TYPES OF SUTURES Absorbable Sutures 1.

Surgical Gut Surgical guts are also known as a catgut and is made from the submucous layer of a sheep's intestine. Once cleaned, dried and twisted into threads of various sizes they are prepared for use by special processes, that include innumerable inspections of gauze and tensile strength and scrupulous sterilization. The length of time for complete absorption of surgical gut in a wound varies according to the action of certain hardening agents. 2. Fascia Lata This muscle connective tissue of beef has been used in reconstructive orthopedic surgery and for the repair of hernias. It is not a true absorbable suture, but becomes part of the tissue after the wound has healed. Non-absorbable Sutures 1. Silk This is prepared from the thread spun by the silkworm larva in making its cocoon. It may be twisted or braided, and it comes in sizes comparable with surgical gut. - High tensile strength - Relatively inexpensive - Less tissue reaction 2. Cotton This is made from cotton fibers. The strands are twisted and used for both internal and external suture. It should always be used wet for maximal strength. 3. Nylon - Monofilament - Multifilament - Braided - The chief disadvantage is that a triple knot must be tied 4. Wire This material has maximal flexibility and tensile strength, yet causes little or no local reaction in the tissue in which it is placed. 5. Dacron This is a synthetic polyester fiber that has greater tensile strength, minimal tissue reaction, maximal

visibility, non-absorbent and non-fraying qualities. 6. Linen This is made of twisted line thread; it has sufficient tensile strength but is rarely used as suture material. 7. Silver Wire Clips Many styles of clips are available for the purpose of holding the edges of the tissue in approximation. They tend to produce some scarring when used in the skin, but may be used when the wound is infected. 8. Silkworm Gut This is made from the fluid secreted by the silkworm when they are ready to form their cocoons. The disadvantage is that they must be soaked in normal saline for about 10 minutes before use to make them pliable. 9. Mesh This type of suture is made of stainless steel, usually used for hernia repairs and large defects. It is rarely used. 10. Tantalum This is a bluish bray metal that is non-irritating to the body tissues. It is used because of its high tensile strength and its inert reaction to tissues. PETCRYL 910 - Polyglactin 910 Sutures PETCRYL 910 [Polyglactin 910] suture is a braided and coated synthetic absorbable surgical suture and is co-polymer of 90% Glycolide and 10% L-lactide. PETCRYL 910 Sutures retain tensile strength of about 70% of initial strength at 14 days of implantation. PETCRYL 910 sutures have mild tissue reaction during the absorption process. PETCRYL 910 sutures are available in undyed and violet colour PETCRYL - Polyglycolic Acid Sutures Petcryl is made from 100% Glycolide popularly known as PGA.This is an ideal and time tested synthetic absorbable suture, widely used by surgeons all over the world. PGA's superior features over catgut are predictable absorption, outstanding tensile strength, in-vivo inertness and excellent handling properties. Linex - Monofilament Polyamide Suture These are nonabsorbable surgical sutures which are known for their tensile strength and excellent knot security properties. These can be easily removed with no tissue adherence. Progut - Catgut Chromic Sutures Most widely used in the surgery. Good tensile strength. Excellent handling property & easy to knot, even in depth. Twisted multifilament with virtually monofilament finish. Sutura - Black Braided Silk Sutures

We are a a leading manufacturer of coated and Braided Silk Sutures of good tensile strength which is retained for long time in tissue. These are uniformly coated with silicone which provides easy passage through tissues. Duracare - Monofilament Polypropylene Sutures These Monofilament Polypropylene Sutures are blue colored for easy identification during surgery. They also do not support infection as well as tissue rupture. Used for orthopaedic, plastic and micro surgeries, general closure and cardiovascular they also conform to the USP standards. Avoid damage to the surface of suture. Petcryl Mono - Poliglecaprone 25 Sutures PETCRYL Mono [Poliglecaprone 25] is monofilament Synthetic Absorbable Suture which is a copolymer of glycolide and caprolactone, available in undyed and violet colour. Polypropylene Mesh for Hernia Repair We are manufacturing Polypropylene Mesh for Hernia repair under the brand name Dolphin Mesh and is available in popular sizes of 2x4, 3x6, 6x6 and 12x12 inches. To facilitate the Surgeons convenience, Dolphin mesh is made available in two types, namely PM and PS types. PM type mesh is thinner, smoother and more flexible. Whereas PS mesh is Strong, thicker and normal flexibility.

TYPES OF ANESTHESIA There are several ways that anesthesia can be given. Local anesthesia involves injection of a local anesthetic (numbing agent) directly into the surgical area to block pain sensations. It is used only for minor procedures on a limited part of the body. You may remain awake, though you will likely receive medicine to help you relax or sleep during the surgery. Regional anesthesia involves injection of a local anesthetic (numbing agent) around major nerves or the spinal cord to block pain from a larger but still limited part of the body. You will likely receive medicine to help you relax or sleep during surgery. Major types of regional anesthesia include: o Peripheral nerve blocks. A local anesthetic is injected near a specific nerve or group of nerves to block pain from the area of the body supplied by the nerve. Nerve blocks are most commonly used for procedures on the hands, arms,feet, legs, or face. Epidural and spinal anesthesia. A local anesthetic is injected near the spinal cord and nerves that connect to the spinal cord to block pain from an entire region of the body, such as the belly, hips, or legs.

General anesthesia is given into a vein (intravenously) or is inhaled. It affects thebrain as well as the entire body. You are completely unaware and do not feel pain during the surgery. Also, general anesthesia often causes forgetfulness (amnesia) right after surgery (postoperative period).

SURGICAL SPECIALTIES AND SUB-SPECIALTIES 1. General Surgery A general surgeon is a specialist who is trained to manage a broad spectrum of surgical conditions affecting almost any area of the body. The surgeon establishes the diagnosis and provides the preoperative, operative, and post-operative care to patients and is often responsible for the comprehensive management of the trauma victim and the critically ill patient. During at least a five-year educational period after obtaining a medical degree, the surgeon acquires knowledge and technical skills in managing medical conditions that relate to the head and neck, breast, skin, and soft tissues, abdominal wall, extremities, and the gastrointestinal, vascular, and endocrine systems. 2. Thoracic Surgery Thoracic surgery involves the operative management, perioperative care, and critical care of patients with pathological conditions within the chest. Specifically, it includes surgical care for coronary artery disease; cancers of the lung, esophagus, and chest wall; abnormalities of the great vessels and heart valves; congenital anomalies; tumors of the mediastinum; and diseases of the diaphragm. The management of the airway and injuries to the chest are also areas of surgical practice for the thoracic surgeon. A thoracic surgeon possesses the knowledge, experience, and technical skill to diagnose accurately, to operate upon safely, and to manage effectively patients with intrathoracic abnormalities that are appropriate for surgical treatment. The ability to provide this kind of treatment requires a substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of extracorporeal circulation, cardiac assist devices, management of cardiac dysrhythmias, pleural drainage, respiratory support systems, endoscopy, and other invasive and noninvasive diagnostic techniques. 3. Colon and Rectal Surgery As a result of their extensive training and experience, colon and rectal surgeons develop the knowledge and skills necessary to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal, and perianal area through medical and surgical means. They are also able to deal surgically with other organs and tissues (such as the liver, urinary, and female reproductive systems) involved with primary intestinal disease. A colon and rectal surgeon has expertise in diagnosing and often managing anorectal conditions in the office, such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum.) 4. Obstetrics and Gynecology A specialist in obstetrics and gynecology is a physician who has been trained to provide medical and surgical care for the pregnant patient, to deliver babies, and to provide medical and surgical care to treat conditions that affect the female reproductive system. 5. Gynecologic Oncology A Gynecologic Oncologist is a specialist trained in the comprehensive management of patients with gynecologic cancercancers that affect the female reproductive system. Surgeons practicing in this specialty study these conditions, which differ significantly in the cause, prevention, detection, treatment and survival rates. 6. Neurological Surgery Neurological surgery is the discipline of medicine and the specialty of surgery that deals with the diagnosis, evaluation, and treatment of disorders of the central, peripheral, and autonomic

nervous systems, including their supporting structures and vascular supply. Neurological surgery involves the evaluation and treatment of pathological processes that modify the function or activity of the nervous system, including the pituitary gland. 7. Ophthalmic Surgery An ophthalmologist is concerned with the comprehensive care of the eyes and vision, and is the only medical practitioner who is medically trained to diagnose and treat all eye and visual problems. Ophthalmologists provide vision services (glasses and contact lenses), treat medical disorders of the eye, and perform surgical procedures for treatment. Oral and Maxillofacial Surgery Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

8.

9. Orthopaedic Surgery Orthopaedic surgery is a surgical specialty that is specifically devoted to the care of the musculoskeletal system. This system includes bones, joints, muscles, associated nerves, arteries, and the overlying skin. Much of the orthopaedic surgeon's practice involves the performance of surgical procedures, but many conditions are treated medically or physically through the use of braces, casts, splints, or physical therapy. o Hand Surgery This specialty focuses on the investigation and treatment of diseases, injuries, or abnormalities affecting the upper extremities. This specialty includes the performance of microvascular surgery, which is necessary for reattachment of amputated fingers or limbs. Sports Medicine This specialty addresses the various concerns of the person who is involved in athletics, including conditioning, equipment, and, of course, injuries to the musculoskeletal system. Pediatric Orthopaedics Specialists in pediatric orthopaedics address their practice to children with orthopaedic problems including scoliosis, cerebral palsy, congenital dislocation of the hips, clubfoot, and a wide variety of other conditions specifically seen in childrenincluding trauma. Spine Surgery Spine surgeons work with patients who have major spine problems as a result of disease, degeneration, or trauma. Orthopaedic spine surgeons frequently work in conjunction with neurosurgeons. Foot and Ankle Orthopaedics This specialty is concerned with problems predominantly involving the foot and ankle that are amenable to treatment by both surgical and nonsurgical techniques. Joint Replacement Specialists in joint replacement take care of damaged or worn-out joints usually by surgically replacing the joint with an artificial device. The majority of cases involve the hip

or kneeand sometimes the ankle or shoulder. Most joint replacement in the hand falls into the area of expertise of the hand surgeons. o Trauma Surgery Because of the complex nature of injuries seen today, a special area of orthopaedics is now related to the management of persons with critical or multiple injuries to the musculoskeletal system. This specialty is largely surgical in nature and involves close cooperative efforts with many other specialties in surgery. Oncology The orthopaedic tumor surgeon specializes in the management of benign and malignant tumors affecting the musculoskeletal system. Options for treatment have expanded greatly in the past few years with the advent of chemotherapy and radiotherapy coupled with the excision of the tumor and replacement with preserved bone or joint specimens

10. Otolaryngology An otolaryngologist is a physician who has been trained to provide comprehensive medical and surgical care to patients who have diseases and disorders that affect the ears, the respiratory and upper alimentary systems, and related structures. The otolaryngologist has a command of the core of knowledge, skills, and understanding of: the basic medical sciences relevant to the head and neck; the respiratory and upper alimentary systems; the communication sciences, including knowledge of audiology and speech-language pathology; the chemical senses; and allergy, endocrinology, and neurology as they related to the head and neck. Head and neck oncology and facial plastic and reconstructive surgery are also fundamental areas of expertise for the otolaryngologist. 11. Pediatric Surgery Pediatric surgeons are primarily concerned with the diagnosis, preoperative, operative, and postoperative management of surgical problems in children and they operate on children whose development ranges from the newborn stage through the teenage years. Some medical conditions in newborns are not compatible with a good quality of life unless these problems are corrected surgically. These conditions must be recognized immediately by neonatologists, pediatricians, and family physicians. Pediatric surgeons cooperate with all of the specialists involved in a child's medical care to determine whether surgery is the best option for the child. Pediatric surgery focuses on providing surgical care for all problems or conditions affecting children that require surgical intervention. They may also have particular expertise in the following areas of responsibility: o Neonatal Pediatric surgeons have specialized knowledge in the surgical repair of birth defects, some of which may be life threatening to premature and full-term infants. Prenatal In cooperation with radiologists, pediatric surgeons use ultrasound and other technologies during the fetal stage of a child's development to detect any abnormalities. They can then plan corrective surgery and educated and get to now parents before their baby is born. In addition, prenatal diagnosis may lead to fetal surgery, which is a new

forefront in the subspecialty of pediatric surgery. Application of most fetal surgical techniques is still in the experimental stage. o Trauma Because trauma is the number one killer of children in the United States, pediatric surgeons are routinely faced with critical care situations involving traumatic injuries sustained by children that may or may not require surgical intervention. Many pediatric surgeons are involved accident prevention programs in their communities that are aimed at curbing traumatic injuries in children. Pediatric Oncology Pediatric surgeons are involved in the diagnosis and surgical care of children with malignant tumors as well as those with benign growths

12. Plastic and Maxillofacial Surgery The specialty of plastic surgery deals with the repair, replacement, and reconstruction of defects of the form and function of the body covering and its underlying musculoskeletal system, with emphasis on the craniofacial structures, the oropharynx, the upper and lower limbs, the breast, and the external genitalia. This surgical specialty also focuses on the aesthetic surgery of structures with undesirable form. 13. Urology A urologist is a physician who manages benign and malignant medical and surgical disorders of the adrenal gland and of the genitourinary system. Urologists have comprehensive knowledge of, and skills in, endoscopic, percutaneous, and open surgery of congenital and acquired conditions of the reproductive and urinary systems and their contiguous structures. 14. Vascular Surgery Vascular surgeons care for patients with diseases that affect the arteries and veins throughout the body. Hardening of the arteries, atherosclerosis, is the most common problem that vascular surgeons treat. In addition, vascular surgeons are trained to diagnose and treat strokes, which can be brought on by a blockage or narrowing of the arteries in the neck. Because the damage done by strokes is often irreversible, vascular surgeons must be able to make early diagnoses of potential stroke victims. The surgeon who treats the vascular system must also be able to diagnose and treat aneurysms and blood clots in the arteries and veins, as well as the after effects of conditions of the vascular system.