Uses of Plain Gut Fast Absorbable Suture and How They Differ From Plain Gut Suture

Fast absorbing surgical gut suture is a strand of collagenous material prepared from the sub mucosal layers of the small intestine of healthy sheep, or from the layers of the small intestine of healthy cattle. Fast absorbing surgical gut sutures are sterile and elicit only a slight to minimal tissue reaction during absorption. Fast absorbing surgical gut sutures differ from U.S.P. minimum strength requirements by less than thirty percent. Fast absorbing surgical gut sutures are intended for dermal suturing only. They should be utilized only for external knot tying procedures.

The results of implantation studies of fast absorbing surgical gut sutures in the skin of animals indicate that nearly all of its original strength is lost within approximately seven days of implantation. When surgical gut suture is placed in tissue, a moderate tissue inflammation occurs which is characteristic of the foreign body response to a substance. This is followed by a loss of tensile strength followed by a loss of suture mass, as the enzymatic digestive process dissolves the surgical gut. This process continues until the suture is completely absorbed. Many variable factors may affect the rate of absorption.  Data obtained from implantation studies in rats show that the absorption of these sutures is essentially complete by the twenty first to forty second post implantation day.

Users should be familiar with surgical procedures and techniques involving gut suture before using fast absorbing surgical gut suture for wound closure, as the risk of wound dehiscence may vary with the site of application and the suture material used. The use of this suture may be inappropriate in elderly, malnourished, or debilitated patients, or in patients suffering from conditions which may delay wound healing. As this is an absorbing material, the use of supplemental non absorbable sutures should be considered by the surgeon in the closure of sites which may undergo expansion, stretching or distention or which may require additional support. As an absorbable suture, fast absorbable surgical gut may act transiently as a foreign body. Acceptable surgical practice should be followed in the management of contaminated or infected wounds.

Adverse effects associated with the use of this fast absorbable surgical gut include wound dehiscence, variable rates of absorption over time (depending on such factors as the type of suture used, the presence of infection and the tissue site), failure to provide adequate wound support in closure of sites where expansion, stretching or distention occur, etc., unless additional support is supplied through the use of non-absorbable suture material, failure to provide adequate wound support in elderly, malnourished or debilitated patients or in patients suffering from cancer, anemia, obesity, diabetes, infection or other conditions which may delay wound healing, allergic response in patients with known sensitivities to collagen which may result in an immunological reaction resulting in inflammation, tissue granulation or fibrosis, wound suppuration and bleeding, as well as sinus formation, infection, moderate tissue inflammatory response characteristic of foreign body response, and calculi formation in urinary track when prolonged contact with salt solutions such as urine and bile occurs, and transitory local irritation at the wound site. 

Fast absorbing surgical gut sutures are only available in sizes 5-0 (metric size 1.5) and 6-0 (metric size 1.0) both with a PC-1 cutting needle which is thirteen millimeters in diameter. They are made by Ethicon and their item code numbers are 1915G for 5-0 and 1916G for 6-0.

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ACTICOAT Wound Dressing: A Wonder of Technology in a Silver Dressing

Technology has surely done wonders for the benefit of mankind and no less is the example of ACTICOAT Barrier dressing by Smith & Nephew, which is a state of the art barrier dressing. Its uniqueness lies in the way that is physical form has been manufactured. It has an external coating of silver coupled with nanocrystals that allows a wide variety of bacteria to be killed at a very fast pace. This usually takes less than half an hour, a much smaller amount of time in comparison to other forms of silver such as silver sulfadiazine or silver nitrate.  The nanocrystalline collating prevents the buildup of bacteria around the site of the wound. Underneath the silver coating is a core made of rayon and polyester that assists in controlling the level of moisture. Thus, the optimum moisture level for the healing of a wound is ensured. In addition to this, the polythene films contained in Acticoat Silver Dressing also have power over how much silver is to be released. This makes sure that as the silver ions are taken up; the right amount of silver is released over the right span of days.  The facilitation of the passage of silver through the dressing provides the patient with a most useful barrier for the protection against all forms of virus, bacteria and microbial fungi.

This silver based technology is not confined to being used only in wound dressings, but also works as an effective technology when used in implants and catheters to fight against infection. A catheter is a tube which issued to introduce liquids into a human body or to withdraw liquids from it, while an implant means to put something into a person’s body usually by means of a surgical operation. As burns are known to bring along severe risks of infection along with them, this technology of silver coating is deemed as a breakthrough the world over. ACTICOAT Barrier Dressing with Silcryst nanocrystals is an antimicrobial dressing that can be used for many kinds of wounds that include ulcers caused by pressure or diabetes, burns, recipient graft sites and cavity wounds.

The benefits of ACTICOAT are countless. Not only do they help reduce the risk of contamination, they also make sure that the barrier control is long lasting. Fortification against more than 150 disease causing organisms has been shown in-vitro. What is more, the pathogens that were included in the range were highly resistant strains such as Pseudomonas, and methicillin resistant Staphylococcus aureus, which have caused endless worries to many patients because of the ease with which they bypass the weakened immune systems. Another special characteristic of ACTICOAT barrier dressing is that yes it can be cut to any shape and size you want. This makes the application of the dressing to any body part very easy. Also, because of the controlled release of silver, you don’t have to keep on changing the dressing. This means that the wound is less exposed to the outside environment, and healing is not hampered.



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