JP2015134195A - sternum suture wire - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a sternum suture wire that can be revolved along a sternum outer circumference, and can be fastened and fixed in a stable fastening force with an expansion/contraction force acting along a longitudinal direction without causing backlash or looseness.SOLUTION: A sternum suture wire 1 is used for closing an incised sternum after surgery. The sternum suture wire is configured as follows: a wire body 2 string-shaped by braiding a filament of a single line is braided so that the filament runs in an oblique direction without conforming in the longitudinal direction; an elastically widening part 2a is formed in at least a portion of the wire body 2 so as to elastically maintain a widened state in which the elastic filament is added and braided for elastically maintaining the wire body 2 in the direction of widening it; the filament is pulled in a shape of a straight line along the longitudinal direction in suture, and thereby the wire body 2 is elongated, and the elastically widening part 2a is also elastically transformed into a linear shape; and elasticity is given to the wire body 2 by the repulsive force of the elastically widening part 2a elastically transformed.

Description

  The present invention relates to a sternal suture wire used for sternal closure suture after surgery.

  Conventionally, when performing surgical operations on the chest, the chest is cut and opened at the center of the sternum, the sternum cut after the operation is closed, and sutured with a wire.

  As the wire used at this time, a single wire made of stainless steel is used.

  Further, a tape-shaped plain weave is used (for example, see Patent Document 1).

  These wires are attached to the sternum by wrapping along the outer circumference of the sternum and then fastening between the ends.

JP 2003-79632 A

  The conventional plain weave wire is obtained by plain weaving a single filament that is plastically deformed in a tape shape so that it can be circulated along the outer circumference of the sternum, so that it can be fastened and fixed along the outer circumference of the sternum. However, since the wire itself is not stretchable, if the rattle or looseness occurs after fastening, the closed clavicle will open. The same applies to a single wire.

  In addition, the chest may be momentarily applied such as sneezing or coughing, and a load is likely to be applied to the stitched portion. Therefore, in the case of the conventional wire, rattling and loosening are likely to occur. Once rattling or loosening occurs, it will not be possible to regain the fastening force on the sternum. Moreover, even if no rattling or looseness occurs, there is a concern that when the above-mentioned instantaneous force is applied, the burden on the sternum is increased and the sternum is ruptured. In particular, in the case of a single wire, since the sternum is fastened by line contact, stress concentrates on the contact portion, and the risk of sternum rupture is greater than that of a plain weave wire in surface contact. In the case of plain woven wire, there is a risk of sternum rupture because the stress is simply dispersed and the wire itself is not stretchable.

  Further, in the case of the above-described conventional wire, unevenness is likely to occur in the fastening state depending on the sense of the surgeon and the state of the operation. For example, if the fastening force is stronger at the place fastened than the place fastened first, as a result, the place fastened first is loosened, causing a problem of rattling.

  Furthermore, in the case of the above-described conventional wire, the fastening degree cannot be adjusted, so that some patients may feel pain after surgery, and it is difficult to obtain a uniform and good fastening force.

  The present invention has been made in view of such circumstances, and can be rotated around the outer circumference of the sternum, and can be stretched along the longitudinal direction to generate a stable fastening force without causing rattling or loosening. An object of the present invention is to provide a wire for sternal suture that can be fastened and fixed with a screw.

  The sternal suture wire of the present invention for solving the above-mentioned problems is a sternal suture wire used for closing a sternum that has been cut and opened at the time of surgery after operation, and is formed by braiding a single filament. A wire body having a string shape is provided, the wire body is braided so that the filament runs in an oblique direction not along the longitudinal direction of the wire body, and the wire body is widened at least at a part of the wire body. By forming an elastic widening part that is braided with elastic filaments that maintain elasticity in the direction to maintain the widened state elastically, and the filaments that run obliquely at the time of sewing are pulled linearly along the longitudinal direction As the wire body stretches, the elastic widened portion also elastically deforms linearly, and due to the repulsive force of this elastically deformed elastic widened portion, the wire main body has elasticity It is those that have been given.

  In the sternum suturing wire, the wire body may be formed by braiding a filament made of a corrosion-resistant metal and having a penetrating blade fixed to one end thereof.

  In the sternum suture wire, the other end of the wire main body may be provided with a fixing jig for inserting and fixing the wire main body.

  As described above, according to the present invention, the filament that ran in an oblique direction at the time of sewing is pulled linearly along the longitudinal direction, so that the wire body is stretched and the elastic widened portion is also elastically deformed linearly. The elasticity of the wire body is imparted by the repulsive force of the elastically widened elastically deformed portion, so that the fastening and fixing state to the sternum can be maintained without causing rattling or loosening.

(A) Perspective view showing an outline of the overall configuration of the sternum suture wire according to the present invention, (b) is a cross-sectional view taken along the line II of FIG. (A), and (c) is a cross-sectional view taken along line II- of FIG. It is II sectional view. It is a top view which shows the normal time of the wire main body of the sternum suture wire which concerns on this invention, and the time of extending | stretching. (A) is a plan view showing a state in which the sternum suture wire according to the present invention is fastened and fixed to the sternum, and (b) is a state before the sternum suture wire according to the present invention is wrapped around the sternum and fastened and fixed. FIG. 6C is a cross-sectional view showing a state after the sternum suture wire according to the present invention is wound around the sternum and fastened and fixed. (A) is a partial expansion perspective view which shows an example of the fixing jig of the sternum suture wire which concerns on this invention, (b) is sectional drawing which shows the fastening fixation state by the fixing jig. (A) is a partial expansion perspective view which shows an example of the fixing jig of the sternum suture wire which concerns on this invention, (b) is sectional drawing which shows the fastening fixation state by the fixing jig.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
FIG. 1 shows an outline of the entire configuration of the sternum suture wire 1, FIG. 2 shows a wire body 2 of the sternum suture wire 1, and FIG. 3 shows a use state of the sternum suture wire 1.

  The sternum suture wire 1 includes a wire body 2 having an elastic widened portion 2 a, a through blade 3 provided on one end side of the wire body 2, and a buckle 4 provided on the other end side of the wire body 2. It is configured.

  The wire body 2 is formed in a cylindrical string shape by braiding single filaments 21. This braiding method is not particularly limited as long as each braided filament 21 is configured to run in an oblique direction without being along the longitudinal direction of the wire body 2. If each filament 21 is configured to run in an oblique direction not along the longitudinal direction of the wire body 2, various types adopted for a general braided wire are used. The wire body 2 is formed by folding the wire body 2 in the shape of a tubular string into two, and in a braided state, the filaments 21 are arranged in the longitudinal direction of the wire body 2 as much as possible, that is, the wire body 2 is elongated. What was comprised so that it might become 2 mm-10 mm in width | variety, more preferably 4-8 mm in the state expanded and contracted to the direction is used.

  As the filament 21 of each single wire constituting the wire body 2, one having a diameter of 9 μm to 300 μm, more preferably a diameter of 15 μm to 150 μm is used.

  Examples of the material of each single wire filament 21 constituting the wire body 2 include those made of a corrosion resistant metal such as a stainless alloy, a nickel titanium alloy, and a titanium alloy.

  The length of the wire body 2 is not particularly limited as long as it can circulate around the outer circumference of the sternum 5 with the tightening white left, and is, for example, 10 cm to 100 cm. Those having a length, more preferably 15 cm to 65 cm, are used.

  As described above, the wire body 2 is formed by folding the wire body 2 in a tubular string shape in half, and in a braided state, the filaments 21 are arranged in the longitudinal direction of the wire body 2 as much as possible. From the state where the wire body 2 is stretched and contracted in the longitudinal direction, the width of the intermediate portion is widened, and each filament 21 is 30 degrees or more with respect to the longitudinal direction of the wire body 2, preferably 60 or more, more preferably 45 to 45 degrees. Widen to run diagonally at an angle of 60 degrees. In this state, the surface of each filament 21 constituting the wire body 2 is coated with a resin to form the coating layer 20, and the elastic widening portion 2 a that elastically maintains the widened state by the resin constituting the coating layer 20. Is formed.

  The coating layer 20 may be coated by immersing the wire body 2 in a liquid bath for coating the resin, or may be flow coated. The coating layer 20 is formed after a through-blade 3 and a buckle 4 (described later) are fixed to the wire body 2 by welding. However, when the penetrating blade 3 and the buckle 4 are not required, they are formed after the wire body 2 is configured.

  In the elastic widened portion 2 a, the filament 21 that runs obliquely with respect to the longitudinal direction by pulling the wire body 2 is pulled linearly along the longitudinal direction. Along with this, the wire body 2 extends and the elastic widened portion 2a also tries to elastically deform in the width-decreasing direction. However, since the coating layer 20 is formed in the widened state, if it is elastically deformed in the width-decreasing direction, the widening direction As a result, a repulsive force is generated, whereby the wire body 2 is provided with a stretching force that can be pulled and stretched, and a contracting force is applied in the direction of contraction when the wire body 2 is stretched.

  In the present embodiment, the surface of each filament 21 constituting the wire body 2 is coated with a resin to form the coating layer 20 to obtain the contraction force. However, the present invention is particularly limited to this. Instead, for example, an elastic body (not shown) that is elastically deformable may be inserted into the tubular shape of the wire body 2 and the contraction force may be obtained by the repulsive force of the elastic body (not shown). This elastic body may be formed by filling and curing the coating agent in the cylindrical shape of the wire body 2 at the time of coating, or by inserting an already formed elastic body. Also good. Further, as the filament 21 for braiding the wire body 2, a contraction force may be obtained by the repulsive force of the elastic filament 21. That is, since the filament 21 passes the die during wire drawing, work hardening occurs, the tensile strength increases, and the elasticity also increases. Accordingly, the filament 21 having a desired elasticity is obtained by post-processing heat treatment, twist heat treatment, and tension heat treatment in accordance with variations in tensile strength, random values, and torque conduction characteristics due to differences in the content of the forming elements of the filament 21. And a contraction force may be obtained by the filament 21. Further, a contraction force may be obtained by combining at least one or more selected from the coating layer 20, the elastic body (not shown), and the elastic filament 21.

  The location of the elastic widened portion 2a is not particularly limited as long as it is an intermediate portion of the wire body 2, and all other intermediate portions except for both ends of the wire main body 2 are elastic widened portions 2a. There may be, and the pole part of an intermediate part may be elastic wide part 2a. However, since the contraction force of the wire body 2 is obtained by the elastic widened portion 2a, if the elastic widened portion 2a is too short, sufficient elasticity cannot be obtained, so at least the length of the wire body 2 before stretching is 100%. As a stretching force (difference T in the length of the wire body before and after tension shown in FIG. 2) that can be stretched to a length of 110 to 150%, more preferably 115 to 135%, It is preferable to form the elastic contraction part 2a having such a length that a contraction force to return to the length can be obtained. Moreover, even if it is called the intermediate part of the wire main body 2, since the one end side of the wire main body 2 in which the penetration blade 3 is provided is cut | disconnected after sewing, as the elastic widening part 2a, it is near the other end side of the wire main body 2. It is preferable to provide it.

  One end of the wire body 2 has a proximal end portion of the penetrating blade 3 having a needle-like tip at an end portion that has a tubular string shape when the wire body 2 is stretched in the longitudinal direction and contracted to the minimum width. Is inserted and fixed by welding.

  The penetrating blade 3 is formed with a blade 31 having a sharp tip on the tip side and is slightly curved, and cuts a place for piercing the human body along the circumference of the sternum to circulate the wire body 2. It has been made so that it can.

  Similarly, the other end of the wire body 2 has a buckle for fastening the wire body 2 in a state where the wire body 2 is stretched in the longitudinal direction to be reduced to the minimum width and is formed into a two-fold flat plate shape. 4 is fixed by welding.

  The buckle 4 is formed in a flat plate shape, one end is fixed to the wire body 2 by welding, and the other end is provided with two long holes 41 and 42 through which the wire body 2 can be inserted. The long holes 41 and 42 are provided with sawtooth-shaped barbs 41 a and 42 a that mesh with the wire body 2. It is preferable to use the buckle 4 that is configured to have a thickness of 2 mm or less in a state in which the buckle 4 is welded and fixed to the wire body 2 so as not to cause a foreign object feeling.

Next, a method for using the sternum suture wire 1 configured as described above will be described.
First, the chest is cut and opened at the center of the sternum 5, and after surgical operation of the chest, the cut sternum 5 is temporarily closed in a closed state.

  Next, the penetrating blade 3 of the sternum suture wire 1 is pierced between the ribs 51 and incised along the circumference of the sternum 5, and the sternum suture wire 1 is turned around the sternum 5.

  The buckle 4 of the sternum suture wire 1 is positioned at the center of the sternum 5 and one end side of the wire body 2 on the side of the penetrating blade 3 that has been circulated is inserted into the long hole 41 of the buckle. When one end side of the wire main body 2 is pulled in this state, the elastic widened portion 2a of the wire main body 2 is reduced in width, and the wire main body 2 extends correspondingly, and the sternum 5 is closed with the wire main body 2 closed. Once pulled, the wire body 2 generates a contraction force as much as it stretches to return to the original widened state. Therefore, even if the hand is released, the wire body 2 is caught by the return 41a of the long hole 41, and the fastening force is maintained. Is done.

  After fastening with a tensile force sufficient to feel elasticity in the hand, after turning one end side of the wire body 2 in the opposite direction to the tensile direction and inserting it into the other long hole 42 so that the wire body 2 does not loosen, The excess wire body 2 is cut to complete the fastening.

  According to the sternum suture wire 1, the elastic widened portion 2a of the wire main body 2 expands and contracts by being pulled, and the repulsive force of the elastic widened portion 2a elastically deformed in this way causes the wire main body 2 to contract. Is granted. Therefore, after the fastening, the fastening state of the sternum can be maintained by the contraction force of the wire body 2. Therefore, even when the fastening force of each wire body 2 of the plurality of sternum suture wires 1 fastened to the sternum 5 is uneven, the wire body 2 having a weak fastening force does not rattle. The fastening state can be maintained.

  In addition, since it is fastened by the contraction force of the wire body 2, even if a force is applied instantaneously, such as sneezing or coughing, the sternum is not ruptured by the wire body 2 and can be expanded and contracted flexibly. can do.

  Further, since the sternum suture wire 1 has the coating layer 20 formed on the outer surface of the wire body 2, it can reduce the stress of the surgeon without damaging the capillaries at the edge of the wire body 2. The burden on the patient can also be reduced.

  In the present embodiment, the sternum suture wire 1 has the through blade 3 welded and fixed to one end of the wire body 2, but is not particularly limited to the one having the weld blade 3 welded and fixed in this way. Instead, for example, one end of the wire main body 2 may be in the form of a cylindrical string with the width reduced to the minimum width, or may be formed into a folded plate shape and fixed by welding. In this case, the sternum suture wire 1 has a guide string (not shown) attached to a penetrating blade 3 or the like that is separately configured, and an incision is made at a place where the wire main body 2 is fixed by the penetrating blade 3 to surround the sternum. Circulate the guide string. And the wire main body 2 can be provided in the circumference | surroundings of the sternum made to circulate by attaching and pulling the wire main body 2 to this guide string. Therefore, in this case, it is preferable that the wire body 2 is provided with a hole or the like for connecting to the guide string on one end side so that the wire body 2 can be easily connected to the guide string.

  Moreover, in this Embodiment, although the wire main body 2 uses what was braided in the shape of a cylindrical string, it may be braided in the shape of a simple band.

  Furthermore, in the present embodiment, the sternum suture wire 1 uses the buckle 4 having the two long holes 41 and 42, but is particularly limited to the one that fastens the wire body 2 with such a buckle 4. For example, as shown in FIG. 4, the roller 61 is biased by a biasing piece 62 in a direction opposite to the insertion direction A of the wire body 2 and obliquely downward from the top to the bottom. The fixing jig 6 made may be used. In the case of the fixing jig 6, when the wire body 2 is pulled in the A direction, the wire body 2 is pulled against the urging force of the urging piece 62, so that the roller 61 rotates and the wire body 2 is sent. When the pulling of the wire main body 2 is stopped, the urging force of the urging piece 62 works, the roller 61 is pressed against the wire main body 2, and the wire main body 2 is stopped. The outer peripheral surface of the roller 61 is knurled so that the wire body 2 does not slip. Moreover, as shown in FIG. 5, the fixing jig 7 which provided the detent 71 with respect to the insertion direction A of the wire main body 2 simply may be sufficient. As these fixing jigs 6 and 7, it is preferable to use those formed so that the total thickness is 2 mm or less, similarly to the buckle 4 described above.

  The wire for sternum suture according to the present invention is used at the time of sternum suture after the sternum is cut and surgically operated.

DESCRIPTION OF SYMBOLS 1 Wire for sternal suture 2 Wire main body 2a Elastic widening part 20 Coating layer 21 Filament 3 Penetrating blade 4 Buckle (fixing jig)
5 Sternal 6,7 Fixing jig

Claims (3)

A sternal suture wire used for closing a sternum that has been cut and opened at the time of surgery after the surgery,
It comprises a wire body that is braided with a single wire filament,
This wire body is braided so that the filament runs in an oblique direction not along the longitudinal direction of the wire body, and at least a part of the wire body is
An elastic widening portion is formed that is braided by adding an elastic filament that maintains elasticity in the direction of widening the wire body, and elastically maintains the widened state,
When the filament that ran diagonally at the time of stitching is pulled linearly along the longitudinal direction, the wire body stretches, and the elastic widened portion also elastically deforms linearly, and due to the repulsive force of the elastic widened portion that has been elastically deformed, A wire for sternum suture, characterized in that stretchability is imparted to the wire body. The sternal suture wire according to claim 1,
The wire body is a sternal suture wire formed by braiding a filament made of a corrosion-resistant metal and having a penetrating blade fixed to one end thereof. The wire for sternum suture according to claim 1 or 2,
A sternal suture wire in which a fixing jig for inserting and fixing the wire main body is provided at the other end of the wire main body.

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