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[骨科与创伤外科中的手术针]

[Surgical needles in orthopedics and trauma surgery].

作者信息

Dresing Klaus, Langer Martin Franz, Slongo Theddy

机构信息

Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland.

出版信息

Oper Orthop Traumatol. 2021 Oct;33(5):405-421. doi: 10.1007/s00064-021-00734-7. Epub 2021 Sep 16.

DOI:10.1007/s00064-021-00734-7
PMID:34529101
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8460540/
Abstract

For surgeons in the clinic and practice, the handling of suture material is the "daily bread". Therefore, one might assume that knowledge of this material is competent and comprehensive. However, daily experience shows a different picture. Often, the knowledge regarding needle shape, needle composition as well as needle size is only marginal and the surgeon has to rely on the knowledge of his OR nurse.The choice of needle is critical for each surgical step and each tissue; however, the use of the correct suture material in relation to the tissue to be sutured is essential, not only with respect to the quality of the suture but also with respect to the traumatization of the tissue. Depending on the tissue, different requirements must be placed on or taken into account for both the needle and the sutures. The purpose of this article is to provide the most essential and basic knowledge, such as the influence of needle shape and dimensions, effect of atraumatic or traumatic (so called sharp) needles on the tissue and shape of the needle tip. The interaction between the needle holder and the needle and the surgeon's hand in different applications is presented. In this present article, the main focus is on the needle and needle holder. A follow-up article specifically dedicated to sutures is being planned. The article does not claim to be 100% complete but the most essential, everyday questions should be clarified.

摘要

对于临床和实际操作中的外科医生来说，缝合材料的操作是“家常便饭”。因此，人们可能会认为对这种材料的了解是足够且全面的。然而，日常经验却呈现出不同的情况。通常，关于针的形状、针的组成以及针的尺寸的知识仅处于边缘水平，外科医生不得不依赖手术室护士的知识。针的选择对于每一个手术步骤和每一种组织都至关重要；然而，根据待缝合组织选择正确的缝合材料不仅对于缝合质量至关重要，而且对于组织的创伤也很重要。根据组织的不同，对针和缝线都必须提出不同的要求或加以考虑。本文的目的是提供最基本的知识，例如针的形状和尺寸的影响、无损伤针或有损伤（所谓的尖锐）针对组织的影响以及针尖的形状。介绍了在不同应用中持针器与针以及外科医生手部之间的相互作用。在本文中，主要关注的是针和持针器。正在计划一篇专门针对缝线的后续文章。本文并不声称是100%完整的，但应该能够澄清最基本的日常问题。

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本文引用的文献

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Suture and Needle Characteristics in Orthopaedic Surgery.骨科手术中的缝线和缝合针特性。
JBJS Rev. 2020 Jul;8(7):e19.00133. doi: 10.2106/JBJS.RVW.19.00133.
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An expanded surgical suture and needle evaluation and selection program by a healthcare resource management group purchasing organization.一个由医疗资源管理集团采购组织开展的扩大的手术缝合线和缝合针评估与选择项目。
J Long Term Eff Med Implants. 2003;13(3):155-70. doi: 10.1615/jlongtermeffmedimplants.v13.i3.30.
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Biomechanical analysis of needle holding security.持针安全性的生物力学分析
J Biomed Mater Res. 1986 Sep;20(7):903-17. doi: 10.1002/jbm.820200706.