Dr Ruff is a plastic surgeon in private practice in Chapel Hill, North Carolina.
Aesthet Surg J. 2013 Sep;33(3 Suppl):12S-6S. doi: 10.1177/1090820X13498505.
Ligatures have been used for millennia to close wounds. Sterilization and synthetic polymers that degrade in a commensurate fashion with wound healing have been the most significant improvements in these age-old devices. However, the constricting loop of a traditional suture and subsequent ischemia ("approximate, don't strangulate") still account for the most common cause of wound dehiscence-necrosis. Inspired by the quill of the North American porcupine, I envisioned a bidirectional array of barbs that could secure tissue without relying on constricting loops. One set of barbs could anchor the other. In this article, I document the development process of these barbed sutures from concept to patent to manufacture and US Food and Drug Administration approval. Knotless, strong, and easy to place, barbed sutures could foreseeably supplant conventional sutures, particularly as endoscopic procedures become more common. They also offer the intriguing potential to suspend ptotic tissues without surgical intervention.
结扎已经使用了几千年以闭合伤口。消毒和可与伤口愈合以相同方式降解的合成聚合物是这些古老器械中最重要的改进。然而，传统缝线的收缩环以及随后的缺血（“近似，不要绞窄”）仍然是伤口裂开-坏死的最常见原因。受北美的豪猪的刺的启发，我设想了一种双向的倒钩阵列，它可以固定组织而不依赖于收缩环。一组倒钩可以固定另一组。在本文中，我记录了这些带刺缝线从概念到专利到制造和美国食品和药物管理局批准的开发过程。无结、坚固且易于放置的带刺缝线可以预见地替代传统缝线，尤其是随着内窥镜手术变得越来越普遍。它们还提供了一种有趣的潜力，可以在不进行手术干预的情况下悬挂下垂组织。
