Surgical suture
From The Art and Popular Culture Encyclopedia
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Surgical suture (commonly called stitches) 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. A number of different shapes, sizes, and thread materials have been developed over its millennia of history. Surgeons, physicians, dentists, podiatrists, eye doctors, registered nurses and other trained nursing personnel, medics, and clinical pharmacists typically engage in suturing. Surgical knots are used to secure the sutures.
History
Through many millennia, various suture materials were used, debated, and remained largely unchanged. Needles were made of bone or metals such as silver, copper, and aluminium bronze wire. Sutures were made of plant materials (flax, hemp and cotton) or animal material (hair, tendons, arteries, muscle strips and nerves, silk, and catgut).
The earliest reports of surgical suture date back to 3000 BC in ancient Egypt, and the oldest known suture is in a mummy from 1100 BC. A detailed description of a wound suture and the suture materials used in it is by the Indian sage and physician Sushruta, written in 500 BC.Template:Citation needed The Greek father of medicine, Hippocrates, described suture techniques, as did the later Roman Aulus Cornelius Celsus. The 2nd-century Roman physician Galen described gut sutures. In the 10th century the manufacturing process involved harvesting sheep intestines, the so-called catgut suture, and was similar to that of strings for violins, guitar, and tennis racquets.
Joseph Lister endorsed the routine sterilization of all suture threads. He first attempted sterilization with the 1860s "carbolic catgut," and chromic catgut followed two decades later. Sterile catgut was finally achieved in 1906 with iodine treatment.
The next great leap came in the twentieth century. The chemical industry drove production of the first synthetic thread in the early 1930s, which exploded into production of numerous absorbable and non-absorbable synthetics. The first synthetic absorbable was based on polyvinyl alcohol in 1931. Polyesters were developed in the 1950s, and later the process of radiation sterilization was established for catgut and polyester. Polyglycolic acid was discovered in the 1960s and implemented in the 1970s. Today, most sutures are made of synthetic polymer fibers. Silk and, rarely, gut sutures are the only materials still in use from ancient times. In fact, gut sutures have been banned in Europe and Japan owing to concerns regarding Bovine Spongiform Encephalopathy. Silk suture is still used, mainly to secure surgical drains.
See also
- Alexis Carrel
- Barbed suture
- Butterfly closure
- Chitin
- Cyanoacrylate
- Knots
- Ligature
- List of medical topics
- Sewing
- Surgical staple
