摘要
医用手术缝合线种类丰富,其制备原料可分为天然材料、合成材料及金属材料等,其中天然高聚物基手术缝合线以其优异的生物相容性、低免疫原性等特性在市场上占据主体地位,但仍存在机械性能较差、降解速率难以调控等问题。为了改善天然高聚物基缝合线的性能,促进新型缝合线的研究发展,并使其进一步满足医用领域的应用需求,本文综述了蚕丝基、胶原基、甲壳素基三类天然高聚物基缝合线的研究现状,比较了三者在实际应用中的优缺点,并分析了三者存在的性能缺陷及改进方向,以期为天然高聚物基手术缝合线的研究发展提供参考。
The surgical suture,a kind of medical material used to suture wound and connective tissue in surgery,is also the most common implantable material.Medical-surgical sutures are abundant in raw materials,including natural materials,synthetic materials and metal materials.Among them,natural polymer-based surgical sutures occupy a dominant position in the market due to their excellent biocompatibility,low immunogenicity and other characteristics.However,there are still some problems,such as poor mechanical properties and difficulty in regulating the degradation rate.In order to improve the property of natural polymer-based sutures and promote the development and application of new sutures,we summarize the research status of silk-based sutures,collagen-based sutures and chitin-based sutures.We compare their merit and demerit in practical application and analyze their existing performance defects and improvement direction,so as to provide a reference for the development of natural polymer-based surgical sutures.Silk-based sutures have a long history of application in the field of sutures because of their excellent hygroscopic properties,operability and knotting stability.However,the disadvantages of monofilament sutures such as poor biodegradability and susceptibility to infection limit the application of silk sutures.Therefore,medical silk sutures generally require antibacterial treatment.The common method is to load antibacterial coatings on the surface of the sutures and new coatings capable of broad-spectrum bactericidal and drug slow-release functions are still being explored.Most of the studies domestically and overseas focus on the improvement of coating modification methods,while there are few studies on the improvement of fiber properties.Based on silk fibers,researchers can improve the performance of the fiber and endow it with special functions such as antibacterial function in future studies,which can effectively improve the performance of silk sutures and expand their application ranges.As an absorbable medical suture material,the collagen-based suture can effectively suture wounds,promote healing and reduce scars.However,compared with other sutures,collagen-based sutures exhibit lower tensile strength and knot strength.In addition,the degradation rate of collagen-based sutures is fast,which makes it difficult to keep pace with the rate of wound healing,resulting in the problem that the sutures have been degraded and absorbed before the wound is healed.In recent years,there are few studies on the modification of collagen-based sutures,which gradually weakens their market competitiveness and restricts their development.If new green crosslinking agents can be developed to improve the mechanical properties of collagen-based sutures,or the sutures can be chemically modified to achieve controllable degradation,the clinical application of collagen-based sutures will be further promoted.Chitin-based sutures,including chitin sutures and chitosan sutures,have unique physiological functions such as hemostasis,pain relief,and antibacterial and anti-inflammatory functions,without additional coating or grafting treatment.Due to the biological inertness of chitin,sutures are less likely to cause complications or tissue reactions after implantation,but the mechanical strength of sutures is poor.Therefore,current research focuses on improving the performance of sutures by blending,chemical modification or developing new spinning processes.The mechanical properties of chitosan sutures are slightly better than those of chitin sutures,but are still lower than those of common silk sutures.Therefore,the current research direction of chitosan sutures is mainly to make the most of antibacterial function and improve mechanical properties.The existing extraction process of chitin is relatively complex,and the dissolution conditions are relatively harsh.If a green,simple and efficient extraction method can be explored,it will be more conducive to the research and application of chitin-based products.Improving the physical and mechanical properties and expanding the application range will be the main direction of the research and development of chitin-based sutures in the future.Nowadays,in the era of rapid development of science and technology,new natural materials are constantly developed and used,and the types of natural polymer-based sutures are gradually expanded.With the increasing coverage and difficulty of surgical procedures,the performance of suture materials is becoming increasingly strict in surgery,which promotes the rapid research and application of sutures to a certain extent.In view of the above-mentioned characteristics and problems of natural polymer-based sutures,researchers can develop advanced manufacturing technology,develop new suture materials and realize multi-functional sutures to carry out in-depth and systematic research in future study.
作者
杨鑫
张昕
潘志娟
YANG Xin;ZHANG Xin;PAN Zhijuan(College of Textile and Clothing Engineering,Soochow University,Suzhou 215021,China;National Engineering Laboratory for Modern Silk,Suzhou 215123,China)
出处
《丝绸》
CAS
CSCD
北大核心
2023年第3期1-7,共7页
Journal of Silk
