Читать книгу Gastrointestinal Surgical Techniques in Small Animals - Группа авторов - Страница 33

Much of the desirable handling properties of suture are associated with the degree of “stiffness” or inherent memory of the suture material. As a rule, multifilament sutures handle better than the monofilaments because they are softer and more flexible. Smaller, more pliable sutures tend to hold their position when inserted and knotted in soft tissues, just as the surgeon intended. Sutures with “memory” that are stiff can force or shift stitches away from their intended path in tissue as they are secured, and this can cause unwanted malapposition and gap formation. The cut ends of stiff sutures can also result in significant mechanical irritation of adjacent tissues, and this can increase adhesion formation, and even cause erosion of adjacent friable tissue. A suture's handling quality is also related to its elasticity, or its tendency to elongate under tensile force. Smaller, more elastic suture materials are desirable because they can elongate with increased tensile loads, and this may help reduce suture cut‐out in tissue.

Multifilament sutures have rough surfaces compared to monofilaments, and they may cause considerable friction and trauma when pulled through tissues, particularly when used in continuous suture lines. Coating is often applied to help smooth out the surface of multifilament sutures so they pass through tissue without “drag.” However, suture coating causes other less desirable handling qualities as it tends to increase the stiffness of the material, and it often reduces its knot security. Braided suture should be avoided even if they received an antimicrobial treatment because bacteria adhere to them more than to monofilament (Chu and Williams 1984; Masini et al. 2011).