CAROLYN'S COMPOSITIONS

August 25, 2013

The Catgut Story


CAROLYN’S COMPOSITIONS

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THE CATGUT STORY

I ended my post  WP Challenge: I Remember…the Agony of Appendectomy Stitch Removal with Since I’ve had a long-time curiosity about catgut stitches, I plan to do a post on that soon.

The soon is today, so here is all you wanted to know about catgut, the material used to secure my appendectomy wound.

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The dictionary definition of catgut is ‘a tough cord made from the intestines of animals, especially sheep.”

Catgut, to Everyman, prompts speculation as to its feline origin. There is, however, in fact no evidence that the intestine of the cat has ever been used to produce catgut strings.

The name can be traced back to the Arabic cither, an early stringed instrument. The same root is seen in the old name for the dancing master’s fiddle, a kit. From kitgut to catgut is an easy etymological step.

Mention catgut to…a musician, he recalls the mellow tones of the violin or cello; to a sportsman and he wonders if he remembered to replace the press on his tennis raquet…and a surgeon…he thinks of a suture material

…the use of animal intestine as a ‘string’ dates back as far as there are records of mankind. Susruta, a Hindu writer who lived about 1500 B. C., refers to the use of cotton, drawn copper, horsehair, and animal intestines as ligatures. Ferrara, an Italian, at the end of the 16th century used intestines of tortoises amongst other suture materials…

A short digression may be permissible to make reference to a natural means of wound closure which has been known for hundreds of years, namely the use of the mandibles of certain species of biting ants. The edges of a wound are brought together manually, the ant is held by its body and allowed to bite across the wound edges; the moment it has done so the body is twisted away from the head which, with the jaws, is left acting like a modern metal clip. This procedure is still used by the aboriginal natives of central Australia and there are records of its use p to recent times in Greece, Serbia and Algeria.

…It was in 1868, the year before he came to Edinburgh University as Professor of Clinical Surgery, that Joseph Lister experimentally tied catgut round the right carotid of the artery of an ll. Thirty days later the animal was killed and Lister examined the ligature. At first he thought it was unchanged, but closer investigation revealed the fact that the catgut was no longer present but had been replaced by a ring of living tissue. Though Lister is mainly remembered for his introduction of antisepsis into surgery, his recognition of the absorbability of catgut has been of fundamental importance in the successful modern use of this material.

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No aid to surgery has has such a chequered career as catgut. It has been in and out of favour, sworn by and swoen at, over a period of some 75 years. Catgut for suturing has been ‘going out of fashion’ since the writer first took interest in it some 17 years ago. Nevertheless, more is being manufactured and sued today than ever before. Why should this be so? The answer lies in one special feature—its absorbability in living animal tissues.

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(Lister) quickly realized also the risk of introducing infection into wounds by the use of ‘raw’ catgut.

(Susruta also seemed) to have had some precognition of the need for sterilizing because he is said to have stored his sutures in wine before use.

In France the importance of catgut makers was recognized in the Guild whose members supplied racquet makers, clockmakers, musicians, cross-bow makers and surgeons.

There are records that in 1869 (Lister) was using an aqueous solution of phenol as a sterilizing agent for catgut. This would be fairly efficient as a sterilizing (means).

 Catgut is still more difficult to purify, inasmuch as boiling in water is out of the question. Lister claims that catgut, prepared according to his directions, remains actively antiseptic for an indefinite period, and all that is needed subsequently is to immerse it for a quarter of an hour in a 1 to 20 solution of carbolic acid. The majority of surgeons, however, prefer to sterilize it before use, and especially so if they use non-chromatized gut, or catgut, which has been hardened in a 5 per cent. Solution of formalin for twenty-four hours. Many different processes have been recommended, but perhaps the simplest and most effective is that known as the ‘iodine’ method. The catgut is wound loosely on a glass spool or winder, and immersed in a solution containing iodine, 1 part; iodide of potassium 1 part; and distilled water, 100 parts. It is kept thus in the dark for seven to ten days, and then removed and kept dry, wrapped in sterile gauze. Before use it is placed for a few minutes in spirit (rectified or methylated), so as to dissolve out a little of the excess of iodine present. Catgut so prepared is not only aseptic, but also actively antiseptic, and rarely causes trouble in the tissues (except, perhaps, in delicate children). An extensive experience of this material for some years has proved its reliability and value. Various instrument-makers provide sterilized catgut in sealed glass tubes, which can usually be trusted.**

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So there it is, all you wanted to know about catgut…and more. All the material on catgut was taken from the listed sources.

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ADDITIONAL READING:

THE OLIVE GREEN DRESS

My Childhood Home: 29 Spring St., Portsmouth, N. H.

Destination: Portsmouth, New Hampshire

SOURCES

The Story of Catgut, Eldred Holder

Rose and Carless’s Manual of Surgery for Students and Practitioners, William Rose, Albert Carless,

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