains at 3 weeks; 25% remains at 4 weeks
--- (tissue reaction) minimal acute inflammatory reaction

 

= PDS II (polydioxanone)
--- (type) monofilament
--- (material) polyester polymer
--- (strength in vivo) 70% remains at 2 weeks; 50% remains at 4 weeks; 25% remains at 6 weeks
--- (tissue reaction) slight reaction

 

不可吸收線(comparison of non-absorbable sutures)

= Perma-Hand-silk suture
--- (type) braided
--- (material) organic protein called fibroin
--- (strength in vivo) progressive degradation of fiber may result in gradual loss of tensile strength over time
--- (tissue reaction) acute inflammatory reaction

 

= Ethilon-nylon suture
--- (type) monofilament
--- (material) long-chain aliphatic polymers nylon 6 or nylon 6,6
--- (strength in vivo) progressive hydrolysis may result in gradual loss of tensile strength over time
--- (tissue reaction) minimal acute inflammatory reaction

 

= Nurolon-nylon suture
--- (type) braided
--- (material) long-chain aliphatic polymers nylon 6 or nylon 6,6
--- (strength in vivo) progressive hydrolysis may result in gradual loss of tensile strength over time
--- (tissue reaction) minimal acute inflammatory reaction

 

= Mersilene-polyester fiber suture
--- (type) braided or monofilament
--- (material) Poly(ethylene terephthalate)
--- (strength in vivo) no significant change known to occur in vivo
--- (tissue reaction) minimal acute inflammatory reaction

 

= Ethibond excel-polyester fiber suture
--- (type) braided
--- (material) Poly(ethylene terephthalate) coated with polybutilate
--- (strength in vivo) no significant change known to occur in vivo
--- (tissue reaction) minimal acute inflammatory reaction

 

= Prolene-polypropylene suture
--- (type) monofilament
--- (material) isotactic crystalline stereoisomer of polypropylene
--- (strength in vivo) not subject to degradation or weakening by action of tissue enzymes
--- (tissue reaction) minimal acute inflammatory reaction

 

= Pronova-poly (hexafluoropropylene-VDF suture)
--- (type) monofilament
--- (material) polymer blend of poly (vinylidene fluoride) and poly(vinylidene fluoride-cohexafluoropropylene)
--- (strength in vivo) not subject to degradation or weakening by action of tissue enzymes
--- (tissue reaction) minimal acute inflammatory reaction

 

Adapted from Ethicon: Wound closure manual, Somerville, NJ, 2007, Ethicon.

 

不可吸收網膜(nonabsorbable synthetic mesh)

= Polypropylene
--- (trade name) Marlex, Prolene, Atrium
--- (type) monofilament
--- (comments) 彈性好，抗感染能力強，廣泛使用於腹壁和疝氣的修補

 

= Polytetrafluoroethylene (PTFE)
--- (trade name) Teflon
--- (type) multifilament
--- (comments) 不可延展的網膜，因有許多的術後併發症而很少被使用

 

= Expanded PTFE
--- (trade name) Gore-Tex
--- (type) multifilament
--- (comments) 在不可吸收網膜之中，有最好的延展性，不容易與組織過度黏合(minimal tissue incorporation)，廣泛使用於腹壁和血管的重建

 

= Polyethyleneterephthalate
--- (trade name) Mersilene, Dacron
--- (type) multifilament
--- (comments) 聚酯纖維(polyester)也是廣泛使用於腹壁和疝氣修補的網膜材料，但比聚丙烯(polypropylene)少一些

 

可吸收網膜(absorbable synthetic mesh)

= Polyglycolic acid
--- (trade name) Dexon
--- (type) multifilament
--- (comments) 使用於暫時性的腹部關閉，可以抵抗感染

 

= Polyglactin 910
--- (trade name) Vicryl
--- (type) multifilament
--- (comments) 使用於暫時性的腹部關閉，可以抵抗感染

 

Adapted from Fenner DE: New surgical mesh. Clin Obstet Gynecol 43:650-658, 2000.