Most importantly, its high elasticity makes it excellent for vascular sutures.
In simple terms, the blood in the blood vessels will fluctuate with the blood pressure. When the blood in the blood vessels is full, it pulls the anastomosis, and it can be stretched like a rubber band and is not easy to be broken like a rope without elasticity. When the blood in the blood vessels is at a low point, it can shrink back well to promote the healing of the incision.
The unique advantages of polypropylene thread are undoubtedly very suitable for the anastomosis of the large blood vessels entering and leaving the heart, the largest blood pump in the human body.
In adult heart transplants, polypropylene sutures are indeed sufficient.
In pediatrics, it’s a little different.
In pediatrics, pediatric surgeons need to focus on the characteristics of children's growth and development, as in pediatric orthopedics and other pediatric surgical fields. In pediatric cardiac surgery, when anastomosing large blood vessels during heart transplantation, pediatric surgeons need to consider that children's blood vessels will continue to grow, and on the other hand, they can focus on the fact that children's vigorous metabolism is an advantage over adults.
After comprehensive consideration, the doctor can use absorbable sutures in combination with non-absorbable sutures in this place to give the child's own body tissue more room for self-repair at the anastomosis.
That is to say, in this operation, when the doctor sews a vascular anastomosis, he can use half non-absorbable sutures and half absorbable sutures.
How to choose absorbable sutures? Remember that absorbable sutures will be absorbed by the human body. Therefore, what the doctor needs to do is to ensure that the absorbable sutures are not absorbed by the human body before the wound heals. Otherwise, if the sutures disappear before the wound heals, it also means that the suture has failed.
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There are many kinds of absorbable sutures on the market, some of which degrade quickly and some slowly, which refers to the time it takes for the suture to disappear in the human body. Is it okay to just choose the suture that degrades slowly for slow-healing human tissues?
No, some absorbable sutures degrade slowly, but the tension support time they provide is shorter, only a few days, which is not as good as sutures that degrade quickly and have a long tension support time. Therefore, when choosing this type of suture, you must pay special attention to whether the human tissue you are suturing needs strong tension support. If it does, the factor that must be considered is the tension support time.
For example, peritoneal suture and current vascular suture all have special requirements for tension support, so this point needs to be considered. For this reason, the commonly used absorbable suture in pediatrics is PDS suture. In this case, can this suture be used in adult large blood vessels? No. Compared with polypropylene suture, it is still inferior.
The above just proves once again that medicine is definitely an engineering discipline.
Doctors choose the right suture material, and how to use it well is also a technical issue. Polypropylene thread or PDS thread has one thing in common: they are too slippery. If they are slippery, it is convenient to pass through human tissues with less damage. On the other hand, the pain point is that they can easily slip out after tying the knot. When using these two kinds of threads to tie knots, doctors need to tie several knots for other materials, while tying too many knots is not good. In terms of suturing methods, interrupted sutures are not suitable, and continuous sutures are used.
Before suturing, confirm that there are six anastomotic sutures in total and they should be arranged in order. The first choice is the left pulmonary vein group because it is located on the posterior wall of the heart.
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