Suture materials synthetic absorbable sutures

The first synthetic absorbable suture was made from a homopolymer of glycolic acid by Davis Geek Co. and manufactured with the tradename Dexon (1970). This suture was followed by a second material produced by Ethicon, Inc., in 1974, a copolymer of lactide and glycolide known as poly-glactine 910 or Vicryl. Both Vicryl and Dexon are made from polymer fibers, which are braided to produce sutures. In addition. Vicryl is Teflon coated for... 

McCarthy, W. H., A new synthetic absorbable suture material a clinical trial of polyglycolic acid suture in general surgery, Aust. NZ J. Surg., 39, 422, 1970. 

Loh IH, Lin HL, Chu CC. Plasma surface modification of synthetic absorbable sutures. In Proceedings, Clemson University Conference on Medical Textiles and Biomedical Polymers and Materials 1996. 

The latest addition to the synthetic absorbable suture materials is TephaFLEX which is thermally melt-spun from poly-4-hydroxybutyrate, a member of the class of absorbable biomaterials known as polydroxyal-kanoates, or PHA (FDA, 2007 Martin and Williams, 2003). Studies have shown that TephaFLEX is both biocompatible and noninflammatory. Their biodegradation occurs through normal processes and the products of the breakdown are metabolites that already exist in the body. 

The percentage of retention of tensile breaking force of five 2/0 synthetic absorbable sutures upon 0.005 M superoxide ion-induced hydrolytic degradation at 25°C. (Sourcff. From Keun-Ho Lee and C. C. Chu, The effect of superoxide ions in the degradation of five synthetic absorbable suture materials, J. Biomed. Mater. Res., 49(1) 25-35, 2000.)... 

Walton M (1989), Strength retention of chromic gut and monofilament synthetic absorbable suture materials in joint tissues , Clin Orthop Related Res, 242,... 

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. 

Polymers used in medicine fall into two main categories those that are sufficiently inert to fulfill a long-term structural function as biomaterials or membranes, and those that are sufficiently hydrolytically unstable to function as bioeradible materials, either in the form of sutures or as absorbable matrices for the controlled release of drugs. For the synthetic organic polymers widely used in biomedicine this often translates to a distinction between polymers that have a completely hydrocarbon backbone and those that have sites in the backbone that are hydrolytically sensitive. Ester, anhydride, amide, or urethane linkages in the backbone usually serve this function. 

Sutures remain the most common method of tpproximating the divided edges of tissue (1). Sutures are categorised by size, material, design and behaviour. Absorbable and nonabsorbable materials are further divided into synthetic versus natural products, some of vdiich can be fabricated in braided and/or monofilament form. Non-absorbable sutures have played an important role in the development of surgical procedures, generally made of silk, polyamide, polyester, polypropylene, polyethylene and poly(tetrafluoroethylene) (2). 

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