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【2556】Pediatric Features

Most importantly, its high elasticity makes it excellent in vascular suturing.

To put it simply, the blood in the blood vessels is like a peak and a trough that fluctuates with the blood pressure. When the fluid in the blood vessel is full, it pulls the anastomosis, which can be stretched like a rubber band and not easy to break.

The elastic rope is pulled hard. When the amount of fluid in the blood vessel is at a low point, it can shrink back well to promote the healing of the wound.

This unique advantage of polypropylene thread is undoubtedly very suitable for anastomosis of the large blood vessels in and out of the heart, the largest blood pump in the human body.

For adult heart transplants, only polypropylene sutures are enough.

In pediatrics, it's different.

In pediatrics, pediatric surgeons need to focus on the characteristics of children's growth and development. In pediatric orthopedics, it is the same as in other pediatric surgeries. When it comes to anastomosis of large blood vessels for heart transplantation in pediatric cardiac surgery, pediatricians need to worry about the regeneration of children's blood vessels.

On the one hand, we can focus on the advantages of children's strong metabolism compared with adults.

Comprehensive consideration, doctors can use absorbable sutures to match non-absorbable sutures at this location, giving the child's own human tissue more room for self-repair at the anastomosis.

It means that in this operation, the doctor can sew a vascular anastomosis using half non-absorbable sutures and half absorbable sutures.

How to choose absorbable sutures? Remember, absorbable sutures will be absorbed by the body. Therefore, what the doctor has to do is to ensure that the absorbable sutures are not absorbed by the body before the wound heals. Otherwise, the wound will

If the thread disappears before it is fully healed, it also means that the suturing failed.

There are many kinds of absorbable sutures on the market, some degrade quickly and some degrade slowly. This refers to the time it takes for the suture to disappear in the human body. Is it enough to choose sutures that degrade slowly for slow-healing human tissues?

No, although some absorbable sutures degrade slowly, they provide a shorter tension support time of only a few days, which is not as good as sutures that degrade quickly and have a long tension support time. Therefore, you should pay special attention when choosing this kind of suture.

The sutured human tissue does not require strong tension support. If it does, the factor that must be considered is the tension support time.

For example, peritoneal sutures, such as current vascular sutures, all have special requirements for tension support, so this point needs to be considered. For this reason, the absorbable suture commonly used in pediatrics clinically is PDS suture. In this case, this line is placed

Is it possible to use adult large blood vessels? No. Compared with polypropylene thread, it is still inferior.

The above just shows once again that medicine is properly an engineering discipline.

It is also a technical issue for doctors to choose the suture material and how to use it well. Whether it is polypropylene thread or PDS thread, the two have one thing in common, they are too slippery. If it is slippery, it is easier to pass through the human tissue and less harm will be done.

The pain point caused by this aspect is that it is easy to slip out after tying the knot. When using these two kinds of threads to tie a knot, the doctor needs to tie several knots with other materials. It is not good to tie too many knots.

As for the suture method, interrupted suture is not suitable and continuous suture is used.

Before suturing, a total of six anastomotic sutures should be determined again and sequenced. The left pulmonary vein group should be selected first because it belongs to the posterior wall of the heart.

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