WOUND CLOSURE 7

SUTURES AND LIGATURES NON ABSORBABLE 2



Metallic wire

Suture wire is prepared mainly from three metals –
non-toxic Stainless steel,
the alloy Tantalum and
Silver.

All these may be obtained as a single-strand monofilament
suture
The first two as several strands, either twisted or
braided, known as multifilament wire.

Surgical stainless steel suture wire is used mainly in
orthopaedics and thoracic surgery.
A stouter wire of sizes 3 to 9(0 to 7) or 29 SWG would be needed for wiring fragments of bone together.

Metal clips (ligature)

Ligatures of flattened silver or tantalum wire are used in
Neurosurgery, and chest surgery, for arresting hemorrhage from
small vessels.
The insertion forceps and cartridges, allow their use for this purpose at depths with safety Fig 5.4.5.1

Metal clips (suture)

These are metal clips having two sharp points which when the
clip is closed, these points grip the edges of the skin incision
and hold them in apposition.

The original types in use are Michel and Kifa Fig 5.4.6.2

Staples

During the past few years there has been considerable
development in the field of suture staples.

These range from disposable magazines of staples which fit
an insertion instrument to completely disposable units.
Examples of two of the latter are
Proximate II(Ethicon) and
Appose (Davis & Geck) Fig 5.4.7.1a,b,c
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