Sutures

February 17, 2019

 

 

A surgical suture is a medical device used to hold body tissues together after an injury or surgery.
Application generally involves using a needle with an attached length of thread.

So, recently I've been thinking of something along the lines of medical play that I could get involved with. Something which is fairly easy to transport, not overly costly and is easily available.  I came to the conclusion that I'd learn how to suture.  This medically related skill has an appeal to it.  Of which I have had thoughts about before now. After a bit of research I decided to take the plunge and get involved.  Even though they are designed to help heal injuries they have good uses for kink play, much like the flesh staple gun, except not as fast and requiring a bit of a higher pain threshold.

 

This little ramble entry is to mark the start of my research and suture practising. It's not a complete history and research piece, but more of a dabble here and there for a better understanding.

 

Suturing in itself is inexpensive.  The sutures come ready with a needle in a sterile packet 

There is a range available, including a silicone, silk and a biodegradable suture that comes out itself over time.  The others need to be removed by someone once the area that has been sutured has healed over time. I went with silk, as it was the first material in the options to buy. 
It turns out that silk sutures are best used on badly damaged injuries that require a longer time to heal, as silk is strong and isn't absorbed by the body in a short space of time like some of the other materials.  A downside; however, is that it can irritate and it also needs regular cleaning care of the wound.

 

Regardless of the material type, they are all around the same cost apart from a few pence. Being strong and durable, silk is my first choice for practising. Plus it's also easy to see with its colour.

 

Catgut is a material that's often used as an absorbable biological suture material. It's an absorbable suture made by twisting together strands of purified collagen taken from bovine intestines. The modern day natural plain thread is precision ground in order to achieve a monofilament character and treated with a glycerol-containing solution.
The material is absorbed by enzymatic degradation over ninety days with full strength lasting up to seven days.. This material is not used in the Uk anymore and is widely replaced in general by Polydioxanone based sutures which are completely absorbed in six months.

 

Catgut and silk having their advantages also had the issue with possible infection, a chap called J. Marion Sims invented a silver wire suture which was naturally antibacterial.  Most modern day materials are synthetic which also includes the above Polydioxanone,  Nylon and stainless steel. All depending on the surgery and wound involved.

 

Catgut itself was invented in the 10th century by a Muslim called Abulcasis and even though the name is cat it was harvested from sheep intestine similar to violin wires. Joseph Lister endorsed the routine sterilisation of all suture threads. At first, he attempted sterilisation in the 1860s with "carbolic catgut," and chromic catgut followed some two decades later.

 

Sterile catgut was finally achieved in 1906 with iodine treatment which was a massive revolution in reducing infections. You can research sutures back to the Romans and Egyptians. It is not a modern-day medical procedure by any means.

 

It's useful to note that non absorbable sutures cause less scarring as they provoke less of an immune reaction which give a better cosmetic option. Adhesives similar to super glue are often the choice over sutures where possible as they stop risk of infection, are quick and are a strong hold. Where glue cannot be used a needle is used to stitch the suture.

 

It's interesting to know that modern sutures have the material sealed smoothly directly onto the needle. This is to reduce the time of threading, to reduce drag as it's passed through the skin and also to reduce chance of picking up bacteria whilst being used.  The needles are also designed to be re-usable so they stay sharp with multiple skin piercings unlike a hypodermic needle which is blunt by design after a single use. Suture needles are indeed hard little pricks.


 

 

Above is the base kit that I now have for practising my suturing.  It is high-grade medical steel, meaning that it won't rust and is easy to sterilise. Very sharp scissors, a needle holder, two types of tweezers - with one having a three finger grip and a scalpel handle. The kit itself is very self-explanatory and is easy to carry with a few packs of sutures and various other medical products such as sterilising liquid and bandage.

 

As I progress with suture practice and proceed with human subjects I will update my ramblings!

 

 

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