Membrane laceration suture

In order to better repair corneal laceration. There is a basic understanding of the general rule of curvature change and suture effect after corneal laceration. The general rule of curvature change after corneal laceration: the slit in the latitudinal direction makes the direction parallel to the wound steep, and the radial direction crack will flatten the meridian direction of the cornea. Vertical wounds have a weaker ability to resist intraocular pressure, making the wound more susceptible to splitting. Oblique wounds are more resistant to intraocular pressure and make the wound more closed. Suture effect: The cornea is flattened at the suture: the center of the cornea becomes steeper; the apex of the cornea moves away from the suture. The range of the effect of the wound edge is equivalent to a long span of the suture. The inner part of the wire loop makes the wound edge eversion, the surface part makes the wound edge inversion; the suture perpendicular to the wound edge cancels twice, and the inner and outer flipping effect does not occur, and the suture which is inclined with the wound edge will make the wound edge dislocation. The distance between the two sides of the vertical wound wound should be equal; for oblique wounds, only the asymmetrical needle insertion method will make the wounds fit well, otherwise the stitching will result in a superimposed effect between the acute angle and the obtuse angle. Treating diseases: corneal abrasions Indication There are no lacerations of corneal tissue defects, including regular or irregular, infected or non-infected wounds, as long as the integrity of the wall is destroyed, the eye communicates with the outside world, and the continuous destruction of the main fiber components of the cornea is difficult to fight against normal intraocular pressure or cornea. Wounds with severe changes in surface refraction morphology should be sutured and repaired even if the wound has been closed by temporary cellulose or iris tissue. Contraindications Significant corneal tissue defects, suppurative eye content has occurred. Preoperative preparation Clean the face, especially the eyelids, rinse the lacrimal passages, fresh open wounds should not be washed with normal saline before surgery, and should be thoroughly rinsed with diluted antibiotic solution before the wound is cleaned. Surgical procedure The key parts of the suture shape, such as the limbal area, and the corners of the irregular wound, the corners, and the weakened part of the oblique line of the oblique wound (vertical type splitting part). The span of the peripheral suture should be larger, and the inner suture should be placed deeper. The obtuse angle of the oblique wound is closer to the needle than the sharp edge. The star-shaped laceration should be carried out in the shape of a 10-0 line in the tip of the corneal flap. After the suture is ligated, the junction of the star wound is well sealed. Edema wounds, sutured with 7-0 silk, accelerate healing. After the corneal wound is sutured, the line knot should be buried in the corneal parenchyma. After the anterior chamber is restored, the intraocular pressure is restored, and the dry cotton swab is used to roll on the surface of the cornea. Carefully check whether the wound is sutured and watertight. complication Infection is the most serious complication after any open eye injury surgery. Investigation of the environment at the time of injury, cleaning and disinfection of preoperative eye appendages, adequate treatment of antibiotics for the injured eye, aseptic operation, minimizing the operation time and reasonable antibacterial preventive measures after surgery are all important steps to prevent infection. The wound was sutured with poor water leakage, and the anterior chamber was shallow or disappeared. If it was not treated, it would cause adhesive corneal palsy, and the area of white sputum was much larger than that of a well-healed wound. The recent leakage of water is a great risk of potential intraocular infection. Wounds in wounds often occur in irregular, edematous, sutured wounds that are quite difficult. Therefore, familiar with the general rule after corneal laceration, the correct method of positioning and the precautions during surgery are necessary. Once a leak is found after surgery, it should be treated again. It is more difficult to perform the operation than the previous one. Sometimes it is necessary to have an experienced doctor to complete it. It is difficult to avoid the problem of adhesion formation and scarring by pressure bandaging the wounds that are barely healed. The suture is broken, and if the water leakage is obvious or the refractive phenomenon of the corneal surface is affected, suturing is required again.