Bioabsorbable suture

In Y, Kim JM, Woo YK, Choi NY, Moon CW, Kim MW (2008) Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures using bioabsorbable suture anchors. Knee Surg Sports Traumatol Arthrosc 16 286-289. doi 10.1007/s00167-007-0466-x... 

Senekovic V, Balazic M (2014) Bioabsorbable sutures versus screw fixation of displaced tibial eminence fractures a biomechanical study. Eur J Orthop Surg Traumatol 24 209-216. doi 10. 1007/S00590-013-1176-3... 

A second application is the controlled release of the polymer. Here, we report two different examples. The first example is a bioabsorbable suture. A suture is defined as bioabsorbable in solid polymeric materials or devices if it can dissolve in body fluids without any polymer chain cleavage or molecular mass decrease. Another example is a water-soluble implant that undergoes slow dissolution in body fluids. A bioabsorbable polymer also can be bioresorbable if the dispersed macromolecules are excreted [6]), or it is a MD belonging at least to class 11b [4] but usually to class 111 (release a drug with an ancillary function or it is completely resorbable) [5],... 

Non-bioabsorbable sutures are defined by their resistance to degradation by living tissues. They are most useful in percutaneous closures. Synthetic, non-bioabsorbable, monofilament sutures include nylon, polypropylene, and polybutester sutures, while synthetic, non-bioabsorbable, multifilament (braided) sutures are composed of nylon and polyester. Polybutester, developed in 2000, is a block copolymer that contains butylene terephthalate and telramethylene ether glycol. Metallic fibers such as steel fibers are also used extensively for suturing. 

Bioabsorbable sutures are defined by the loss of most of their strength within 60 days after placanent. They provide temporary wound support until the wound heals well enough to withstand normal stress and are used primarily as buried... 

Synthetic, bioabsorbable sutures available today are listed in Table 8.9, together with their chemical structure. As can be seen, they are composed of copolymers, except for PGA and poly-p-dioxanone. One of the monomers in the copolymers of aU sutures is glycolide. The surface of most multifilament sutures is coated to permit easy tissue passage, precise knot placement, and smooth tie-down. The coating materials applied include calcium stearate, poly(E-caprolactone) (PCL), PGLA (30 70), and poly(CL-co-GA). The characteristics of these bioabsorbable sutures are briefly described below. 

This type of copolymer is prepared as A-B-A block copolymers in a 2 1 GA trimethylene carbonate (TMC) ratio, with a GA-TMC center block (B) and pure GA end blocks (A). These materials have better flexibility than pure PGA and are absorbed in approximately 7 months. This copolymer was developed to combine the predictable in vivo performance of a synthetic absorbable suture with the handling characteristics of a monofilament suture. The copolymer has a high initial tensile strength (greater than that of polydioxanone) and retains 81 % of its strength at day 14, 59 % at day 28, and 30 % at week 6. This suture is easier to handle and has greater knot security than the three bioabsorbable sutures mentioned above. 

Caprolactone has also been copolymerized alternatively with glycolide and trimethylene carbonate to provide coating for bioabsorbable sutures. Sutures treated with these coatings exibited improved knot security and knot repositioning characteristics. A block copolymer of e-caprolactone with glycolide is marketed by Ethicon (Monocryl ), which has reduced stiffness compared to pure PDA sutures. 

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