Clinical experience has demonstrated that the problem of ideal wound healing is complicated. It involves not only the presence or absence of bacteria in the wound, the nature of the organisms and the resistance of the patient but also a number of other factors. Aseptic healing of an incision requires a systematic, meticulous, aseptic operating room technic in all its many details, minimum traumatization of the tissues, complete hemostasis and, less important, but nevertheless significant, the selection of proper ligature and suture material. After more than half a century of use of an absorbable suture, many surgeons now seem ready to discard such materials to return to the use of silk in the repair of clean wounds and incisions. The older masters of the craft who, after unsatisfactory experience, rejected catgut and returned to silk include such leaders as Theodore Kocher, Heidenhain, Hagler and, in our own country, William Stewart
THE RENAISSANCE OF SILK IN SURGERY. JAMA. 1939;113(15):1417. doi:10.1001/jama.1939.02800400045013
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