Ординатура / Офтальмология / Английские материалы / Basic Principles of Ophthalmic Surgery_Arnold_2006

chapter 6 I suture materials and needles 79I

is derivedfrom the domesticatedsilkworm speciesBombyxmori.Silk sutureis braidedandcoatedwith awax mixture to reducecapillarityandincreasethe ease of passagethroughtissue.Silksuturesarenot absorbed,but progressivedegradation of theproteinaceousfiber maycausea very graduallossof the suture'stensile strengthovertime.This sutureenhancesbacterialinfectivity.

Polypropylene (Surgipro, Prolene)is a monofilament suture with no changein tensile strength over time. This suture resistsinvolvement in infection and hasbeensuccessfullyemployed in contaminatedand infected woundsto

eliminate or minimize later fistula formation and suture extrusion. The lack of adherenceto tissuehasfacilitated the use of polypropylene suture asapullout suture.This materialdoesnot deform easilyand may require extrathrowsto

avoid knot slippage.

Nylon suturesareavailablein both monofilament (Monosof, Dermalon, Ethilon) and braided (Surgilon, Nurolon) forms. The braided suture is coated

with silicone to increasethe easeof passagethrough tissueand to reducecapil-larity. This suture is not absorbed,but progressivehydrolysis of the suture

may result in gradualloss of tensile strength over time. Nylon has easier handling thanpolypropylene, but may still require anextra throw with the monofilament version.

Polyestersuturecomposedofpolyethyleneterephthalate(ficron, Mersilene)isa braidedsuturethatis notabsorbedanddoesnotdegradeovertime. It hasa higher

coefficientof frictionandmaintainstensiononawoundafterthe firstthrow.