Plastic surgery is an art form in which the doctor, wielding a scalpel, like a sculptor, carves out new features for his patient. The work of a plastic surgeon is a very delicate matter, in which every detail, even the most insignificant at first glance, affects the final result. In plastic surgery, as in any other branch of surgery, wounds are sutured using surgical threads. The doctor must approach the issue of choosing suture material with all seriousness, since correctly selected surgical threads are the final touch in the entire surgical process.
How the quality of suture material affects the outcome of the operation
Suture material in plastic surgery is selected in accordance with each type of surgical intervention. The quality of suture materials is one of the main factors influencing the healing process of a postoperative wound. All patients in the postoperative period eagerly await the day of suture removal, because only then can they examine and evaluate the result of the operation in more detail. Suture material in surgery is used not only to close skin wounds, but also to stitch other tissues of the body, so when choosing surgical threads, you should take into account what will subsequently happen to the tissues that are stitched.
Suture material:
- requirements for suture materials;
- basic properties of absorbable suture materials;
- when it is advisable to use non-absorbable suture material.
Requirements for suture materials
Today, plastic surgery places high demands on the quality of suture materials. The basic requirements for surgical threads are as follows:
- suture materials must be biocompatible - that is, the threads must not produce a toxic, teratogenic or allergic effect on the patient’s body;
- biodegradation - the suture material must have the ability to disintegrate and be removed from the patient’s body, and the rate of this process should not exceed the rate of scar formation;
- the threads must be atraumatic - this means that the surgical threads must have sufficient flexibility and elasticity, connect well to the needle and not produce a “dissolving” effect;
- suture materials must be strong - the strength of the thread must guarantee the preservation of the seam until the postoperative scar is completely formed.
Basic properties of absorbable suture materials
Absorbable threads are the main suture material in modern plastic surgery, since they do not require removal and dissolve in the wound on their own. The main absorbable suture materials include:
- catgut is an absorbable suture material that completely dissolves within 60-90 days after surgery. Most relevant when applying sutures to the back surface of the auricle after otoplasty, or when closing wounds of the scalp;
- Vicryl and Dexon are coated multifilament surgical sutures. Such threads are stronger and less reactogenic than catgut. Vicryl is completely absorbed 70 days after surgery, and Dexon is completely absorbed after 90 days;
- Polysorb is an absorbent coated suture material. Its density is even higher than the density of vicryl and dexon, while complete resorption of the thread occurs 70 days after surgery;
- monocryl is an elastic absorbable suture material that practically does not cause an inflammatory reaction and is completely absorbed no earlier than 90-120 days after surgery.
When is it appropriate to use non-absorbable suture material?
Non-absorbable suture materials differ from absorbable ones in much higher strength, better handling properties, less reactogenicity, and such materials are not able to disintegrate and be removed from the patient’s body. Such suture materials are most often used for fixing implants and cartilage structures, as well as for suspending soft tissues of the body. These include:
- polyamides - have high strength and flexibility, but cause a fairly pronounced reaction from tissues;
- pyloethers are more inert, but less elastic than polyamides;
- polyolefins - have high inertness, elasticity and strength, guarantee the reliability of the surgical unit;
- metal clips - often used in plastic surgery to close wounds on the scalp. Their main advantage is the ease of application and removal, as well as the formation of a reliable and quick connection of damaged tissues.
Any average person, one way or another throughout his life, will at least once encounter serious wounds or operations. In both cases, doctors stitch up the damage to speed up the healing process. What is the difference between surgical thread and ordinary thread?
When are stitches needed?
And wounds, other injuries - most people, one way or another, are faced with the fact that their tissues have to be sewn together for better and faster healing. For a long time, this problem, along with effective pain relief, was the main obstacle to the further development of surgery.
Throughout history there have been several periods of rise and fall of this discipline. Thus, in Ancient Rome, surgery experienced unprecedented development; every gladiator school had a doctor who treated the wounds of fighters after unsuccessful performances. In the Middle Ages, medicine in general and all knowledge of the past were forgotten, only to be restored in the Renaissance and Modern times.
The need for healing wounds has never disappeared, because throughout human history there have been constant wars, and even in peacetime, sterile surgical thread has saved many lives. How did she appear?
Story
Science has a fairly large amount of evidence that the first operations, including quite complex ones, were carried out long before the advent of special instruments and deep knowledge of human anatomy.
The first documented use of suture material occurred 2000 BC. The use of threads and needles in healing wounds was described in a Chinese treatise on medicine. In those days, leather was stitched with horsehair, animal tendons, fibers and other plants. In 175 BC, Galen first mentioned catgut, which was made from the connective tissue of livestock. Until the 20th century, it remained practically the only suture material. However, in 1924, a material was invented that was later called nylon. It is considered the first synthetic thread suitable for suturing wounds. A little later, lavsan and nylon appeared, which almost immediately began to be used in surgery. Polypropylene was invented in the middle of the century, and artificial absorbable fibers were invented in the 70s.
At the same time as the surgical thread changed, the needles also underwent metamorphosis. If earlier they were no different from ordinary ones, were reusable and in themselves injured the tissues, then later they acquired a modern curved shape, became thinner and smoother. Modern disposable micro-roughness on their surface is filled with silicone.
Modern suture material
In surgery of the 21st century, threads of various origins and properties are used. They can be either natural or synthetic. There are also those that, some time after the operation, dissolve on their own when the need for them disappears. With their help, internal fabrics are often sewn together, while for external ones, regular ones can be used, which need to be removed later. The final decision on this is made by the doctor depending on various factors, the nature of the wound and the condition of the patient. He also evaluates the size of surgical threads, choosing the appropriate thickness to support the tissues, but not to injure them again.
Requirements
There are a number of properties that a modern surgical thread should have. These requirements for suture material were formulated in 1965. However, they are still relevant today:
- simple sterilization;
- hypoallergenic;
- low cost;
- inertia;
- strength;
- resistance to infection;
- absorbability;
- versatility for any fabric;
- plasticity, comfort in the hand, no thread memory;
- lack of electronic activity;
- node reliability.
Modern natural and synthetic surgical threads one way or another meet most of these requirements. More often than not, with proper treatment, even the most serious wounds can be healed. And thanks to this, surgery could successfully develop to the modern level, when both micro-level operations and complex manipulations with such important organs as the heart and brain are carried out, and patients often recover in a fairly short time.
Thickness
Of course, over several thousand years, surgical thread has undergone serious changes and cannot be compared with what doctors were forced to use at that time.
Today, doctors have a wide arsenal of a wide variety of suture materials suitable for a wide variety of body tissues. The most understandable characteristic for the average person is the thickness of the surgical threads. The strength and invasiveness of the suture and, accordingly, the wound healing time depend on it.
There are about two dozen threads, differing only in thickness. Moreover, the values vary from 0.01 to 0.9 millimeters. Thus, the very first in a row of these threads is approximately 8 times thinner than a human hair!
Varieties
Initially, there are two types of suture material:
- monofilament surgical thread;
- multi-filament, which, in turn, can be twisted or braided.
Each of these types has its own advantages, disadvantages and characteristics. So, monofilament has the following advantages:
- Smoothness. The structure of this type is less traumatic, which avoids more bleeding.
- Ease of manipulation. Monofilament is often used for intradermal sutures, since it does not adhere to tissues and can be easily removed if necessary.
- No wick effect. This phenomenon lies in the fact that when the fibers do not adhere tightly to each other, microvoids are formed between them, which are filled with the contents of the wound, increasing the risk of infection. With monofilament there is no such danger.
- Inertia. Single-fiber thread is less irritating to the skin, and when used, there is a lower chance of wound inflammation.
At the same time, monofilament suture material also has one significant drawback. Relatively low strength. The requirements for modern threads are such that there must be a minimum number of knots - they irritate the tissue and slow down healing. Since monofilament has a smoother surface, it does not hold complex structures very well. When using this type of material, you have to use more knots to make the seam hold better.
To improve the properties of the threads, they are coated with different compounds to reduce the risk of infections, increase smoothness and biocompatibility. In addition, work is constantly underway on new fibers and materials, so surgery does not stand still.
Catguts and cellulosic materials
As already mentioned, surgical thread, the name of which comes from the phrase cattle gut, became one of the first. Today, the technology for its production is much more advanced than before; there is suture material with chrome plating, which increases strength and resorption time.
This is still a very popular type of thread, despite the fact that its use in some cases is equivalent to an organ transplant and can cause an appropriate immune response. Nevertheless, catgut is great if the stitch is needed for a short time, because after 10 days it can dissolve by half, and after 2 months it will completely collapse, having fulfilled its purpose.
Cellulose fibers are used to make polyfilaments called occelon and cacelon. They also have a relatively short absorption period, which makes them indispensable in urology, plastic and pediatric surgery. At the same time, they have an important advantage - they are not rejected by the body as foreign tissue.
The rest are absorbable
Other surgical threads have a longer withdrawal period, which is useful in general, thoracic and oncology surgery. Polydiaxanone takes the longest to dissolve - it takes 6-7 months for it to completely disappear.
The advantage of artificial fibers is that they promote faster and cleaner wound healing and reduce the risk of any complications and inflammation. That is why catgut is gradually being abandoned, finding safer analogues.
Silk and nylon
These two types are conditionally absorbable surgical threads. In practice, this means that it takes several years to remove them from the body. Silk has long been considered the gold standard, possessing versatility in use. However, due to the fact that its fibers are of natural origin, seams using it often become inflamed and require more attention. But at the same time, it is very elastic, durable and soft, which is why it has earned the love of surgeons.
It also often causes an inflammatory response. However, it is often used for tendon suturing and in ophthalmology.
Non-absorbable
Surgical threads, which then have to be removed manually, are also quite varied. Some of them have excellent manipulation properties, but are reactogenic. Others are inert and safe, but inconvenient to work with and have little strength. Nevertheless, almost all of them are widely used in both general and specialized surgery.
The following groups are distinguished:
- Polyolefins - prolene, polypropylene. Despite the fact that such seams almost never fester, the ease of use leaves much to be desired, and you also have to tie a lot of knots.
- Polyesters - nylon and lavsan. Mainly used to support stretched fabrics and
- Fluoropolymers. The most advanced group - they have good handling properties and sufficient strength. They do not require a large number of nodes.
Steel and titanium
This may even seem strange, but metal is still used in surgery in the form of both a thread-wire and a staple for a special apparatus. A serious drawback is injury to surrounding tissues. However, in some cases in orthopedics and bone surgery, nothing can replace metal.
So, there are a great many varieties of suture material. They are used for different purposes, and it is very important which surgical thread is ultimately chosen. The name, of course, does not play any role here, but the doctor always takes into account many factors when deciding what will be best for the patient.
MEPFIL synthetic absorbable threads are intended for the production of suture material and further use in surgical operations for stitching tissue. The variety of types and sizes allows the use of MEPFIL threads in all types of surgical operations.
MEPFIL threads have received positive feedback from surgeons: they do not curl, have high strength, elasticity, corresponding to the material used for making the threads and the indications for their use in surgical practice. Cause a minimal inflammatory reaction in surrounding tissues.
MEPFIL surgical thread is certified in the Russian Federation and meets all international standards.
Types of threadsMEPFIL:
| MEPFIL | Synthetic absorbent surgical braided polyglycolic acid (PGA) suture. Coating: polycaprolactone and calcium stearate. |
| MEPFIL-II | Synthetic absorbent surgical suture made of polyglycolic acid (PGA) coated with calcium stearate and copolymer (30% glycolide and 70% L-lactide). |
| MEPFIL-QUICK | Synthetic absorbent surgical braided polyglycolic acid (PGA) suture with short absorption time. |
| MEPFIL-LAC | Synthetic absorbent braided polyglycolide-lactide (PGLA: 90% glycolide and 10% L-lactide) thread coated with calcium stearate and copolymer (30% glycolide and 70% L-Lactide). |
| MEPFIL-LAC QUICK | Synthetic absorbent braided thread made of polyglycolide-lactide (PGLA: 90% glycolide and 10% L-lactide) with a short resorption period. |
| MEPFIL-LAC PLUS | Synthetic absorbent braided polyglycolide lactide thread with triclosan coating. |
| MEPFIL-D | Synthetic, absorbable surgical monofilament made from polydioxanone (PDO), a non-allergenic and non-pyrogenic material. Causes a weak tissue reaction during resorption. |
| MEPFIL DV | Polydioxanone (PDO) surgical fixation monofilament with notches and a loop at the end. Increased strength. |
| MEPFIL-MO | Synthetic absorbable surgical monofilament made of 75% glycolide and 25% caprolactone (PGCL) with a short resorption period. |
| MEPFIL-UPE | Ultra-strong, non-absorbable suture made from high molecular weight polyethylene. |
Characteristics of threadsMEPFIL:
- high initial tensile strength;
- convenient processing;
- sizes available from USP 8/0 to USP 3
- available colors: beige, purple;
Length of thread in spool:
| USP | P.G.A. | PGLA | PDO | PGCL | |||
| MEPFIL | MEPFIL II | MEPFIL-QUICK | MEPFIL-LAC | MEPFIL-LAC QUICK | MEPFIL-D | MEPFIL-MO | |
| 3&4 | 500 | 500 | - | - | - | - | - |
| 2 | 500 | 500 | 350 | 500 | 500 | 500 | - |
| 1 | 1000 | 1000 | 350 | 1000 | 500 | 500 | 500 |
| 0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 2/0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 3/0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 4/0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 5/0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 6/0 | 1000 | 1000 | 350 | 1000 | 500 | 1000 | 1000 |
| 7/0 | 200 | 200 | - | - | - | 200 | - |
| 8/0 | 200 | 200 | - | - | - | - | - |
Resorption time:
| Name of suture material | Partial resorption | 100% resorption |
| Absorbable surgical thread MEPFIL | 65% in 2 weeks | 60-90 days |
| Surgical absorbable thread MEPFIL II | 65% in 2 weeks | 60-90 days |
| Absorbable surgical thread MEPFIL - QUICK | 45% for 1 week | 40-60 days |
| Surgical absorbable thread MEPFIL - LAC | 65% in 2 weeks | 54-70 days |
| Surgical absorbable thread MEPFIL – LAC QUICK | 45% for 1 week | 40-60 days |
| Surgical absorbable thread MEPFIL - D | 65% in 4 weeks | 180-240 days |
| Surgical absorbable thread MEPFIL - MO | 50% for 1 week | 80-120 days |
There are contraindications. Consult a specialist.
Manufacturers produce 10 types of absorbent threads - two types of biological and eight synthetic threads (Table 3).
Smooth (polished) catgut and chrome-plated catgut are produced from biological absorbent threads.
Synthetic absorbable sutures are BIOSIN, FAST VICRYL, VICRYL, DEXON, MAXON, MONOCRYL, POLYSORB, PDS 2.
CATGUT consists of collagen fibers with a significant admixture of non-collagen proteins. The ETHICON company produces the highest quality CATGUT containing up to 97-98% pure collagen in the thread composition.
Due to the protein structure, CATGUT causes an inflammatory reaction of an allergic nature in tissues with a slow progression, manifested by lymphoid infiltration and edema. The most pronounced inflammatory tissue reaction to CATGUT during the formation of anastomoses in the gastrointestinal tract occurs 7-14 days after surgery. Subsequently, this leads to the development of fibrosis in the area of the anastomosis, sometimes even to the point of narrowing of its lumen. CATGUT is absorbed due to enzymatic reactions. The resorption time of CATGUT is unpredictable, variable in nature, and depends on the technology of its preparation and the type of tissue being stitched. If there is a suture on the stomach, the time for catgut to dissolve can be 2-3 days.
The unpredictability of the timing of catgut resorption, which may occur before the completion of repair of stitched tissues, does not allow the use of catgut for a single-row suture on the organs of the gastrointestinal tract and aponeurosis suture.
The strength of CATGUT is lower than that of absorbable synthetic threads, which indicates the need to use larger diameter CATGUT threads.
The difference between CATGUT produced by ETHICON and similar products from other companies is the particularly careful selection of raw materials and polishing of the semi-finished product, which is reflected in the name CATGUT: SMOOTH CATGUT. As a result of polishing, CATGUT does not become fluffy and is actually a monofilament material with the same diameter. the entire length of the thread, which increases its strength. A type 1-1 knot (“sea knot”) is recommended.
KETGUT should not be used in situations that do not allow additional inflammation of the wound (purulent wound, plastic surgery) and long-term support.
Impregnation of CAT GUT thread with chromium salts (CHROME CAT GUT) reduces the tissue reaction, provides some predictability of resorption times, and increases the strength of the thread.
There are three main methods for producing chrome-plated CATGUT. In the first method, ordinary CATGUT is dipped into a solution of chromic acids. As a result, a chrome coating is formed on the surface of the material, but the interior of the material does not undergo any special changes. The second method of chrome plating consists of initially dipping strips of collagen in a solution of chrome salts and then twisting them. This method also does not provide uniform chrome plating of the material, although it is more preferable. The most reliable method of chrome plating is a combination of these two methods - chrome plating of collagen strips followed by chrome plating of the surface. This method is called the true chrome plating process. When receiving chrome-plated CATGUT, its surface is polished in the same way as in the case of SMOOTH CATGUT. It is recommended to use a “marine knot” type 1-1.
VICRIL coated (COATED VICRYL) from ETHICON. The coating does not affect the biological properties of the suture material. The chemical bond between the coating and the braided thread is constantly maintained during the suture process. The fiber and coating are absorbed at the same rate by hydrolysis.
VICRIL is the only woven material that allows the “sea knot” to be pulled to the desired location in vivo (thanks to the unique coating, the knot does not stop). For VICRIL, a knot type 1-1+2, or 1-1+1-1 is recommended. Application of the "ladies' knot" type
1+1+1+. . . , when each subsequent overlap is made in the same direction as the previous one, it is not recommended. For additional support of the suture, non-absorbable threads can be used in alternation with VICRIL.
Fast VICRIL coated (VICRYL RAPIDE-ETHICON) is obtained from VICRIL by dosed irradiation with gamma rays to obtain shorter wound support and resorption. It has lower initial strength compared to VICRIL, although it does not differ from it in appearance. It is not a substitute for VICRIL. It has its own area of application - where long-term wound support is not required and subsequent removal of sutures is difficult or undesirable. The same type of knot is recommended as for VICRIL (1-1+2).
MONOCRYL-ETHICON. Its initial strength is twice that of catgut, 5% higher than MAXON and 22% higher than that of PDS II. Thanks to special processing, MONOCRYL is the most flexible and smooth of all known suture materials. It is recommended to use two square knots (1-1+1-1) plus a fifth overlap for metric thread sizes 0-1-2. When tightened, the knot decreases in volume and reliably self-locks. Due to the similarity in resorption time with chrome-plated catgut, it received the unofficial name “synthetic catgut”.
PDS II (PDS I1-ETHICON)- softer and more flexible suture material than its analogue MAXON. Therefore, when tightened onto the SDS, the knot decreases in volume and reliably self-locks, which is impossible with a less plastic material.
With a less flexible monofilament thread (MAXON) there is an increased risk of knots untying even when they are applied correctly. For PDS, a 2-1+2 node is recommended.
When tying a knot of absorbent thread, you must not grab it with a tool (only by the tip of the thread), otherwise it will lose its strength. Absorbable sutures, due to their sufficiently long-term wound support, minimal tissue reaction, and knot reliability, are the most advanced and can be used in all areas of surgery, except for the prosthetics of blood vessels and heart valves.
SILK(Table 3) in terms of its manipulation properties - softness, flexibility, reliability of the knot (allows you to tie 2 knots) - it is the “gold standard” in surgery. The pronounced reactogenicity of silk, sorption capacity and wicking force us to treat it with restraint.
To improve the properties of SILK, ETHICON impregnates it with wax and subjects it to special cleaning to remove foreign impurities. (MERSILK, MERSILK). The reaction of fabrics to such silk is moderate. Tensile strength is completely lost during the first year; after 2 years the material is no longer detectable in the body.
Considering that silk, although slowly, is absorbed, it should not be used when long-term wound support is required - prosthetics of blood vessels, heart valves, etc. Due to the presence of sorption and wick properties, silk is not indicated in inflamed and infiltrated tissues.
Table 3
|
Silk threads |
||
|
Material name |
Company manufacturer |
Material type |
|
Braided Silk |
Matsuda |
woven silk |
|
Mersilk |
Ethicon |
woven silk |
|
Ne-Silk |
Braun |
coated woven silk |
|
Silk |
Giba-Geigy |
woven silk |
|
Ergon Sutramed |
coated woven silk |
|
|
Sofsilk |
USSC |
woven silk |
|
Twisted Silk |
Matsuda |
twisted silk |
|
Virgin Silk |
Matsuda |
natural silk |
A significant disadvantage of non-absorbable threads is their constant presence, like a foreign body, in tissues with the possibility of developing an inflammatory reaction of varying severity. The advantages of non-absorbable threads are their strength, better handling properties compared to absorbable threads, long-term wound support under tension, and are indispensable for vascular prosthetics.
Non-absorbent surgical threads are of natural origin (linen, cotton) and synthetic. Threads of natural origin are almost never used due to their pronounced wicking properties and reactogenicity towards body tissues.
Synthetic non-absorbent threads, depending on the chemical structure, are divided into polyamide (nylon), polyester (lavsan), polypropylene, polymer, fluoropolymer, and polyvinylidene-based.
Table 4
|
Polyamide (nylon, nylon) surgical threads |
||
|
Material name |
Material type |
Company manufacturer |
|
Amifil M Amifil M |
monofilament wire |
Polfa |
|
Amifil R AmifilP |
wicker |
Polfa |
|
Dafilon Dafilon |
monofilament |
Braun |
|
Dermalon Dermalon |
monofilament |
Davis & Geek |
|
Ethylone (Nylon/Polyamide66) Ethilon |
monofilament |
Ethicon |
|
Monosophist Monosof |
monofilament |
USSC |
|
Nurolon Nurolon |
wicker |
Ethicon |
|
Supramid Supramid |
coated wicker |
Braun Sharpoit |
|
Surgilon Surgilon |
braided nylon |
Davis & Geek |
Polyamide threads have high strength and flexibility (Table 4). To reduce the inflammatory reaction in tissues, modern nylon threads are produced in the form of monofilaments or coated braided threads. A number of polyamide threads have the commercial name “nylon”-ETHYLON (nylon/polyamide 66). Nylon sutures are not truly non-absorbable. 15-20% of polyamide thread is excreted from the body annually. There are no contraindications to their use. A type 2-1 knot (“surgical knot”) is recommended.
Polyester (lavsan) threads are more inert than polyamides, but inferior to them in elasticity, and to polypropylene threads - in inertness and knot reliability (Table 5).
ETHICON produces two types of high-quality polyester threads - Merilen And COATED ETHIBOND. Mersilene completely reproduces the mechanical properties of silk (softness, reliability of tying knots), but in comparison with it causes an insignificant tissue reaction. It is almost neutral in the body. Mercilene does not dissolve and remains encapsulated in the tissues of the body without losing its original tensile strength.
The areas of application are varied - general and cardiovascular surgery, plastic surgery, ophthalmology. A type 2-1 knot (“surgical knot”) is recommended.
In order to reduce the capillarity of MERSILENE, a polybutyl coating is applied to it. This thread is called ETHIBOND. This coating feature is very important when replacing heart valves. A “surgical knot” is also tied.
Table 5
|
Polyester (lavsan) surgical threads |
||
|
Material name |
Material type |
Company manufacturer |
|
Bralon Bralon |
woven polyester sheath |
USSC |
|
Dacron Dacron |
polyester |
Davis & Geek |
|
Dagrophile Dagroul |
woven polyester |
Braun |
|
Etibond Ethibond |
woven polyester with polybutylate coating |
Ethicon |
|
Estafil Estafil |
woven polyester |
Polfa |
|
Maxilene Maxilene |
monofilament polyester |
Giba-Geigy Ergon |
|
Mercilene Mersilene |
woven polyester |
Sulramed Ethicon |
|
M-Dec M-Deck |
Teflon coated woven polyester |
Matsuda |
|
Miralen Miralen |
monofilament polyester |
Braun |
|
Synthophile Synthofil |
coated woven polyester |
Braun |
|
Surgidak Surgidac |
coated multifilament woven polyester |
USSC |
|
Sutron Sutron |
Monofilament polyester |
PROLENE (Ethicon). PROLENE does not dissolve and is encapsulated in tissues without losing its original tensile strength. There are no contraindications to its use. PROLENE has the following features - when stress increases, it first stretches (linear reversible elongation according to Hooke's law), then thins to a smaller diameter (irreversible linear elongation) and only then breaks. Linear elongation allows you to smooth out blood pulsations in large vessels. Nonlinear elongation is a signal to the surgeon to “moderate his ardor” when tightening tissue or tying a knot. Knots of more rigid polypropylene threads from other companies tend to weaken and even unravel, which reduces the reliability of the tightness of the gastrointestinal tract anastomoses. When large vessels pulsate, the rigidity of the polypropylene thread may cause it to rupture. In the USA, the share of PROLENE among the total number of polypropylene threads used in cardiovascular surgery is 90-95%. FLUOROPOLYMER threads (Flexamid from Ergon Sutramed) are even more inert than polypropylene threads, have high manipulation properties and thromboresistance. These threads are used in cardiovascular surgery. Threads based on polyvinylidene (Coralene from Ergon Sutramed) have high strength, low hygroscopicity and reactogenicity. Recommended for vascular surgery. Elastic thread Matsuda is specially designed to tighten tissue around a catheter inserted intra-arterially or intracardiacly. Having high elasticity, when tying a knot, the thread can lengthen by 3-4 times. After removing the catheter, it compresses the hole in the wall of the vessel, preventing bleeding. Metal steel wire has become widespread for the suture of the sternum, as well as in orthopedics and traumatology - STEEL (Ergon Sutramed, USSC), SS WIRE (ETHICON). The suture material is attached to atraumatic needles in such a way that it is their continuation. This is achieved by sawing or flattening the base of the needle and then pressing the thread into it. As a result, the base of the needle becomes thicker than the suture thread, which reduces the atraumatic nature of the suture material. In needles from ETHICON and USSC, a hole in the needle for the thread is drilled with a laser beam, the thread is fixed by light pressing, as a result of which the diameter of the needle and thread are almost equal. Despite the fact that the diameters of the base of the needle and thread can differ very little, the point of the needle can significantly exceed the diameter of the thread (cutting, piercing-cutting needles). Therefore, for anastomosing hollow organs, especially with a single-row suture, it is necessary to use threads with a stabbing needle. Suture material is available in combination with atraumatic needles or in the form of separate ligatures. Suture material on atraumatic needles can have individual packaging for each thread or packaging with several threads. Thus, the ETHICON company produces Multi-Strand 10 and Multi-Multi-Strand 4 packages, which have 10 and 4 needles and thread, respectively. Threads without needles are produced in the form of standard lengths, packaged one at a time (1.5 m) or several threads (45-50 cm), as well as three-meter thread on a spool - “LIGAPAK” from ETHICON. The packaging of ETHICON threads guarantees their sterility for 5 years, USSC - 3 years, except for Biosin (1 year). The expiration date is marked on each package. Packaged suture material cannot be re-sterilized, since the strength of the material and the timing of wound support become unpredictable. |
During the session, gold of the highest standard is used, with a diameter of less than 0.1 millimeters. Polyglycol envelops the thread. Gold has long been time-tested, hypoallergenic and safe.
Gold reinforcement makes you look ten years younger. The effect is noticeable 2 months after the introduction of the threads and lasts up to 12 years.
Thanks to the positive changes, such threads are used throughout the body to get rid of sagging skin and cellulite.
Result:
- smoothing wrinkles;
- improved blood circulation;
- increase in skin tone.
The peculiarity of gold fiber is the inability to use the services of hardware cosmetology in the future.
We invite you to watch a video about how gold threads are used in thread face lifting:
French Spring Thread
Spring Thread is non-absorbable. Composition: polyester fiber and silicone. The tightening occurs due to microhooks, or teeth, located along the entire length. The effect lasts from three to five years, depending on the condition of your skin. After the expiration of the period, it is not necessary to remove them; it is enough to pull the thread higher.
With Spring Thread you will adjust:
- wrinkles on the neck, décolleté and face;
- nasolabial folds;
- double chin;
- facial asymmetry.
Double Needle
Double Needle differs in the method of insertion from the above threads. Two needles at the ends of the thread are inserted into one puncture of the skin, due to which a loop is formed - a fixed point, with the help of which it is easy to tighten the sagging tissue.
The work is done quickly, while correcting the oval of the face, eliminating wrinkles and improving the quality of the skin is guaranteed.
The duration of the lifting is 30-36 months. The fiber is self-absorbable and consists of caploractone.
Indications for thread installation:
Boca
Boca is used for correction only in the lip area. Over time, due to the activity of the orbicularis oris muscle, multiple wrinkles form.
Indications for installation:
- purse string wrinkles;
- dull complexion;
- unclear outline of the upper lip;
- photoaging of the skin.
The fibers are self-absorbable. The duration of the lifting is 24-30 months.
The results of the procedure are improved skin quality, botulinum-like effect, skin tightening. The thread can be combined with the introduction of hyaluronic acid to slightly increase the volume of the lips.
Pros and cons of this type of lifting
Advantages:
Flaws:
- the presence of side effects and complications;
- there is a list of contraindications;
- this type of facelift is not suitable for people over 50 years of age;
- If the technician is inexperienced, incorrect facial correction may occur.
We invite you to watch a video about the pros and cons of thread lifting:
Efficiency – how quickly the result is visible, how long it lasts
Efficiency directly depends on the chosen. Before the procedure, discuss with your cosmetologist what effect you want to achieve and for how long.
The golden thread retains its effect for about 12 years, and the Double Needle thread for a maximum of three years.
After the procedure, positive changes are not immediately noticeable. In the first week, swelling and puncture marks are possible. The effect becomes noticeable after three weeks. This fact also takes on different meanings depending on the threads you choose.
Photos before and after
Possible complications and side effects
Choose an experienced specialist, and then you will minimize side effects. Choose a thread based on the characteristics of your skin.
Side effects after the procedure:
- allergy to the material;
- incorrect and uneven insertion of the thread, resulting in facial asymmetry;
- despite local anesthesia, discomfort and pain during the procedure;
- threads may be visible through the skin;
- swelling of soft tissues;
- whitening of the skin;
- hematomas;
- severe constriction of the skin, the appearance of folds;
- skin damage.
We invite you to watch a video about possible complications after thread lifting:
Is it possible to remove non-absorbable mesothreads?
Experienced specialists carry out the procedure, both the installation of surgical non-absorbable threads and their removal.
Over time, the effectiveness of threads decreases, so you have to either tighten them or remove them in order to introduce new ones.
There are also a number of reasons why thread removal is required:
- allergic reaction;
- infection;
- unprofessional installation;
- thread cutting;
- deformation of soft tissues.
How much does the material used cost? The cost of the procedure itself?
Almost all stores only a doctor who has received permission for the procedure can buy threads for the face.
Mesothreads are available for free sale. Their effect lasts from six months to a year. They are considered the most painless, safe, and most importantly, budget-friendly.
The cost of a package of mesothreads (10 pieces) varies from only 1,500 to 2,000 rubles. The price for installing one mesothread in the clinic starts from 700 rubles (the price includes materials).
The installation procedures for gold reinforcement threads, Spring Thread, Double Needle, Boca will cost you at least 50 thousand rubles. Often the cost of the procedure can reach up to 200 thousand rubles. It depends on the materials, their quantity, as well as the prestige of the clinic.
Conclusion
The result of using threads is comparable to expensive plastic surgery. With the help of surgical threads, you will achieve improved skin condition, face lift, and reduction of wrinkles. Be very responsible when choosing a manufacturer, otherwise you will only get side effects.
It should be understood that the result depends almost entirely on the cosmetologist performing the procedure. Carefully look for a specialist and read reviews about him.