{"id":118826,"date":"2023-04-18T01:31:28","date_gmt":"2023-04-18T08:31:28","guid":{"rendered":"https:\/\/www.pandasilk.com\/are-silk-sutures-absorbable\/"},"modified":"2025-01-15T10:32:13","modified_gmt":"2025-01-15T18:32:13","slug":"are-silk-sutures-absorbable","status":"publish","type":"post","link":"https:\/\/www.pandasilk.com\/cs\/are-silk-sutures-absorbable\/","title":{"rendered":"Jsou hedv\u00e1bn\u00e9 stehy vst\u0159ebateln\u00e9? Rozbor a fakta."},"content":{"rendered":"

Hedv\u00e1bn\u00e9 stehy jsou v chirurgii pou\u017e\u00edv\u00e1ny po stalet\u00ed pro svou jemnost a pevnost. Ot\u00e1zka jejich vst\u0159ebatelnosti je v\u0161ak kl\u00ed\u010dov\u00e1 pro pochopen\u00ed jejich pou\u017eit\u00ed a n\u00e1sledn\u00e9 hojen\u00ed. Na rozd\u00edl od syntetick\u00fdch materi\u00e1l\u016f, kter\u00e9 se \u010dasto pln\u011b vst\u0159ebaj\u00ed, hedv\u00e1bn\u00e9 stehy se vst\u0159eb\u00e1vaj\u00ed pomaleji a ne v\u017edy \u00fapln\u011b. Tento \u010dl\u00e1nek se podrobn\u011bji zam\u011b\u0159\u00ed na vlastnosti hedv\u00e1bn\u00fdch steh\u016f a jejich vst\u0159ebatelnost.<\/p>\n

Vst\u0159ebatelnost versus rozpustnost<\/p>\n

Je d\u016fle\u017eit\u00e9 rozli\u0161ovat mezi vst\u0159ebatelnost\u00ed a rozpustnost\u00ed. Vst\u0159ebateln\u00e9 stehy se postupn\u011b rozkl\u00e1daj\u00ed v t\u011ble a jsou t\u011blem metabolizov\u00e1ny. Rozpustn\u00e9 stehy se naopak rozpou\u0161t\u011bj\u00ed v t\u011bln\u00edch tekutin\u00e1ch. Hedv\u00e1bn\u00e9 stehy nejsou ani vst\u0159ebateln\u00e9 v prav\u00e9m slova smyslu, ani rozpustn\u00e9. M\u00edsto toho se postupn\u011b oslabuj\u00ed a degraduj\u00ed vlivem enzymatick\u00e9 aktivity a hydrol\u00fdzy. Tento proces je pomal\u00fd a z\u00e1vis\u00ed na n\u011bkolika faktorech.<\/p>\n

Faktory ovliv\u0148uj\u00edc\u00ed degradaci hedv\u00e1bn\u00fdch steh\u016f<\/p>\n

    \n
  1. Typ hedv\u00e1b\u00ed:<\/strong> Kvalita a zpracov\u00e1n\u00ed hedv\u00e1b\u00ed ovliv\u0148uje jeho odolnost v\u016f\u010di degradaci. Vy\u0161\u0161\u00ed kvalita hedv\u00e1b\u00ed obecn\u011b znamen\u00e1 pomalej\u0161\u00ed rozklad.<\/li>\n
  2. Tlou\u0161\u0165ka stehu:<\/strong> Ten\u010d\u00ed stehy se rozkl\u00e1daj\u00ed rychleji ne\u017e siln\u011bj\u0161\u00ed.<\/li>\n
  3. Um\u00edst\u011bn\u00ed stehu:<\/strong> Stehy v oblastech s vysokou enzymatickou aktivitou (nap\u0159. v za\u017e\u00edvac\u00edm traktu) se rozkl\u00e1daj\u00ed rychleji.<\/li>\n
  4. Infekce:<\/strong> Infekce v r\u00e1n\u011b m\u016f\u017ee urychlit degradaci steh\u016f.<\/li>\n
  5. Hydratace:<\/strong> Vlhkost prost\u0159ed\u00ed ovliv\u0148uje rychlost hydrol\u00fdzy.<\/li>\n<\/ol>\n

    \u010casov\u00e1 osa degradace<\/p>\n

    P\u0159esn\u00e1 doba, za kterou se hedv\u00e1bn\u00e9 stehy rozlo\u017e\u00ed, je velmi variabiln\u00ed a nelze ji p\u0159esn\u011b ur\u010dit. Obecn\u011b se v\u0161ak d\u00e1 \u0159\u00edci, \u017ee proces degradace trv\u00e1 n\u011bkolik t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f. Stehy se postupn\u011b zten\u010duj\u00ed a ztr\u00e1cej\u00ed na pevnosti, dokud se nakonec \u00fapln\u011b nerozlo\u017e\u00ed. V n\u011bkter\u00fdch p\u0159\u00edpadech mohou z\u016fstat mal\u00e9 zbytky hedv\u00e1b\u00ed v t\u011ble, kter\u00e9 v\u0161ak t\u011blo v\u011bt\u0161inou bez probl\u00e9m\u016f vst\u0159eb\u00e1.<\/p>\n

    Srovn\u00e1n\u00ed s jin\u00fdmi typy steh\u016f<\/p>\n\n\n\n\n\n\n\n\n
    Typ stehu<\/th>\nVst\u0159ebatelnost<\/th>\nDoba degradace<\/th>\nPevnost<\/th>\n<\/tr>\n<\/thead>\n
    Hedv\u00e1b\u00ed<\/td>\n\u010c\u00e1ste\u010dn\u00e1, pomal\u00e1 degradace<\/td>\nT\u00fddny a\u017e m\u011bs\u00edce<\/td>\nVysok\u00e1<\/td>\n<\/tr>\n
    Katgut<\/td>\nVst\u0159ebateln\u00fd<\/td>\nDny a\u017e t\u00fddny<\/td>\nSt\u0159edn\u00ed<\/td>\n<\/tr>\n
    Polyglykolov\u00e1 kyselina (PGA)<\/td>\nVst\u0159ebateln\u00e1<\/td>\nT\u00fddny a\u017e m\u011bs\u00edce<\/td>\nSt\u0159edn\u00ed<\/td>\n<\/tr>\n
    Polydioxanon (PDS)<\/td>\nVst\u0159ebateln\u00fd<\/td>\nM\u011bs\u00edce<\/td>\nVysok\u00e1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Z\u00e1v\u011br<\/p>\n

    Hedv\u00e1bn\u00e9 stehy nejsou pln\u011b vst\u0159ebateln\u00e9 v tradi\u010dn\u00edm smyslu slova. Degraduj\u00ed pomalu v pr\u016fb\u011bhu n\u011bkolika t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f v z\u00e1vislosti na n\u011bkolika faktorech. I kdy\u017e se nerozkl\u00e1daj\u00ed tak rychle jako n\u011bkter\u00e9 vst\u0159ebateln\u00e9 syntetick\u00e9 materi\u00e1ly, jejich pomal\u00e1 degradace a vysok\u00e1 pevnost je \u010din\u00ed vhodn\u00fdmi pro ur\u010dit\u00e9 chirurgick\u00e9 z\u00e1kroky. Je d\u016fle\u017eit\u00e9 si uv\u011bdomit variabilitu doby degradace a konzultovat s chirurgem nejvhodn\u011bj\u0161\u00ed typ stehu pro dan\u00fd z\u00e1krok.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Hedv\u00e1bn\u00e9 stehy jsou v chirurgii pou\u017e\u00edv\u00e1ny po stalet\u00ed pro svou jemnost a pevnost. Ot\u00e1zka jejich vst\u0159ebatelnosti je v\u0161ak kl\u00ed\u010dov\u00e1 pro pochopen\u00ed jejich pou\u017eit\u00ed a n\u00e1sledn\u00e9 hojen\u00ed. Na rozd\u00edl od syntetick\u00fdch materi\u00e1l\u016f, kter\u00e9 se \u010dasto pln\u011b vst\u0159ebaj\u00ed, hedv\u00e1bn\u00e9 stehy se vst\u0159eb\u00e1vaj\u00ed pomaleji a ne v\u017edy \u00fapln\u011b. Tento \u010dl\u00e1nek se podrobn\u011bji zam\u011b\u0159\u00ed na vlastnosti hedv\u00e1bn\u00fdch steh\u016f a<\/p>\n","protected":false},"author":1,"featured_media":101432,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37823],"tags":[],"class_list":["post-118826","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-faqs-cs","prodpage-classic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/posts\/118826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/comments?post=118826"}],"version-history":[{"count":0,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/posts\/118826\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/media\/101432"}],"wp:attachment":[{"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/media?parent=118826"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/categories?post=118826"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pandasilk.com\/cs\/wp-json\/wp\/v2\/tags?post=118826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}