Surgical devices sutures

For much of the last century, scientists attempted to make useful plastics from hydroxy adds such as glycolic and lactic acids. Poly(glycolic acid) was first prepared in 1954, but was not commercially developed because of its poor thermal stability and ease of hydrolysis. It did not seem like a useful polymer. Approximately 20 years later it found use in medicine as the first synthetic suture material, useful because of its tendency to undergo hydrolysis. After the suture has served its function, the polymer biodegrades and the products are assimilated (Li and Vert 1995). Since then, suture materials, prosthetics, artificial skin, dental implants, and other surgical devices made from polymers and copolymers of hydroxy carboxylic acids have been commercialized (Edlund and Albertsson 2002). 

There are many medical and surgical devices of various shapes and sizes made of aliphatic polyesters.These devices are made by various processing routes. In general, large-scale devices such as sutures [e.g. Dexon (100%PGA),Viciyl (copolymer of glycolide in combination with L-lactide), Monocry 1 (copolymer of e-caprolactone) or Maxon (copolymer of trimethylene carbonate)] and macroscopic implants used for bone fixation can be manufactured by solvent-or melt-spinning processes. The fibre forms can then be drawn under different conditions in order to orient the polymer chains. Fibres prepared... 

To compensate for these issues, surgical devices may offer a level of assistance that goes beyond the mere execution of the surgeon s commands. This includes the automation of certain tasks. For instance, the device may be able to perform suturing in an autonomous fashion. 

Although the softness and flexibility inherent in poly(p-dioxanone) has allowed researchers to develop this material for monofilament suture applications, poly(p-dioxanone) has also been injection molded into a number of non-filamentous surgical devices, namely ABSOLOK and LAPRA-TY . ... 

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... 

Heart Assist Devices Heart Valves Hydrocephalus Shunts Immobilized Enzymes Implantable Pumps Inner Ear Repairs Joint Replacement Pacemakers Plasma Extenders Plastic Surgery Polymeric Drugs Polymeric Food Additives Pseudoenzymes Reinforcing Mesh Replacement Blood Vessels Replacement Skin Soft Tissue Replacement Surgical Adhesives Surgical Tape Sutures... 

Medical apparatus assembled with ultrasonics include disposable arthroscopic surgical devices, small to medium size culture fiasks, intravenous manifolds, suture and stints. 

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. 

Color additives are routinely added to medical devices such as surgical sutures, surgical cements, and contact lenses (32). Sutures are usually colored to make them more visible during survery and, depending on the appHcation, during removal of the suture after the sutured area has healed. Surgical cements, too, are colored to make them more visible during use (Table 4). 

The use of synthetic polymers in medicine and biotechnology is a subject of wide interest. Polymers are used in replacement blood vessels, heart valves, blood pumps, dialysis membranes, intraocular lenses, tissue regeneration platforms, surgical sutures, and in a variety of targeted, controlled drug delivery devices. Poly(organosiloxanes) have been used for many years as inert prostheses and heart valves. Biomedical materials based on polyphosphazenes are being considered for nearly all the uses mentioned above. 

Specific details of the sterility testing of parenteral products, ophthalmic and other non-injectable preparations, catgut and surgical sutures will be found in the European Pharmacopoeia. These procedures cannot conveniently be applied to items like surgical dressings and medical devices because they... 

Placement of an annuloplasty ring is a common surgical approach for treatment of mitral regurgitation. There are currently a number of novel devices designed to simulate suture mitral annuloplasty surgery percuta-neously. All are currently in preclinical and early pilot clinical phase of development. 

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