Suture multifilament

Braided Synthetic Nonabsorbable Sutures. Braided synthetic nonabsorbable sutures are made by melt-spinning thermoplastic polymers into fine filaments (yams), and braiding them, with or without a core, to form multifilament sutures in a range of sizes. Nylon-6,6 [32131 -17-2] (7) is a polyamide produced by the condensation polymerization of adipic acid and 1,6-hexanediamine. 

Multidentate V-heterocyclic ligands, thorium and, 24 767 Multidimensional gas chromatography, 4 617-618 6 433-434 Multidrug resistant bacteria, 18 252 Multi-effect distillation (ME), 26 65—67 Multi-effect vapor-compression submerged-tube desalination plant, 26 70 Multielevation piperacks, 19 515 Multifeed fractionation, 10 616 Multifilamentary superconductor, 23 846 Multifilament sutures, 24 218 threads for, 24 207 Multifilament yarns, 11 177-178 Multifile patent searches, 18 244 Multifunctional aliphatic epoxies, 10 376 Multifunctional coatings, 1 714-716 Multifunctional epoxy resins, 10 367-373, 418, 454... 

Besides chemical factors, physical form, the amount and stiffness of suture materials have also been reported to elicit different levels of tissue reactions. For example, a stiff suture would result in stiff projecting ends in a knot where cut. These stiff ends could irritate surrounding tissues mechanically, a problem associated with some monofilament sutures but generally not found in braided multifilament sutures. Because the extent of a reaction relates to the quantity of the buried structure, it is a well-known practice in surgery that one should use as little suture material as possible, such as a smaller knot and a smaller size, to close wounds. The use of a smaller size suture which provides adequate support to wounds and does not cut... 

Monofilament sutures are considered to be a better choice than multifilament ones in closing contaminated wounds. Multifilament sutures elicit more tissue reactions which may lessen tissue ability to deal with wound infections. They also have a capillary effect which could transport microorganisms from one region of the wound to another. The reason that multifilament sutures generally elicit more tissue reactions than their monofilament counterparts is because inflammatory cells are able to penetrate into the interstitial space within a multifilament suture and invade each filament. Multifilament sutures also have a larger surface area in contact with tissues which should be expected to elicit more tissue reaction. 

Multifilament sutures are more commonly coated than monofilament sutures. For example, multifilament Vicryl and Dexon Plus or Dexon II have coating materials applied, while monofilament PDS and Maxon sutures have no coatings. Traditional coating materials are nonabsorbable bee wax, paraffin wax, silicone and polytetrafluoroethylene (Teflon). New coating materials have been developed, particularly those that are absorbable. This is because the coating materials used for absorbable sutures must also be absorbable (Conn and Beal, 1980 Mattei, 1980 Casey and Lewis, 1986). Absorbable coating materials should also have adequate tissue biocompatibility. 

Trimbos J B, van Rijssel E J C and Klopper P J (1986), Performance of sliding knots in monofilament and multifilament suture materials , Obstet Gynecol, 68,425. 

Monosof, 297 Monosyn, 235,238,278 multifilament sutures, 258 multilayer flow modulator (MF.M), 664 multUimbed grafts, 121-4 design considerations, 123... 

Vicryl , Vicryl Rapide (Ethicon) Multifilament suture... 

PANACRYL Multifilament suture with slow rate of degradation... 

Osterherg B. Influence of capillary multifilament suture on the antibacterial action of inflammatory cells in infected wound. Acta Chir Scand 1983 149(8) 751—7. 

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. 

As demonstrated in this chapter, a variety of bioabsorbable polymers, both natural and synthetic, have been investigated as surgical materials and devices. Sutures have the largest market share among the synthetic bioabsorbable polymer used in medicine. Since different types of monofilament and multifilament sutures with... 

Monofilament sutures have no interstices in which to lodge bacteria, but they are more difficult to handle and require more throws to each knot for security than braided sutures. Multifilament sutures are generally easier to handle, with greater knot security, but do allow capillarity and interstitial bacteria colonization which can increase the risk of wound infection, particularly with nonabsorbable sutures. Both monofilament and multifilament sutures can be absorbable or nonabsorbable. 

During application, a specific knotting technique is required to handle and tie the sutures. With multifilament sutures, the nature of the material and the braided or twisted construction provide a high coefficient of friction and the knots remain as they are laid down. In monofilament sutures the coefficient of friction is relatively low, resulting in a greater tendency for the knot to loosen after it has been tied. In addition, monofilament synthetic polymeric materials possess the property of memory, with a... 

Surgical cotton From these cottons were obtained from the natural cellulose which is soft and silky. We can find cotton remains in body tissues, where the suture loses 50% of its strength within 6 to 9 months. The permeability of this multifilament suture to bacteria is similar to that of silk and is the major factor affecting tissue reaction. 

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