The National tribune. [volume] (Washington, D.C.) 1877-1917, 1900-09-27
THE SURGEONS THREAD.
Many Kinds of Needles and a Variety o
Stitches Used in Operations

Stitches Used in Operations.
Imagine q tailor who deliberately plans
to have the stitches he SO carefully sews
give way at a certain time. Suppose he
should use one kind of thread in a coat,
warranted to break in one week: another
kind in the trousers, guaranteed to fall
apart in a month, and using permanent
material only in making up a waistcoat.
Yet this is exactly what the surgeon does
every day. Sutures, as the surgeons
thread is called, are made from various
materials according to the requirements.
Catgut, silk thread. silkworm gut, silver
wire, kangaroo tendons and horsehair are
in common use.
Catgut was at one time obtained from
members of the feline tribe. As its use
increased, the supply ran short. Expert
ments showed that sheep furnished an ac-
ceptable substitute. So catgut used by
surgeons, jewelers. and makers of musical
instruments comes now from the sub
mucosa, or middle layer of the intestine
of a sheep. 1t is the most commonly used
of all suturing material. Catgut stitches
are absorbed in from five to seven days,
depending on the individual upon whom
they are used. In occasional instances
catgut stitches have been known to be alb
sorbed in 80 hours. By treating it with
chronic acid, such suture will remain in
position for many weeks. Because of its
adaptability and the cheapness of the ma
terial catgut heads the list of surgical
threads.
SilkwOrm gut can be more thoroughly
sterilized than any other known suture
material. In preparing sutures of all sorts,
the usual method is to boil the material
in ether, allow it to soak for "a hours,
then place it in alcohol for day or two,
and follow this with bath of mercury
plt1tt Nntt tutar IN
cleansing, the microscope reveals germs
still present in varying numbers in many
instances. Silk worm sutures show fewer
micro-organisms than any other materials
treated in this way, hence it is highly
recommended for surgical work. The ma
terial is extracted from silkworm killed
Immediately before it begins to weave its
cocoon. Unfortunately for surgeons, silk
worm sutures are not absorbed, but re-
main permanently in place. For this rea
son its use is restricted to special work.
The short, tough tendons taken from the
tail of a kangaroo furnish surgeons with
valuable thread. kangaroo tendon
stitches will hold fast for many days.
The time of absorption is estimated from
four weeks to two months.
Horsehair and silver wire sutures are
non absorbable. The fluids OF the body
do not affect them in any way, and once
in place the stitches will remain until
forcibly removed. By some it is asserted
that silver wire has distinct antiseptic
properties. Nitrate of silver in solution is
known to be a good germicide. Hence
it is argued that a silver salt injurious to
germ development is formed by the con-
tact of body fluids with silver wire. Thus
stitch assesses are said to be of rare oc-
currence when silver wire is utilized.
Silk thread, such as is used by tailors.
but of the finest quality and Of larger cal
iber, is frequently used. The stitches are
practically non absorbable, though at times
no trace OF the thread has keen found
in the tissue at the expiration CT year.
To accommodate this assortment of
threads special varieties Of needles are
naturally required. A surgeons ''house-
wife" contains needles that would scarce
ly he recognized as such by the initiated.
Besides the needles curved in different
segments of circle, surgeons use needles
shaped like spears, javelins and bayonet
points. Some are as long as bOdkins, ter
minating in point like miniature knife
blade. Others have the sharpened end
triangular, with the apices of the angles
sharpened to a razor edge. Some few
are formed like ordinary sewing needles,
but made of greater tensil strength.
Instead of a thimble, a surgeon uses an
instrument called needle holder. 1t is
shaped like pair of scissors, the points
of which are blunt clamps. The needle
is held fast between the paws of the
clamps until released by opening the two
blades as scissors are opened. Then
fresh hold is taken and the action re-
peated with every stitch.
A skillful surgeon has perfect command
of the needle at all times. There are
moments during an operation when a
well-placed stitch means saving the life
of a patient. At such times the skillful
surgeon displays a celebrity and dizziness
not surpassed in embroidery.
The surgeon relies upon certain stitches
for different needs just as the dressmaker
picks and chooses among the various
forms of stitching. The hemstitch, cat
stitch. whalebone, herring bone, running
stitch and back-hand so dear to the femi-
nine fingers have their cOunterparts in the
surgeons mattrass suture, interrupted and
continuous suture, subcuticular suture,
purse-string and figure eight sutures, Lem
bert and Czerney sutures. AS the seam
stress selects AN appropriate stitch for a
seam, buttonhole or an edging, so the
surgeon chooses in forming his life-sav
ing stitches.