Sewing thread operations.

There are three things that determine the choice of sewing thread, namely the type of material, the body's ability to absorb and arrangement of its filaments.
Threads that can be absorbed through enzymatic reactions in the body fluids are now widely used. Yarn absorption by the network may take between three days to three months depending on the type of yarn and sewn network conditions.
According to the original material, yarn was divided into yarns made from sheep intestines despite its name catgut and distinguished in which no mixture of pure catgut and chromic catgut which the material is mixed with a solution of chromic acid. Pure catgut is absorbed quickly, approximately within one week while chromic catgut longer absorbed approximately 2-3 weeks.
Besides, there are yarns made from synthetic materials, both of poliglikolik acid or of poliglaktin-910 is inert and has a great tension. This thread is used on all networks including the skin. Threads that can be absorbed causing local tissue reaction that can cause fistula yarn or infiltrate the network that may be characterized by induration.
Threads that can not be absorbed by the body is generally made of a material that does not cause tissue reaction because it is not a biological substance. This yarn can come from a very strong silk and clay, from cotton which is less powerful and easy to decompose, and of polyester, which owns strong synthetic material and are usually coated with Teflon. In addition there is also a powerful thread Nailon great tension, which is made of polypropylene that consists of highly inert materials and steel made of stainless steel.
Because it can not be absorbed by the thread will remain in the tissues of the body. Yarns of this type usually used on networks that are difficult to heal. In the event of infection will form a new fistula can be cured after a thread that is foreign objects removed.
Natural yarns made of silk or cotton. Both of these natural substances can react with body tissues though minimal because they contain natural chemicals also. Tense enough power and can be strengthened when moistened first with saline solution before use.
Synthetic material is made of polyester, or polypropylene Nailon generally coated by coating Teflon or Dacron material. With this coating, smoother surface that is not easily curled or decompose. Yarn has a great power strained and used for networks that require the power of a great unification.
According to the shape of the fiber strands, yarns can be monofilament when it consists of only one fiber only, and polifilamen when it consists of many fibers are strung into one. Dangle his way to align assisted coating material or in the strand cross so that the cross section was more rounded, more flexible and not easily curled.
Steel can be shaped monofilament yarn or polifilamen, often used in the sternum after thoracotomy, if contaminated easily happen infections.

Seide (silk / silk)

Silk is not as slick as usual because it was combined with an adhesive, not absorbed by the body. On the outside, the next use of the thread should be reopened.
Color: black and white
Size: 5.0 to 3
Usefulness: leather sewing, tying the arteries (large arteries) and as teugel (control)

Plain catgut

Absorbed by the body within 7-10 days
Color: white and yellowish
Size: 5.0 to 3
Usage: to tie the bleeding source is small, sew subcutaneous and can also be used to sew the loose skin, especially the area (abdomen, face) that is not a lot of moving and extensive small wound.
Plain catgut should be knotted at least 3 times, because the body will inflate.

Chromic catgut

In contrast to plain catgut, before it spun added chrome, sehinggan became harder and longer absorbed 20-40 days.
Color: brown and bluish
Size: 3.0 to 3
Usefulness: suturing wounds were considered not docked within 10 days, to sew the tendon to the patient uncooperative and when mobilization should be done immediately.

Ethilon

Synthetic yarn in packaging atraumatis (direct yarn together with a sewing needle) and is made of nylon is stronger than seide or catgut. Is not absorbed by the body, does not cause irritation to the skin and other body tissues
Color: blue and black
Size: 10.0 to 1.0
Usage: plastic surgery, larger sizes are often used on the skin, a small number used in eye surgery.

Ethibond

Synthetic yarn (polytetra methylene adipate). Packaging atraumatis. Gentle, strong, body reaction to a minimum, it is not absorbed.
Color: hiaju and white
Size: 7.0-2
Usage: cardiovascular and urology

Vitalene

Synthetic yarn (polymer profilen), very powerful soft, not absorbed. Packaging atraumatis
Blue
Size: 10.0 to 1
Usefulness: microsurgical particularly for heart and blood vessels, eye surgery, plastic, sewing leather

Vicryl

Atraumatis synthetic yarn packing. Absorbed by the body does not cause tissue reaction. In subkuitis last three weeks, the muscle last 3 months
Purple
Size: 10.0 to 1
Usage: eye surgery, orthopedics, urology and plastic surgery

Supramid

Synthetic yarn in packaging atraumatis. Unabsorbed
Color: black and white
Usefulness: cutis and subcutaneous suturing

Linen

Of natural cotton fibers, strong enough, easily knotted, not absorbed, the body's reaction to minimum
Colour: White
Size: 4.0-0
Usage: sewing small intestine and skin, especially facial skin

Steel wire

A metallic thread made of stainless steel polifilamen. Very strong non-corrosive, and reaction to the minimum body. Easily knotted
Color: white metallic
Packaging atraumatuk
Size: 6.0-2
Usefulness: sew the tendon

The size of the thread.

Thread size is expressed in units of European raw or in metric units. The smallest size is 11.0 European standards and the largest is size 7.
Thread size is one factor that determines the strength of the seam. Therefore, the selection of the size of the surgical thread for suturing depends on what networks are stitched and with consideration of factors cosmetics. While the strength of the seam is determined by the number of stitches, stitch spacing, and type of yarn. On the face used small size (5.0 or 6.0)
Location suturing thread type Size
All fascia 2.0 to 1
All the muscles from 3.0 to 0
Skin Not absorbed 2.0 to 6.0
Absorbed fat 2.0-3.0
Hepatic chromic catgut 2.0 to 0
Kidneys All catgut 4.0
Silk or cotton pancreas 3.0
Small intestine catgut, silk, cotton 2.0-3.0
Colon chromic catgut 4.0 to 0
Tendon Not absorbed 5.0 to 3.0
The joint capsule is not absorbed from 3.0 to 2.0
Peritoneum chromic catgut 3.0 to 2.0
Microsurgical Not absorbed 7.0 to 11.0

1. The stitches used for hemostasis, or to connect an anatomical structure is truncated (Sabiston, 1995).
2. According Sodera and Saleh (1991), the stitches is the result of the use of materials such as yarn for binding or ligation of blood vessels and connect between the two edges of the wound.
From the above understanding can be concluded that the act of connecting tissue suturing is interrupted or cut off to prevent bleeding using yarns.

General Principles Tailoring wound.

According to Brown (1995), the general principles that must be implemented in the wound suturing lacerations are as follows:
Healing will happen faster if the edges of leather fastened to each other with caution. Voltage from the edges of the skin should be as minimal as possible or if it may not exist at all. This can be achieved by cutting or smoothing the skin carefully before sewn.
Skin edges should be drawn lightly, this is done by using a light traction on the edges of the skin and are more vulnerable again in the dermal layer of the skin rather than sewn.
Each dead space should be closed, either by stitching subcutaneus that can be absorbed or by including these layers at a time to sew the skin
But many subtle stitching is sewn at the same distance preferably greater than stitches and far apart.
Each suture is left in place only as long as necessary. Therefore stitches on the face should be removed as soon as possible (48 hours 5 days), while the stitches in the abdominal wall and legs should be left for 10 days or more.
All wounds should be closed as clean as possible.

The use of forceps and tissue trauma kept to a minimum.

Tailoring is a way to get closer to sew or to connect two edges of the wound.

Can be distinguished :

1. Stitch Primary (Primary Suture Line) is the sutures used to maintain the position of the wound edges are interconnected during the healing process so it can be cured primer.

2. Continuous Suture is stitching with a sewing from around the wound by using the same thread and concluded at the end of the seam and cut once made the knot. Peritoneum is used to sew the skin, subcutis and organs.

3. Stitch Node / crate / Knot, which is a bonding technique which ended a seam. Used to strengthen and maintain the suture so that the stitches are not disconnected or loosened. The meaning of a noose is the binding one, being the node is the binding of the two meshes or more.

The types of yarn used in sewing.

1. Seide (Silk): 

Characteristically not as slick as silk usual because it was combined with an adhesive, is not absorbed by the body. On the next use of the outside, then the thread must be reopened. Useful for sewing leather, tying a large arteries. Measure often used is the number 2 three zero zero, 1 zero and the number 1.

2. Plain catgut: 

Characteristically can be absorbed by the body, the absorption takes place within 710 days and the color is yellowish white. Useful for binding source of minor bleeding, sew the subcutis and can also be used to move and spacious small wound. This thread inference should be done 3 times because the body will inflate. When the inference made only 2 times will be open again.

3. Chromic catgut: 

Characteristically can be absorbed by the body, longer absorption is up to 20 days. Chromic catgut usually cause an inflammatory reaction that is greater than the plain catgut. Useful for suturing wounds were considered not docked within 10 days and if mobility must be done

Complications stitches.

1. Overlapping: 

Occurs as a result do not do adaptation wound so that the wound be overlapping and slow healing of wounds suffered when cured and then the result will be bad.

2. Necrosis: 

Stitches are too tense can cause avaskularisasi causing tissue death.

3. Infection: 

Infection can occur due to non-sterile technique suturing, wound that has been contaminated, and the presence of foreign bodies that are still lagging behind.

4. Bleeding: 

Anticoagulant therapy or in patients with hypertension.

5. Hematoma: 

Occurs in patients with arteries severed and no ligation / binding so that the bleeding continues and causes swelling.

6. Dead space (space / cavity die): 

That the cavity of the wound did not happen because suturing layer by layer.

7. Sinus: 

When the wound healed by leaving a sinus tract, usually there is a thread on a multifilament suture sinus floor that acts as a foreign body.

8. Dehiscence: 

Is a wound that opened prematurely due to seams that are too strong or the use of bad threads.

9. Abscesses: 

severe infections that have produced pus / pus.

Various stitches.

1. Single Node Stitches:

Disconnected seam Simple, Simple Inerrupted Suture is a kind of stitches that are often used. Also used for stitching techniques situation: Doing needling with the distance between half to 1 cm edge cuts and simultaneously take all his subcutaneous tissue with a needle is perpendicular to the direction of the line or injuries. Single knot is done with absorbable thread premises distance between 1 cm. Knot in place the edge of the wound on one of the threads puncture cut approximately 1 cm.

2. Stitch mattress Horizontal:

Horizontal Mattress suture, Interrupted mattress Stitches by stabbing like a knot, before knotted followed by stabbing aligned as far as 1 cm from the first stitch.

3. Vertical Stitch Mattress:

Vertical Mattress suture, Donati, Near to near and far to far Stitch by stitch in depth below the wound was followed by sewing the edges of the wound. Usually produces rapid wound healing because in its hold the edges of the wound by stitching it.

4. Stitch Matras Modification:

Half Buried Mattress Suture Modification of horizontal mattress stitch the wound area but opposite in its subcutaneous region.

5. Stitch baste simple:

Simple running suture, Simple continuous, continuous over and over Stitches is very simple, the same as we baste shirt. Usually produces good cosmetic hasiel, its use is not recommended in loose connective tissue.

6. Stitches baste Feston:

Running locked suture, suture Interlocking continuous Stitches by linking threads on the seam before, used often used in stitching the peritoneum. Is a variation of the usual running suture

7. Stitch baste horizontal:

Horizontal Running Stitch continuous suture stitches interspersed with the horizontal direction

8. Stitch Node intrakutan:

Subcutaneus interupted suture, Buried intradermal suture, Interrupted dermal stitch. Suture knot on intrakutan area, usually used to sew area in the later sewn on the outside as well with a simple knot

9. Stitch baste intrakutan:

Running subcuticular suture, Suture Stitches baste baste subcuticular conducted under the skin, stitching is known to produce good cosmetic

Close the wound or bandage.

After sewing the wound in neatly cleaned with desinfeksan Cover the wound with sterile gauze moistened with betadine Attach with adhesive tape or hipafix (if necessary tied with bandages)

Suturing wounds.

Suturing wounds aims to unite the disconnected network and improve the process of grafting and tissue healing and also prevents open wound that will result in the entry of microorganisms / infection

Preparation Tool Hecting.

1. 5 cc syringes
2. Cotton Alcohol 70%
3. Lidocaine 1%
4. Pedestal
5. Kasa sterile
6. Cut yarn
7. Naldpoeder
8. Tweezers anatomic
9. Korentang
10. The needle skin
11. Needle muscle (if necessary)
12. Yarn leather (side)
13. Yarn muscle / catgut (if necessary)
14. Nierbekken (crooked)
15. antiseptic solution / physiological salt
16. Kom
17. Sterile Gloves
18. Waskom containing 0.5% chlorine solution

Preparation of the patient and the nurse.

1. Inform the client actions that will be performed.
2. Install the cover / curtains.
3. Adjust the position of the clients as comfortable as possible.
4. Wash hands with soap and running water, then dry with a clean towel or hand dryer.
5. Install pedestal and sheets.

Tailoring implementation.

1. Clean the wound with antiseptic solution or physiological saline solution.
2. Use a separate gauze for each swab, clean the wound from the less contaminated areas into the contaminated area.
3. Preparing injection of lidocaine 1%.
4. Perform disinfection at the end of the wound / area to be injected using 70% alcohol is circular with a diameter of over 5 cm shells.
5. Inject lidocaine in sub cutan around the edges of the wound.
6. aspirations, if there is no input lidocaine blood slowly pulling the needle and administer along the edge of the wound. Do it on the other edge of the wound.
7. As he waited drug reactions, prepare nalpoeder, needle and thread.
8. Wait 2 minutes for lidocaine react.
9. Test drug reactions using tweezers
10. Sew the wound approximately 1 cm above the tip of the wound and tie, yarn scissors leaving approximately 1 cm, sewing stitches one by one at a distance from one another approximately 1 cm, continue until all the wounds sewn.
11. Give an antiseptic on the wound.
12. Cover the wound with sterile gauze and tape with plaster.
13. Trim the patient.
14. Clean up tool.
15. Remove gloves and soak in a solution of chlorine of 0.5% along other tools for 10 minutes.
16. Wash your hands.
17. Document.

Basic theory up Hecting.

When the wound has been strong and cured primer, then stitching or thread can be lifted. Often within 5 10 days postoperatively.

Lift Stitches (up-Hecting).

Is a yarn-making process in the wound by location and day of action:
Face or neck 5th day.
Ke7-10 the stomach.
Palms 10.
Day 10 fingers.
Limbs on day 10.
Lower limbs 10-14.
Dada day 7.
Backs days 10-14

Preparation tool up Hecting.

1. Cut the suture lift
2. Handscoen sterile
3. Tweezers anatomical 2 pcs
4. Nierbekken (crooked)
5. Towel small
6. Cut bandages
7. Kassa taste
8. 0.5% chlorine solution
9. Perlak
10. The medical waste

Implementation.

1. Put perlak and sheets under the area to be treated.
2. Wash hands with soap and running water.
3. Wear gloves.
4. Open the old wound dressing and dispose bent.
5. Assess the wound (be sure to dry wounds).
6. Lift and hold down the outside seam with tweezers, then cut the thread under the knot with scissors up hecting.
7. Remove the thread of skin slowly.
8. Perform antisepsis measures. Close the back wound with sterile gauze. Replace the plaster.
9. Trim the patient.
10. Organize tool.
11. Remove gloves soak tools and gloves in 0.5% chlorine solution.
12. Wash your hands.
Stitches are used for hemostasis, or to connect an anatomical structure is truncated (Sabiston, 1995). According Sodera and Saleh (1991), the seam is the result of the use of materials such as yarn for binding or ligation of blood vessels and connect between the two edges of the wound. From the above understanding can be concluded that the act of connecting tissue suturing is interrupted or cut off to prevent bleeding using yarns.

General Principles Tailoring wound.

According to Brown (1995), the general principles that must be implemented in the wound suturing lacerations are as follows :

1. Healing will happen faster if the edges of leather fastened to each other with caution.
2. The voltage of the edges of the skin should be as minimal as possible or if it may not exist at all. This can be achieved by cutting or smoothing the skin carefully before sewn.
3. The Bank of skin to be pulled lightly, this is done with less wear light traction on the edges of the skin and are more vulnerable again in the dermal layer of the skin rather than sewn.
4. Each dead space should be closed, either by stitching subcutaneus that can be absorbed or by including these layers at a time to sew the skin.
5. Stitch smooth but many are sewn at the same distance preferably greater than stitches and far apart.
6. Each seam is left in place only as long as necessary. Therefore stitches on the face should be removed as soon as possible (48 hours - 5 days), while the stitches in the abdominal wall and legs should be left for 10 days or more.
7. All wounds should be closed as clean as possible.
8. The use of forceps and tissue trauma kept to a minimum.

According Sodera and Saleh (1991), the sewing is a way to get closer to sew or connect two edges of the wound. Can be distinguished :

1. Stitch Primary (Primary Suture Line) is the sutures used to maintain the position of the wound edges are interconnected during the healing process so it can be cured primer.
2. Continuous Suture is stitching with a sewing from around the wound by using the same thread and concluded at the end of the seam and cut once made the knot. Peritoneum is used to sew the skin, subcutis and organs.
3. Stitch Node / crate / Knot, which is a bonding technique which ended a seam. Used to strengthen and maintain the suture so that the stitches are not disconnected or loosened. The meaning of a noose is the binding one, being the node is the binding of the two meshes or more.

The types of yarns are used in Tailoring wound.

1. Seide (Sutra) :

Silk is not as slick as usual because it was combined with an adhesive, is not absorbed by the body. On the next use of the outside, then the thread must be reopened. Useful for sewing leather, tying a large arteries. Measure often used is the number 2 three zero zero, 1 zero and the number 1.

2. Plain catgut:

Can be absorbed by the body, the absorption takes place within 710 days and the color is yellowish white. Useful for binding source of minor bleeding, sew the subcutis and can also be used to move and spacious small wound. This thread inference should be done 3 times because the body will inflate. When the inference made only 2 times will be open again.

3. Chromic catgut:

Can be absorbed by the body, longer absorption is up to 20 days. Chromic catgut usually cause an inflammatory reaction that is greater than the plain catgut. Useful for suturing wounds were considered not docked within 10 days and if mobility must be done immediately.

Tailoring wound complications.

1. Overlapping:

Do not occur as a result of adaptation to the wound so that the wound be overlapping and slow healing of wounds suffered when cured and then the result will be bad.

2. Necrosis:

Stitches are too tense can cause avaskularisasi causing tissue death.

3. Infection:

Infection can occur due to non-sterile technique suturing, wound that has been contaminated, and the presence of foreign bodies that are still lagging behind.

4. Bleeding:

Anticoagulant therapy or in patients with hypertension.

5. Hematoma:

Occur in patients with arteries severed and no ligation / binding so the bleeding continues and causes swelling.

6. Dead space (space / cavity die):

Namely the cavity on the injuries occurred because no suturing layer by layer.

7. Sinus:

When the wound healed by leaving a sinus tract, usually there is a thread on a multifilament suture sinus floor that acts as a foreign body.

8. dehiscence:

Is a wound that opened prematurely due to seams that are too strong or the use of bad threads.

9. abscess:

Severe infection that has produced pus. Thank you for reading this article.
Written and posted by Bambang Sunarno. sunarnobambang86@gmail.com
author:
http://schema.org/Personal.
https://plus.google.com/105319704331231770941.
name: Bambang Sunarno.
http://primadonablog.blogspot.com/2015/06/sewing-thread-operations.html
DatePublished: June 21, 2015 at 12:32

Tags : Sewing thread operations.

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