Absorbable surgical sutures

Meanwhile Ethicon (and others) developed alternative absorbable surgical sutures, based, for example, on copolymers of polyglycolide with poly-L-lactide or poly(trimethylene carbonate), and on polydioxanone, and on poly(e-oxycaproate), and also on copolymers of these with polyglycolide or with each other. These different structures made it possible to provide fibres with different rates of absorption, with different degrees of stiffness or flexibility, and for use in monofilaments, braided multifilaments, and other yam structures, as required for different surgical operations. 

Figure 2. In vivo breaking strength retention of Poly(i lactide) compared with commercial absorbable surgical sutures.

Studies in Xenopus oocytes are performed with the two microelectrode voltage clamp method. For isolation of the oocytes, the toads are anesthetized using a 1 g/1 solution of 3-aminobenzoic acid ethyl ester and placed on ice. A small incision is made to retrieve sacs of oocytes and is subsequently closed with absorbable surgical suture. On waking up, the toads are placed back into the aquarium. The ovaries are cut up into small pieces and the oocytes are washed in Ca2+-free Or-2 solution (82.5 mM NaCl, 2mM KC1, ImM MgCb, 5 mM HEPES pH 7.4) and subsequently col-... 

Polymers undergoing Type III erosion have found applications in (a) absorbable surgical sutures, (b) surgical adhesives, (c) contraception, and (d) controlled drug release. 

W. Channuan, J. Siripitayananon, R. Molloy, G.R. Mitchell, Defining the physical structure and properties in novel monofilaments with potential for use as absorbable surgical sutures based on a lactide containing block terpolymer, Polymer 49 (20) (2008) 4433-4445. 

Dattilo, P. P. (2002). Knotless bi-directional barbed absorbable surgical suture. Master s thesis. North Carolina State University. 

Barrows, T.H. (1991) Synthetic bioabsorbable polymers, in M. Szycher (ed.), High Performance Biomaterials, Technomic Publ., Lancaster PA, pp. 243-257. Benicewicz, B.C. and Hopper, P.K. (1991) Polymers for absorbable surgical sutures-Part II. J. Bioact. Comp. Polym. 6, 64-95. 

Surgical sutures are sterile, flexible strands used to close wounds or to tie off tubular structures such as blood vessels. Made of natural or synthetic fiber and usually attached to a needle, they are available ia monofilament or multifilament forms. Sutures are classified by the United States Pharmacopeia (USP) (1) as either absorbable or nonabsorbable. The USP also categorizes sutures according to size (diameter) and Hsts certain performance requirements. Sutures are regulated by the Food and Dmg Administration (FDA) as medical devices under the Food, Dmg, and Cosmetics (FDC) Act of 1938, the Medical Device Act of 1976, and the Medical Device Reporting regulation of 1995. 

C.K.S. Pillai, C.P. Sharma, Review paper absorbable polymeric surgical sutures chemistry, production, properties, biodegradability, and performance. J. Biomater. Appl. 25 (2010) 291-366, doi 10.1177/0885328210384890. 

Surgical suturing thread can be made from this polymer, since it is absorbed by metabolism by the body instead of being encapsulated and does not cause inflammation. 

Poly(glycolide), with the monomeric unit - CO—CH2—O, is available through polymerization of the cyclic dimer (glycolide) or the 0-carboxylic acid anhydride of the acid glycol. Surgical suturing thread can be made from this polymer, since it is absorbed by the body instead of being encapsulated and does not cause inflammation. 

PLA have been used in films for packaging, thermoformed and injection moulded disposable rigid containers (for example, food containers and trays), blown flasks and bottles, filaments, and biomedical uses (capsules for drug delivery, fibers for tissues and absorbable/degradable surgical sutures, and internal bone fixation implants). It is a polymer with consolidated use in the medical area, due to its biocompatibility and biodegradability in the human body. PLA-based resins may be modified to adapt to many applications, from disposable food-service items to sheet extrusion, and coating for paper [40]. 

Abstract Biotextile sterilization presents unique challenges. The chapter describes the principles of sterilization and the way in which sterility assurance levels are defined and demonstrated.Traditional thermal, chemical and radiation sterilization methods are described, as well as newer methods such as plasma and microwave sterilization, and applications for which each is suitable. The advantages of the emerging technology of radiochemical sterilization are described, together with some of its successful applications, such as surgical sutures and tissue adhesive and the results of recent comparative studies of radiochemical and other sterilization methods for absorbable materials. Projected future trends in sterilization technology are also outlined. 

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