Silk

Silk is used in surgery for sutures, ligatures, and in appropriate cases for tendon plasticity. To prevent unraveling, twisted or braided S. is used. S. is sold in spools up to 10 m in length. The thickness of S. is indicated by corresponding numbering. Twisted S. has numbering 00, 0, 1, 2, 3, 37«, 4, 472, 5, 6, 7, 8. The most commonly used are No. 1 (intestinal) and thicker ones for aponeurosis. The thickness of S. No. 1 is 0.01 mm, and No. 8 is 0.14 mm. The first withstands a load of 0.8 kg at break, the second - 6.2 kg. Braided, so-called English S. is produced in 17 sizes. For eye operations, black S. is manufactured by Turner's method. Some firms produce this S., as well as ordinary S., in Vomel's aseptic solution in small bottles with screw caps. After preliminary degreasing and winding on spools, S. is sterilized by boiling in mercuric chloride or dry in an autoclave. Extra-thin S., used for vascular sutures, is sterilized for 10-20 minutes at 130° in oil or liquid paraffin, where it is stored until use. Brunner, Haegler believe that S., in addition to sterilization by the aforementioned methods, must be given bactericidal or bacteriostatic properties, which is achieved by impregnating S. with antiseptic agents (see Antisepsis and asepsis). After sterilization, S. is stored in pure alcohol or in alcohol with added antiseptic agents (thymol, formalin, mercuric chloride). To prevent secondary contamination, S. is stored in special jars that allow the procedure of removing S. to be performed using forceps and prevent tangling of threads. For storing sterile S., special jars by Schwabe (fig. 1, 2), Schuler (fig. 3), Dyakonov (fig. 4) and various other modifications (fig. 5, 6, 7, 8, 9, 10, 11) are available. For the same purpose, Schimmelbusch proposed a cylinder with a ground-in stopper (fig. 12, 13). S. is wound on special spools (fig. 14), pegs (fig. 15) and plates (fig. 16). For winding S. on spools of various sizes, special devices are available (fig. 17). To maintain greater asepsis, it is recommended to take S. directly from spools enclosed in special drums. For this purpose, Braun proposed a ring (fig. 18), and Lanz - a glass egg with a spool inside (fig. 19). For grasping and threading ligatures into a needle, there is the Rubaix forceps (fig. 20). S. belongs to the non-absorbable materials. At present, in the USSR, instead of S., remiz thread is widely used, which is distinguished by great strength.