The Sterilization of Suture Material
Suture material is applied for suture and bandaging some anatomic structures in a wound. Any contact with a wound, any operative intervention should be free from bacteria and should be conducted in sterile conditions. That's way the question about the sterilization of suture material is very relevant.
In order not to traumatize tissues in the course of operation, to cause minimal local inflammatory and allergic reaction the suture material should have smooth surface, has high durability and isn't worn out. Besides it should easily undergo sterilization without losing its quality, also forming reliable unit. Sterilization means the destruction of microorganisms and their spores with the help of physical and chemical agents.
There are several methods of sterilization of suture material, every method is applied for the certain kind of strings.
For the sterilization of nonabsorbable suture, made of synthetic materials, like silk, capron, lavsan, perlon and also the strings made of flax and cotton autoclaving is used. This method means that the skeins of suture material are washed with soap in water, rinsed and boiled in distilled water during 15 minutes. Then they are dried and put in the autoclave for 20 minutes under pressure of 2 atmospheres. The suture that undergone the sterilization is kept in 96% alcohol in hermetically sealed sterile packings.
The methods of sterilization offered by Koher and Pershin gain the wide spread occurrence in medicine. By the procedure of Koher the skeins of suture material are placed for 12 hours first in ether, and then for 12 hours in 70% ethyl alcohol. Degrease silk strings are boiled during 10 minutes in the solution of mercuric chloride, after that they are placed in sterile packings with 96% alcohol that should be changed every 7 days. By the procedure of Pershin silk, cotton and synthetic strings are degreased during 2-4 days in ether and sterilize in the solution of diocide during 2-4 hours. The sterile suture material is kept in the lean solution of diocide.
Catgut is a biological suture material resolving in the body. It is made of submucous layer of the intestines of horned cattle. Taking into account the great anaerobic microflora of catgut it should be sterilized very carefully. Catgut can't stand boiling and sterilization in the autoclave, that's why it should be sterilized with chemical agents. There are several ways of the sterilization of resolving suture material. The simplest is the treatment with the alcoholic solution by Lugol containing some iodine. Strings catgut are poured with ether during 12-24 hours. Then ether is replaced with the solution by Lugol for 8-10 days. After that the strings are poured with the fresh solution by Lugol, where they are kept. Besides there are many other methods of the sterilization of catgut - method by Sitkovskii (in fume of iodine), method by Pokotilo (catgut is placed for 3 days in the solution of formalin) and ray-path method(gamma irradiation).
As the modern methods of sterilization are regarded radiation and gas methods, which are successfully used by company "VOLOT". The gas method means the sterilization with the gas mixture containing 10% ethylene oxide. The radiation means the sterilization with the electron jet. The both methods don't influence the durability of strings and guarantee the high quality of the material.