Title:
BARBED SUTURE
United States Patent 3716058
Abstract:
A surgical suture useful in closing incisions, lacerations and wounds of human tissue comprising a relatively short section of rigid or flexible suture material with a return barb on both ends. The suture may be flat or arcuate and may contain single or multiple barbs on the ends. A notched and slotted needle is useful in inserting flexible sutures.
US Patent References:
Lip and mouth adjuster
Eaton - January 1957 - 2779083
Surgical connecting device
Noble - December 1965 - 3221746
/1321011.html
Cottes - November 1919 - 1321011
Surgical clip
Brown - October 1965 - 3209754
/3123077.html
Alcamo - March 1964 - 3123077
Lip and mouth adjuster
Eaton - January 1957 - 2779083
Surgical connecting device
Noble - December 1965 - 3221746
/1321011.html
Cottes - November 1919 - 1321011
Surgical clip
Brown - October 1965 - 3209754
/3123077.html
Alcamo - March 1964 - 3123077
Application Number:
05/055927
Publication Date:
02/13/1973
Filing Date:
07/17/1970
View Patent Images:
Export Citation:
Primary Class:
International Classes:
A61B17/064; A61B17/11; A61B17/06; A61B17/03; A61B17/04
Field of Search:
128/334,335,337,339,346
US Patent References:
| 2817339 | Rigid fascial suture | December 1957 | Sullivan |
Primary Examiner:
Truluck, Dalton L.
Claims:
I claim
1. A barbed suture of a length between 5/8ths of an inch and 4 inches having an intermediate body portion at least one barb on each end of the body portion, each end being sufficiently sharp to easily penetrate human tissue and each barb forming an acute angle with respect to the body portion of the suture, said ends being in substantial axial alignment with said body portion, said suture being adapted to be inserted into and snag on or penetrate into human tissue.
2. The barbed suture of claim 1 wherein the suture is constructed of substantially rigid material.
3. The barbed suture of claim 1 wherein the body portion is arcuate in configuration and the suture is constructed of a material having sufficient rigidity to return to its arcuate shape after deflection therefrom.
4. The barbed suture of claim 1 wherein the suture includes multiple barbs on each end of the body portion.
1. A barbed suture of a length between 5/8ths of an inch and 4 inches having an intermediate body portion at least one barb on each end of the body portion, each end being sufficiently sharp to easily penetrate human tissue and each barb forming an acute angle with respect to the body portion of the suture, said ends being in substantial axial alignment with said body portion, said suture being adapted to be inserted into and snag on or penetrate into human tissue.
2. The barbed suture of claim 1 wherein the suture is constructed of substantially rigid material.
3. The barbed suture of claim 1 wherein the body portion is arcuate in configuration and the suture is constructed of a material having sufficient rigidity to return to its arcuate shape after deflection therefrom.
4. The barbed suture of claim 1 wherein the suture includes multiple barbs on each end of the body portion.
Description:
The present invention relates to individual surgical sutures and more particularly concerns a relatively short surgical suture having return barbs on the ends thereof.
In manual suturing of the incisions, lacerations and wounds to human tissue, a suture is stitched through the tissue and tied to hold the incised, lacerated or wounded edges together for healing. Such an operation is time consuming and often leaves scars in the areas surrounding the suture. In addition, conventional suturing techniques for rejoining the ends of such items as severed nerves have become quite complicated and often unsuitable. It is an object of the present invention therefore to provide a relatively short barbed suture which may be used to suture human tissues in an efficient and effective manner.
This and other objects, features and advantages of the present invention will become apparent from a review of the following detailed description and the accompanying drawings wherein:
FIG. 1 is a side elevational view of one embodiment of the present invention;
FIG. 2 is a side elevational view of another embodiment of the present invention;
FIG. 3 is a side elevational view of another embodiment of the present invention;
FIG. 4 is a side elevational view of another embodiment of the present invention;
FIG. 5 is an elevational view of the insertion needle of the present invention;
FIG. 6 is an elevational view of the insertion needle of FIG. 5 after 180° rotation thereof; and
FIG. 7 shows a laceration of tissue in cross-section which is closed by an internal suture of the present invention.
Referring now to the drawings, and more particularly to FIG. 1, it may be seen that the barbed suture 10 is a relatively short section of suture material having return barbs 12 and 14 at acute angles with respect to the body portion 16 of the suture. It has been found that this type of suture prevents slippage in sutured incisions, lacerations, or wounds. The suture is generally a fiber, filament or thread of "cat gut" or other suitable material such as silk, cotton, synthetic material, nylon or wire. It is preferable that the suture material have sufficient dimensional stability to assume a substantially rigid configuration during use of the barbed suture. A particularly preferred material is absorbed by the human body after a period of time so that the suture does not require removal from its inserted position.
The suture is basically an internal stitching element which is positioned by insertion into opposite walls of the incision, laceration or wound below the external surface of the particular section of tissue involved. The barbed suture is driven into the tissue by manual force and the barbs on the ends of the suture are designed and adapted to snag or penetrate into surrounding tissue and thereby prevent slippage of the suture.
The suture shown in FIG. 1 is substantially flat but it should be understood that this suture as well as the other embodiments may be non-straight and may also be non-uniform in diameter. The barbs on the suture of this figure are on the same side of the body portion of the suture and are directed generally toward each other.
In FIG. 2 a barbed suture 20 is shown with barbs 22 and 24 which lie on opposite sides of the body portion 26 of the suture. These barbs form acute angles with respect to the body portion and are generally directed toward each other. Otherwise this suture is identical to that shown in FIG. 1.
In FIG. 3 a barbed suture 30 is shown with double barbs 32 and 34. These double barbs form acute angles with the body portion 36 of the suture and are generally directed toward each other. It should be understood that the present invention also encompasses sutures having multiple barbs on either end in excess of two when such an arrangement is desirable.
In FIG. 4 an arcuate barbed suture 40 is shown with single barbs 42 and 44 on either end forming acute angles with respect to body portion 46. The arcuate configuration of this suture requires the use of a resiliant suture material such as hard wire which is capable of returning to an original configuration after deflection therefrom. The arcuate suture finds particularly interesting use in closing deep lacerations and incisions. The suture is momentarily deflected to a flat shape and inserted into the opposite walls of the laceration or incision at a relatively deep level. The resiliance of the suture material then deflects the suture back to its original configuration which causes the upper level and surface are of the wound to close. Thus the suture serves to both stitch the incision or laceration at a deep level and force the upper level and surface area of the incision or laceration closed. With conventional techniques such an operation would have possibly required tow levels of conventional sutures; one lower level of sutures to close the lower area of the wound and a second upper level of sutures to close the surface area of the wound. FIG. 7 shows such an arcuate suture in position within a section of lacerated tissue.
It has been found that when manually inserting these sutures into position within tissue, an appropriately modified hollow needle is quite helpful for the more flexible sutures. Such a needle 50 includes a shaft 52 and a base cap 54, both of which are of conventional manufacture. The distal end of the shaft is modified to include a notch 56 for carrying a barb such as barb 24 of barbed suture 20. On the side of the shaft opposite form the notch, there is defined a slot 58. In use, a barb of a barbed suture would be carried in notch 56 during insertion of the suture into one wall of a wound. After insertion, the needle would be removed rearwardly from the area and the body portion of the barbed suture would pass through slot 58. Such an operation would be repeated for the opposite end of the suture for the completion of the insertion operation. It should be understood, of course, that slot 58 may be positioned along the needle in areas other than immediately behind notch 56 at 180° rotation of the needle. Such an arrangement is shown here simply for purposes of illustration.
One interesting application of these sutures is in the suturing of severed nerve ends. Through the use of a very small barbed suture, the nerve ends may be efficiently and effectively joined for healing by positioning one end of the suture in one nerve end and the opposite end of the suture in the opposite nerve end. With this procedure it is not necessary to stitch through and around both ends of the nerve in order to obtain a strong joint.
The barbs on the sutures of the present invention may be prepared by bending the ends of the suture toward the body portion thereof when the suture material is a rigid material, such as wire. When employing synthetic plastics and natural filaments it is necessary to construct a barb on both ends of the suture through conventional techniques. It is preferable that the barbs be prepared from the same material as the body of the suture, but when using inherently flexible material such as nylon, silk or cotton thread, the barbs must be of another material such as an appropriate metal. No matter what type of barb is employed or what technique is used to create the barb on the suture, it is important for the ends of the barb to be sufficiently sharp to penetrate or snag on tissue as retracting force is applied to an inserted suture.
When employing a metallic suture such as wire, it has been found that wire of a gauge size between 40 AWG and 8 AWG yields suitable results. Whem employing a synthetic or natural thread as the suture (such as nylon, silk, catgut and the like), it has been found that a thread size of 00000 to 6 yields suitable results. Whem employing both metallic and thread sutures, an overall length of suture material of from 3/8ths of an inch to 4 inches yields suitable results.
While this invention has been described in detail with particular reference to preferred embodiments thereof, it should be understood that variations and modifications can be effected within the spirit and scope of the invention as described hereinbefore and as defined in the appended claim.
In manual suturing of the incisions, lacerations and wounds to human tissue, a suture is stitched through the tissue and tied to hold the incised, lacerated or wounded edges together for healing. Such an operation is time consuming and often leaves scars in the areas surrounding the suture. In addition, conventional suturing techniques for rejoining the ends of such items as severed nerves have become quite complicated and often unsuitable. It is an object of the present invention therefore to provide a relatively short barbed suture which may be used to suture human tissues in an efficient and effective manner.
This and other objects, features and advantages of the present invention will become apparent from a review of the following detailed description and the accompanying drawings wherein:
FIG. 1 is a side elevational view of one embodiment of the present invention;
FIG. 2 is a side elevational view of another embodiment of the present invention;
FIG. 3 is a side elevational view of another embodiment of the present invention;
FIG. 4 is a side elevational view of another embodiment of the present invention;
FIG. 5 is an elevational view of the insertion needle of the present invention;
FIG. 6 is an elevational view of the insertion needle of FIG. 5 after 180° rotation thereof; and
FIG. 7 shows a laceration of tissue in cross-section which is closed by an internal suture of the present invention.
Referring now to the drawings, and more particularly to FIG. 1, it may be seen that the barbed suture 10 is a relatively short section of suture material having return barbs 12 and 14 at acute angles with respect to the body portion 16 of the suture. It has been found that this type of suture prevents slippage in sutured incisions, lacerations, or wounds. The suture is generally a fiber, filament or thread of "cat gut" or other suitable material such as silk, cotton, synthetic material, nylon or wire. It is preferable that the suture material have sufficient dimensional stability to assume a substantially rigid configuration during use of the barbed suture. A particularly preferred material is absorbed by the human body after a period of time so that the suture does not require removal from its inserted position.
The suture is basically an internal stitching element which is positioned by insertion into opposite walls of the incision, laceration or wound below the external surface of the particular section of tissue involved. The barbed suture is driven into the tissue by manual force and the barbs on the ends of the suture are designed and adapted to snag or penetrate into surrounding tissue and thereby prevent slippage of the suture.
The suture shown in FIG. 1 is substantially flat but it should be understood that this suture as well as the other embodiments may be non-straight and may also be non-uniform in diameter. The barbs on the suture of this figure are on the same side of the body portion of the suture and are directed generally toward each other.
In FIG. 2 a barbed suture 20 is shown with barbs 22 and 24 which lie on opposite sides of the body portion 26 of the suture. These barbs form acute angles with respect to the body portion and are generally directed toward each other. Otherwise this suture is identical to that shown in FIG. 1.
In FIG. 3 a barbed suture 30 is shown with double barbs 32 and 34. These double barbs form acute angles with the body portion 36 of the suture and are generally directed toward each other. It should be understood that the present invention also encompasses sutures having multiple barbs on either end in excess of two when such an arrangement is desirable.
In FIG. 4 an arcuate barbed suture 40 is shown with single barbs 42 and 44 on either end forming acute angles with respect to body portion 46. The arcuate configuration of this suture requires the use of a resiliant suture material such as hard wire which is capable of returning to an original configuration after deflection therefrom. The arcuate suture finds particularly interesting use in closing deep lacerations and incisions. The suture is momentarily deflected to a flat shape and inserted into the opposite walls of the laceration or incision at a relatively deep level. The resiliance of the suture material then deflects the suture back to its original configuration which causes the upper level and surface are of the wound to close. Thus the suture serves to both stitch the incision or laceration at a deep level and force the upper level and surface area of the incision or laceration closed. With conventional techniques such an operation would have possibly required tow levels of conventional sutures; one lower level of sutures to close the lower area of the wound and a second upper level of sutures to close the surface area of the wound. FIG. 7 shows such an arcuate suture in position within a section of lacerated tissue.
It has been found that when manually inserting these sutures into position within tissue, an appropriately modified hollow needle is quite helpful for the more flexible sutures. Such a needle 50 includes a shaft 52 and a base cap 54, both of which are of conventional manufacture. The distal end of the shaft is modified to include a notch 56 for carrying a barb such as barb 24 of barbed suture 20. On the side of the shaft opposite form the notch, there is defined a slot 58. In use, a barb of a barbed suture would be carried in notch 56 during insertion of the suture into one wall of a wound. After insertion, the needle would be removed rearwardly from the area and the body portion of the barbed suture would pass through slot 58. Such an operation would be repeated for the opposite end of the suture for the completion of the insertion operation. It should be understood, of course, that slot 58 may be positioned along the needle in areas other than immediately behind notch 56 at 180° rotation of the needle. Such an arrangement is shown here simply for purposes of illustration.
One interesting application of these sutures is in the suturing of severed nerve ends. Through the use of a very small barbed suture, the nerve ends may be efficiently and effectively joined for healing by positioning one end of the suture in one nerve end and the opposite end of the suture in the opposite nerve end. With this procedure it is not necessary to stitch through and around both ends of the nerve in order to obtain a strong joint.
The barbs on the sutures of the present invention may be prepared by bending the ends of the suture toward the body portion thereof when the suture material is a rigid material, such as wire. When employing synthetic plastics and natural filaments it is necessary to construct a barb on both ends of the suture through conventional techniques. It is preferable that the barbs be prepared from the same material as the body of the suture, but when using inherently flexible material such as nylon, silk or cotton thread, the barbs must be of another material such as an appropriate metal. No matter what type of barb is employed or what technique is used to create the barb on the suture, it is important for the ends of the barb to be sufficiently sharp to penetrate or snag on tissue as retracting force is applied to an inserted suture.
When employing a metallic suture such as wire, it has been found that wire of a gauge size between 40 AWG and 8 AWG yields suitable results. Whem employing a synthetic or natural thread as the suture (such as nylon, silk, catgut and the like), it has been found that a thread size of 00000 to 6 yields suitable results. Whem employing both metallic and thread sutures, an overall length of suture material of from 3/8ths of an inch to 4 inches yields suitable results.
While this invention has been described in detail with particular reference to preferred embodiments thereof, it should be understood that variations and modifications can be effected within the spirit and scope of the invention as described hereinbefore and as defined in the appended claim.