Wound closure devices

Gingras, K., Zaruby, J. and Maul, D. (November 2011). Comparison of V-Loc TM 180 wound closure device and QuiUTM PDO knotless tissue-closure device for intradermal closure in a porcine in vivo model Evaluation of biomechanical wound strength./ouma/ of Biomaterials Research B 1-5. 

V-Loc 180 wound closure device, 392 vacuum-remelted (VM) process, 304 Valiant devices, 653-6 Valsalva aortic root graft, 454 Valsalva sinuses, 486 Vascufll monofilament, 295 vascular endothelial growth factor (VEGF),467... 

The history of biomaterials (i.e. the use of natural or artificial materials in restoring the function of tissue or parts of the body) dates further back than even the most ancient ruins on this beautiful island of Sardinia. The Edgar Smith papyrus papers of over 4000 B.C. describe sutures and other wound closure devices. Later work around 2000 B.C. describe metals in bone repair. Somewhat later, the use of goose quills in vascular repair was mentioned. However, it was not until the 1800 s that we saw the real beginning of metals used in bone reconstruction surgery and in the 1930 s (with the beginning of plastic industries) to see the beginning use of polymers in a variety of reconstruction applications. 

The mechanical properties as well as in-vitro testing of cylindrical dumbbells were also studied (Tables 4-6 and 8-14). As can be seen from the tables, the yield strength and modulus of the aromatic poly(anhydride)s developed by the methods described herein are similar to or greater than poly(p-dioxanone), an absorbable polyester used extensively for medical devices, and poly(anhydride)s described by other researchers. This is another indication that the aromatic poly(anhydride)s have the high molecular weights (I.V. > 1.0 dl/g), and consequently, the high strengths required in wound closure devices. 

A barbed suture, which is self-anchoring with no knots required for wound closure, is manufactured from polydioxanone. This suture consists of axially barbed segments on each side of a mid-point at which the barbs change direction. This wound closure device appears to offer gastrointestinal closure comparable to the poly(GA-co-TMC) suture. 

These wounds and incisions have been traditionally closed with sutures, staples, or surgical tapes, and more recently, tissue adhesives. An ideal wound closure device should be user friendly, quick, pain free and result in excellent cosmesis, without device removal requirement, and of course be cost-effective [87]. None of the current closure devices possesses all of these requirements. Topical cyanoacrylate tissue adhesives, however, have a number of the characteristics of an ideal wound closure device. 

Figure 10 Diagram showing three methods of wound closure after insertion of a ganciclovir sustained-release device. (A) Wound closure with an X suture on either side of the anchoring suture. Note that the X suture is started within the wound so that the knot remains buried when the suture ends are trimmed. The long ends of the anchoring suture are placed under the two X sutures. (B, C) Wound closures with a running suture. Note that the suture is started within the wound so that the knot remains buried when the suture ends are trimmed. The long ends of the anchoring suture are placed under the running suture.

Source Kimura, Y., 1993. Biomedical Applications of Polymeric Materials, T. Tsuruta, T. Hayashi, K. Kataoka, K. Ishihara, and Y. Kimura, Eds. CRC Press, Boca Raton, FL and Chu, C.C., von Fraunhofer, J.A., and Greisler, H.P., 1996. Wound Closure Biomaterials and Devices. CRC Press, Boca Raton, FL. 

C Chu, J A von Fraunhofer, H P Greisler, Wound Closure Biomaterials and Devices, New York, CRC Press, 1997. 

In 1996, Brotz et al patented a suturing device which has lateral members with spikes in two directions (Fig. 13.7). These lateral members have a pointed tip, and can penetrate tissue for wound closure. Once inserted the lateral members hold the tissue in position (Brotz, 1996). In 1999, Buncke patented a bi- and uni-directional surgical suture, shown in Fig. 13.8. The uni-directional suture had one needle at one end. The bi-directional suture had two needles, one at each end of the monofilament suture. While suturing... 

Chu C C, von Fraunhofer J A and Greisler H P (1997), Wound closure biomaterials and devices, Boca Raton, FL, CRC Press. 

The lactide/glycolide bioresorbable polymers are thermoplastics which can be processed by many methods, including fibre spinning, extrusion, and injection moulding, which means they can be fabricated into a variety of wound closure items (e.g. sutures), implantable devices (e.g. bone plates, bone screws), and drug delivery systems, which include microspheres, fibres, films, rods and others. 

Pressure-sensitive adhesive products are utilized in a broad variety of medical applications in very different fields First aid products for consumers, medical tapes, island dressings, surgical drapes, wound-closure strips in hospitals and physician s practices, as well as tapes and bandages for orthopedic and athletic use. Other uses include transdermal systems for therapeutic purposes, and ostomy moimts, attaching electrocardiogram devices, and protective foot products. 

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