Wednesday, February 24, 2016

A Historical Glimpse of Suturing

From: theapprenticedoctor.com


Suturing is commonly used today as a means by which wounds are closed in order to prevent infection and hasten healing. Stitches are used by surgeons, doctors, nurses, podiatrists, dentists, first aid workers, veterinarians and survivalists. However, where did the concept for suturing wounds begin?

Archeologists have discovered primitive needles of bone and later metal that were thought to be used for surgical suturing thousands of years ago. It is suggested that the original versions of suture threads were coarse and made from plant fibers before progressing to animal parts much later in history. The first obvious proof of using sutures surgically comes from the Egyptians who used the technique extensively for burial preparation of their mummies. It is assumed that they also used their suturing skills on living people as well. The Greek physician Hippocrates recorded his use of sutures and plant-based materials, but the crude methods and materials most assuredly led to infections and severe scarring during that time of use.

Although the exact date of the transition from plant fibers to animal suturing materials is unknown, the first recorded use of catgut as a suturing material is attributed to Galen of Pergamon in the second century AD. Catgut was and still is made from cattle and sheep intestines, although synthetic catgut is more commonly used today, but like its predecessor, does not require removal because it dissolves in the body.

One of the main problems with suturing surgical incisions and wounds early on was that sterile instruments were not used which often led to skin irritations and infections. In 1860, Joseph Lister addressed the problem by creating a method of for sterilizing suture material by using carbolic acid. Chromic acid was later used to achieve sterilization and then iodine was introduced to sterilize catgut in 1902. These substances greatly decreased the incidents of infection in sutured wounds.

Sterilized catgut has been successfully used for decades and is still in use today. Eventually, however, doctors began to seek other suture options because catgut dissolved unpredictably in different patients which sometimes led to wounds reopening. Scarring was also a major problem with catgut sutures. Synthetic suture materials were produced in the 1920’s and the 1930s saw the creation of two types of surgical sutures, absorbable and non-absorbable which offered doctors a broader choice in suturing materials.

Today, most suture kits contain suture thread made from polymer fiber materials which work well for a variety of surgical suturing procedures. Polymer fiber suture thread comes in a wide selection of styles, designs and types which can be utilized for various wounds and under numerous conditions. Due to its flexible nature, polymer fiber is the preferred choice of physicians, nurses, dentists, veterinarians and first responders and is the best selection for survivalists, adventurers, sports teams and high-risk job workers. Suturing has come a long way since its conception and suture kits offered today contain top sterile equipment and materials to perform wound stitching properly which significantly reduces both infection and scarring.

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