Bresadola F, Uzzau A, Menghi R, Zamboni P, Trignano M
Ann Ital Chir. 1989 Jul-Aug;60(4):321-7; discussion 328.
The most important physical and chemical properties of the new synthetic absorbable suture materials are shown. Particularly this paper make a comparison between multifilament and monofilament suture wire from the point of view of tensile strength, "in vivo" tensile strength retention, reabsorbability, foreseeability of the reabsorption time of the capillarity. On these theoretical basis the AA. think that actually the best suture wire for the gastrointestinal surgery must be a synthetic absorbable monofilament suture material. Clinical and experimental experience of the AA. utilizing in the surgery of the gastrointestinal tract a copolymer monofilament of the glycolic acid and of the trimethylene carbonate (polyglyconate-Maxon), resorbable by not-enzymatic hydrolysis in about 180 days are described. The clinical experience was acquired performing 43 manual gastroenteric anastomosis by polyglyconate suture material and making an endoscopic follow-up in 19 cases (12 oesophago-jejunal anastomoses and 7 colo-rectal anastomoses). The experimental study consist of 30 enteric anastomosis performed on rats. The results evaluation was made from three points of views: bacteriological, optical diffuse light microscopy and electronic transmission microscopy. The conclusions of the clinical and experimental studies are favourable for the use the polyglyconate suture wire in digestive surgery, and confirm also "in vivo" its theoretical properties.
展示了新型合成可吸收缝合材料最重要的物理和化学性质。特别是本文从拉伸强度、“体内”拉伸强度保留率、可吸收性、毛细吸收时间的可预测性等方面对多股缝线和单股缝线进行了比较。基于这些理论基础,作者认为实际上胃肠道手术中最佳的缝线必须是一种合成可吸收单股缝合材料。描述了作者在胃肠道手术中使用乙醇酸和碳酸三亚甲基酯的共聚物单丝(聚甘醇酸酯 - 马克松)的临床和实验经验,该材料可通过非酶水解在约180天内吸收。临床经验是通过使用聚甘醇酸酯缝合材料进行43例手工胃肠吻合术并对19例(12例食管空肠吻合术和7例结直肠吻合术)进行内镜随访获得的。实验研究包括对大鼠进行30例肠吻合术。结果评估从三个角度进行:细菌学、光学漫射光显微镜和电子透射显微镜。临床和实验研究的结论有利于在消化外科手术中使用聚甘醇酸酯缝线,并在“体内”证实了其理论特性。