Surgical dressings & sutures

These are composed of fibers that are characterized

by

Flexibility
Fineness
High ratio of length & thickness

Fibers may be defined as hair-like material directly obtained

from animlas, vegetables or minerals

These may also be defined as an agglomeration of cells in

which the diameter is negligible
Although nature provide a variety of fibrous materials e.g
Cellulose

Wood

Grains

Straws

But only a limited variety can be used for commercial and

industrial purposes
Classification of fibres
used in surgical dressings
Types of surgical dressings

 A material used to protect a wound and to assist healing process

is called as surgical dressing.

 It is used to remove wound exaudates , prevent infection,

provide physical protection and mechanical support to the
tissue.
 Further classified as
 Primary wound dressing
 Absorbents
 Bandages
 Adhesive tapes
 protectives
 wool

 Itis obtained from fleece of sheep (Ovis aries)

that belongs to family bovidae

 Utilization
of wool for clothing and fabrics has
been reported since earliest civilizations.

 Woolhas been considered as one of the major

commodities to generate revenue
Preparation

 After removing Sheep hair and are separated into five

main types i.e.

 Fleece
 Pieces
 Bellies
 Crutching
 locks
Preparation

 It is then treated with certain detergents to remove dirt

and grease that contains lanolin.

 After removing dirt and grease wool is bleached with

hydrogen peroxide

 After bleaching it is spreaded on nets and dried with hot

air.
Characteristics

 It is creamy white in colour but some species also

produce black, brown or grey colour wool (moorit)

 Wool is smooth, elastic , slippery to touch and slightly

curly in appearence

 Diameter varies from 15-40 µm

 Wool is soluble in warm alkaline solution but insoluble

in dilute or strong acids
Composition

 Wool is mainly composed of a Sulphur containing protein

known as “keratin”

 Keratin also contain cysteine in Sulphur bridges which

gives elasticity to the fibre
Uses

 Used as filtering aid and straining medium

 Used to generate fine fibers for dressings

Silk

 It is obtained from the cocoons from the larvae of

Bombayx mori that belongs to family
Bombycideae/Moraceae

 The cocoon is made up of single continuous thread of

raw silk that may 300-900 meter long

 The fibers are very fine and lustrous about 1/2500th of

an inch in diameter
Preparation

 One gram of silk worm contains about 15000eggs which

are kept at 00C to overcome immature development

 Silk worms eat mulberry leaves day and night to grow

fastly

 When the colour of their head changes into darker that

indicates the stage of moulting

 After one month of this stage they become fully mature

 After this stage the colour of their body changes into
slightly yellow and reaches in a size of 4cm.

 After this stage the silk worm eats a final meal of about
20-25times of its own weight and attains a size of 9cm
and thickness of 10 mm

 The skin becomes tight and all these symptoms indicate

that worm is going to cover itself with cocoons
 The process of spinning continues almost for 3 days

 After 7-8 days larvae changes into chrysalides and

cocoons are collected by throwing them into hot water

 This process kills the worms and makes the separation

of fibers easier.
Characteristics

 Colour is yellow
 Size ranges from 5-25 microns in diameter and 1200
meter in length

 Appearance is fine, solid and smooth to touch

 Soluble in dilute sulphuric acid

 Hygroscopic in nature with good elasticity

 Composed of a protein known as fibrion
Uses

 Pharmaceutically used in preparation of sutures,

ligiatures and sieves

 Infected larvae is used in the treatment of certain

traditional remedies
Animal fibres - different microscopically, differentiated by following chemical tests:
Cotton

 It is obtained from the gossipium species i.e.

Gossypium herbacium
Gossypium hirsutum
Gossypium barbadense

Belongs to family Malvaceae

Preparation

 After the collection of cotton bolls these are subjected

to the process of drying and ginning by which the
trichomes are removed from seed

 Hair, short in length are known as “linters” used for low

grade cotton while long hair are used for cloth
preparation.

 Raw cotton contain impurities, for making it more fine

it is subjected to further purification
 By treating with dilute soda ash solution under pressure
for 15 hours

 After this process it is bleached, washed and dried

 After packing the cotton is sterilized by using radiations

Characteristics

 It is white in colour, tasteless and odourless

 Filaments are fine, hair like in texture, soft and unicellular

 Size ranges between 2.2-4.6cm in length and 20-35 micron in

diameter

 Chemically it is composed of 90% cellulose, 7-8% moisture,

0.5-2% wax, fat oil and cell contents

 Purified cotton contains about 6-7% of moisture

Purified cotton has some impurities
As it is almost impossible to remove all the
impurities because process becomes too
expensive
BPC has limits
certain amount of shell & leaf material allowable
for surgical procedures it is discouraged to be
used in the body cavity to prevent going into the
body or it should be wrapped first in gauze to
prevent loose fibres
Regenerated fibres

Produced from

naturally occurring or semi-synthetic that

may have long chain molecules,isolated,
controlled and possibly modified
VISCOSE RAYON

 viscose rayon, viscose, rayon, regenerated cellulose

It is a viscous orange red-aquoues solution of sodium cellulose
xanthogenate obtained by dissolving wood pulp cellulose&
linters in sodium hydroxide and by treating with carbon
disulphide

The material is delignified and packed in the form of white pulp

boards and forwarded to rayon manufacturers.

Thiswhite pulp contains cellulose about 80-90% and 7-8% of

hemicellulose

Hemicellulose is removed by treating with alkali solution, liquid

is removed by pressing and alkali-cellulose (Na Cellulosate) is
obtained

 This is treated with carbon disulphide and sodium
hydroxide to give a viscous solution of sodium cellulose
xanthate

 After filteration the material is immersed in dil.

sulphuric acid and sodium sulphate until the cellulose is
regenerated as continuous filaments.

 Now the material is drawn from the solution and twisted

for strength, desulphurized , bleached and washed to
obtain a final product that contains 10% of moisture
contents.
 Rayon is white fibre
 Its tensile strength varies from two-third to 1 & a half
times than cotton

 In wet conditions it looses about 60% of strength

 Fibers prepared from it are water repellant e.g. cotton

crepe bandages
Chemistry & Uses

 Viscose rayon is pure form of cellulose

 The size of cellulose molecule is reduced

 It is used in the manufacturing of surgical dressings,

absorbent wool and cellophene
Nylon

 It is a thermostatic synthetic polymer prepared from

inorganic materials like coal, water and air, the units
are linked by peptide bonds.

 Nylon is a copolymer formed by the condensation

reaction of equal parts of diamine and dicarboxylic acid
Terylene

 Polyester fiber produced by the condensation of

ethylene glycol with teraphthalic acid

 Prepared in the same way as nylon

Sutures & ligiature

 Suture is a thread or material used for stitching or

sewing together the tissues, muscles and tendons with
the help of a needle.

 Absorbable threads or fibers may be used to tie a blood

vessel during a surgical procedure without using a
needle as they are digested in the tissues e.g. catgut,
kangroo tendons

 Non-absorbale sutures e.g. silk, cotton, nylon, polyester

fiber and stainless steel wires
 Good quality suture may be non-irritant, sterilized with
good mechanical strength and have good absorption
capacity.
Absorbable suture

 Surgical catgut arethe sterilized fiber or strands prepared

from collagen of connective tissues obtained from healthy
animals.

 Generally submucosal layer of small intestine of freshly

killed animal is used for the preparation of catgut

 About 7.5m long intestine of sheep is cleaned and split

longitudinally into ribbons

 The inner most mucosa and two outer layers of submucosa,

muscularis and serosal layers are removed
 Upto 6 ribbons are stretched and dried to form a
uniform strand.

 These fibers are polished to get a smooth strings and

gauzed diameters.

 These are then cut into suitable lengths and are

sterilized by placing them in glass tubes filled with
anhydrous high boiling liquids like toluene or xylene and
heating is carried out in an autoclave.
 Final sterilization may be done by the radiations of
gamma rays from cobalt-60.

 Kangroo tendons are used in hernia and bone repairs are

prepared from the tail of kangroo in the same way by
which the catgut is prepared.

 Chromicized surgical catguts are prepared by soaking

the material in chromium salts for tanning the tissue so
catgut is not affected by the proteolytic enzymes and
stay longer in body
Non absorbable sutures

 the examples include

 Silk suture
 Cotton suture
 Linen suture
 Nylon suture
 Metallic sutures