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      Chirurgisches Nahtmaterial – Grundlagen Translated title: Surgical suture material—fundamentals

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          Abstract

          Am Ende der chirurgischen Therapie wird der Zugang mit Nahtmaterial geschlossen. Chirurgische Nähte werden also zur Adaptation von Wundrändern und Gewebe verwendet. Aufgabe des Nahtmaterials ist, die Gewebe bis zur Heilung zusammenzuhalten. Für Patienten ist eine kosmetisch gute Naht häufig das Zeichen einer guten Chirurgie. Für verschiedene Gewebe und -schichten werden unterschiedliche Anforderungen an das Nahtmaterial gestellt. Es werden die verschiedenen Arten von monofil über polyfil, geflochten, von resorbierbar bis nichtresorbierbar vorgestellt. Die Eingruppierung der Fadenstärken wird verglichen. Die Einsatzgebiete verschiedener Fadenstärken und die Dauer bis zum Fadenzug in den verschiedenen Körperregionen werden vorgestellt. Detailliert werden die Einhand- und Zweihandtechnik der chirurgischen Knoten erläutert. Die Technik der Nahtmaterialentfernung wird präsentiert. Im Online-Material können die Nahtmaterialien verschiedener Zusammensetzung und Hersteller gegenübergestellt werden.

          Zusatzmaterial online

          Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00064-023-00812-y) enthalten.

          Translated abstract

          At the end of surgical therapy, the access is closed with sutures. Surgical sutures are thus used to adapt wound edges and tissues. The task of the suture material is to hold the tissues together until healing. For patients, a cosmetically good suture is often the sign of good surgery. Different tissues and layers have different requirements regarding the suture material. The different types from monofil to polyfil, braided, from absorbable to nonabsorbable are presented. The classification of suture strengths is compared. The areas of application of different strengths and the duration until removal of the sutures for the different body regions are presented. The one-hand and two-hand techniques of surgical knots are explained in detail. The technique of suture removal is presented. In the online material, the suture materials of different composition and manufacturers can be compared.

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          Most cited references33

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          The Surgical Suture

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            Bacterial adherence to suture materials.

            Wound infections may be problematic for physicians. Whether a practitioner is managing complex penetrating trauma or a skin biopsy, there may be a need for suture closure. Suture material is an operator dependent variable and while little objective data exist to guide the choice of suture, it may play a role in wound infection. This study evaluates bacterial adherence to commonly used suture materials with a bioluminescent in vitro model. In all, 11 strands of size 2-0 poliglecaprone suture (Monocryl; Ethicon, Inc, Somerville, New Jersey), polypropylene suture (Prolene; Ethicon, Inc), silk suture (Ethicon, Inc), polyglycolic acid suture (Vicryl; Ethicon, Inc), and antimicrobial polyglycolic acid suture treated with triclosan (VicrylPlus; Ethicon, Inc) were immersed in a broth of Staphylococcus aureus engineered to emit photons. After biofilm formation, the suture strands were irrigated and imaged with a photon-capturing camera system yielding a total photon count that correlates with residual bacteria. The Vicryl suture had the highest counts and was statistically significant in bacterial adherence versus all other sutures. No other suture material was significantly different from any other. This study gives data to guide the selection of suture materials. Absorbable braided suture should not be used in closure of contaminated wounds or wounds at risk for developing infection. The antibiotic impregnated absorbable braided suture was similar to the other suture types; however, it is at risk for reverting to the properties of its untreated counterpart over time. The bacterial adherence of suture materials should be taken into account by all practitioners when closing wounds or debriding infected wounds. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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              Is there an evidence-based argument for embracing an antimicrobial (triclosan)-coated suture technology to reduce the risk for surgical-site infections?: A meta-analysis.

              It has been estimated that 750,000 to 1 million surgical-site infections (SSIs) occur in the United States each year, causing substantial morbidity and mortality. Triclosan-coated sutures were developed as an adjunctive strategy for SSI risk reduction, but a recently published systematic literature review and meta-analysis suggested that no clinical benefit is associated with this technology. However, that study was hampered by poor selection of available randomized controlled trials (RCTs) and low patient numbers. The current systematic review involves 13 randomized, international RCTs, totaling 3,568 surgical patients.
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                Author and article information

                Contributors
                klaus.dresing@med.uni-goettingen.de
                theddy.slongo@insel.ch
                Journal
                Oper Orthop Traumatol
                Oper Orthop Traumatol
                Operative Orthopadie Und Traumatologie
                Springer Medizin (Heidelberg )
                0934-6694
                1439-0981
                21 August 2023
                21 August 2023
                2023
                : 35
                : 5
                : 298-316
                Affiliations
                [1 ]Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, ( https://ror.org/021ft0n22) Robert-Koch-Str. 40, 37075 Göttingen, Deutschland
                [2 ]GRID grid.412353.2, Dept. of Paediatric Surgery, , University Children’s Hospital, ; 3010 Bern, Schweiz
                Author notes
                [Wissenschaftliche Leitung]

                Klaus Dresing, Göttingen

                Frank Unglaub, Bad Rappenau

                [Zeichnungen]

                Martin Lay, Breisach

                Article
                812
                10.1007/s00064-023-00812-y
                10520208
                37603082
                3e82e611-cc40-4fb0-8bd7-8e46f8d1dba3
                © The Author(s) 2023, korrigierte Publikation 2023

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

                Die in diesem Artikel enthaltenen Bilder und sonstiges Drittmaterial unterliegen ebenfalls der genannten Creative Commons Lizenz, sofern sich aus der Abbildungslegende nichts anderes ergibt. Sofern das betreffende Material nicht unter der genannten Creative Commons Lizenz steht und die betreffende Handlung nicht nach gesetzlichen Vorschriften erlaubt ist, ist für die oben aufgeführten Weiterverwendungen des Materials die Einwilligung des jeweiligen Rechteinhabers einzuholen.

                Weitere Details zur Lizenz entnehmen Sie bitte der Lizenzinformation auf http://creativecommons.org/licenses/by/4.0/deed.de.

                History
                : 12 January 2023
                : 23 February 2023
                : 9 March 2023
                Funding
                Funded by: University of Bern
                Categories
                CME
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2023

                eigenschaften,knotentechniken,techniken der fadenentfernung,fadenstärken ,fadenzug,properties,knotting techniques,suture removal techniques,suture strengths,suture removal

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