SILK as ni arieses y m ate-r and and l — the threads from natural silk used for a surgical seam and ligatures.
Use of silk as suture material (see) it is mentioned in the literary monuments of ancient Egypt which reached us. The detailed description of a seam is provided by silk in the Indian source of medicine to Ayurveda (see).
In surgical practice use silk threads of various thickness. Threads No. 1 are most used (to dia. 0,23 — 0,255 mm, breaking weight of 1250 g*s), No. 4 (to dia. 0,44 — 0,495 mm, breaking weight 4400 — 4450 g*s), No. 8 (to dia. 0,68 — 0,77 mm, breaking weight of 10300 — 10500 g * c). The most fine silk (No. 000) has diameter of thread of 0,13 — 0,14 mm, a breaking weight of 370 g * page. Threads of zero numbers release connected to atraumatic needles and sterilized, threads of other numbers — in unsterile hanks; length of thread for numbers 1, 2 and 3 is equal in a hank to 50±1 m, for numbers 4, 6 and 8 — 20 ±0,5 of m. Sh. also in the soldered ampoules, the filled 70% alcohol, with a length of thread of 1 — 2 m, sterilized by gamma radiation is issued. Zero numbers III. use for a vascular seam (see), number 3 —
396 SILK PRODUCTION
4 — for connection of soft tissues, thicker threads — for rapprochement of edges at thoracic operations, imposings of secondary P-ob-raznykh seams on the granulating wounds etc.
As a suture material of Sh. has a number of negative properties, in particular hygroscopicity and ability to cause the expressed inflammatory reaction in surrounding fabrics. The last can proceed a long time, proceeding as an aseptic inflammation. At accession of pyogenic microflora suppuration of a wound develops and there are alloyed fistulas (see the Ligature). In this regard, and also due to the lack of appropriate durability at fine ends of Sh. in surgical practice even more often replace synthetic not resolving or it is long the resolving suture material (capron, nylon, lavsan, vikrit, PDS, etc.), especially at suture on vessels (see. Vascular seam), bodies went. - kish. a path (see. Intestinal seam), bronchial tubes, etc.
III. will sterilize in surgical departments, a thicket by Kokher's method. Sh.'s autoclaving did not gain distribution because of considerable strength loss of threads. Just before sterilization Sh.'s hanks subject to power tool cleaning for what they are washed in Tazy with hot water in soapsuds to light water (water 2 — 3 times change). Further manipulations are made in the same conditions of sterility, as well as surgery: process
hands, put on a sterile mask, a dressing gown, gloves, lay a table a sterile sheet. Sterile towels dry Sh.'s hanks, the son-in-law reel up threads on glass coils or slide plates with not keen edges and immerse them for 24 hours in the glass jars with a ground stopper filled with ether. After that the sterile tool Sh. shift in banks from 70% alcohol also for 24 hours, and then boil in the enameled pan in solution of corrosive sublimate 1: 1000 within 10 — 20 min. (depending on thickness of threads). For further storage of the coil with silk shift in banks with a ground stopper, the filled 96% alcohol, and in 2 days take a piece of thread for control bacterial. researches. In the absence of growth of microflora of Sh. it can be used during operation. Before operation of the coil with silk boil within 2 min. in solution of corrosive sublimate 1: 1000.
Store silk in the marked banks with the indication of number of threads, dates of preparation and bacterial. researches. Alcohol is changed by each 10 days. During the replacement of alcohol carry out control bacterial. researches of threads Sh.
Bibliography: Kabatov Yu. F. and P. E's List distance. Medical merchandizing, page 74, M., 1984. V. K. Gostishchev.