Walton M
Department of Orthopaedic Surgery, University of Otago Medical School, Dunedin, New Zealand.
Clin Orthop Relat Res. 1989 May(242):303-10.
The rate at which absorbable sutures lose their mechanical strength in vivo is particularly important in orthopedic applications where high physical loads, often increased by early mobilization, severely test the strength of sutures. The failure load and maximum tensile strength of chromic catgut and two monofilament absorbable synthetic suture materials (polydioxanone and polytrimethylene carbonate) were measured up to six weeks after implantation in sheep as: (1) a suture securing a synovial incision and (2) coils located either within the synovial cavity of the knee or intramuscularly. Although all synovial wounds healed satisfactorily, the performances of the different materials varied. The strength of chromic gut was largely lost within a week and fragmentation occurred at Week 4. The synthetic materials lost their strength relatively slowly. Polytrimethylene carbonate degraded in a linear manner, remaining intact but with little strength by Week 6. Polydioxanone, though losing strength at a slower rate, tended to fragment early, which may be of clinical importance in situations of delayed wound healing.
在骨科应用中,可吸收缝线在体内丧失机械强度的速率尤为重要,因为在骨科应用中,高物理负荷(通常因早期活动而增加)会严重考验缝线的强度。在绵羊体内植入铬制肠线和两种单丝可吸收合成缝线材料(聚二氧杂环己酮和聚三亚甲基碳酸酯)后长达六周的时间里,测量了它们作为(1)缝合滑膜切口的缝线以及(2)位于膝关节滑膜腔内或肌肉内的线圈时的失效负荷和最大拉伸强度。尽管所有滑膜伤口均愈合良好,但不同材料的性能有所不同。铬制肠线的强度在一周内基本丧失,在第4周时发生断裂。合成材料的强度丧失相对较慢。聚三亚甲基碳酸酯呈线性降解,到第6周时仍保持完整但强度很小。聚二氧杂环己酮虽然强度丧失速率较慢,但往往较早断裂,这在伤口愈合延迟的情况下可能具有临床重要性。