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DEXON縫線在眼科手術的使用
The Use of Dexon Absorbable Suture in Ophthalmic Surgery
並列摘要
Our experience with Dexon absorbable suture in ophthalmic surgery consists of its use in 50 patients and follow-up of these patients for a period between one to 12 months. The 50 patients comprised 26 males and 24 females with an age range between 3 and 73 years. The operations covered a variety of ophthalmic surgical procedures in the lid skin, conjunctiva, corneo-sclera and extra-ocular muscle. Table 1 showed the variety of operations, the site of suture and case numbers of each category. At operation, we found that the handling properties of Dexon sutures closely resemble those of silk but differ from catgut, for Dexon is flexible and can handled easely. It is extremely strong and no suture broke on tying during the trial. The knot holds well without slipping. Findings after operation such as tissue reaction, condition of wound and complication will be discussed in the following special groups. Group 1. Lid skin (6 patients) (Table 2) All wounds healed well. Tissue reaction of lid skin was almost mild to nil No complication was found at all. Group 2. Conjunctiva (25 patients) (Table 3) All wounds healed well. One patient developed severe tissue reaction and three patients developed moderately severe tissue reaction after operation. All the remaining wounds reacted so mild to be neglectable. Some complications occurred without attributable to the suture material. Group 3. Corneo-sclera (14 patients) (Table 4) All wounds healed well. There one severe and one moderate wound reaction but otherwise minimal local reaction occurred. The severe one had prolonged the congestive tissue reaction for more than one month but it had returned to normal at last. No complication related to suture occurred. Group 4. Extra-ocular muscle (5 patients) (Table 5) All wounds reacted mild to moderate in degree and the healing processes were quite good. No complication occurred in all the cases. Observations from the above-mentioned variety of ophthalmic surgical procedures revealed the Dexon suture was well tolerated and was not absorbed before adequate healing took place. No postoperative wound separation or poor wound healing occurred. Only rarely had adverse reactions or complications followed the use of Dexon sutures. All of these may be experienced following the use of any suture material and they are not uniquely attributable to Dexon sutures. Late results of these observations revealed the wounds closed with the Dexon were essentially indistinguishable from those closed with conventional suturing technique. This study has shown that Dexon absorbable suture can be used safely in tissue repair in ophthalmic field including lid skin, conjunctiva, cornea, sclera, and extra-ocular muscle. They offer a definite advantage in the closure of corneal wounds because they do not have to be removed. The removal of corneal sutures is frequently a hazardous procedures and may result in loss of anterior chamber, wound separation, or even hyphema. In children the removal of nonaborlable sutures usually necessitates a second general anesthesia. Most of these difficulties may be obviated by the use of Dexon sutures which are absorbable and do not require removal. (The part of this report was presented at the 14th annual meeting of the Ophthalmological Society of the Republic of China on Dec. 2, 1973)