Monofilament Polydioxanone Research Articles

COMPARISON OF THE MECHANICAL PROPERTIES OF POLYGLYCOLIDE-TRIMETHYLENE CARBONATE (MAXON) AND POLYDIOXANONE SUTURES (PDS2) USED FOR FLEXOR TENDON REPAIR AND ACTIVE MOBILIZATION

Thirty-six canine flexor digitorum profundus tendons were repaired using 5-0 polyglycolide-trimethylene carbonate monofilament (Maxon) or polydioxanone monofilament (PDS2). All the tendons healed without rupture or formation of gaps of more than 2 mm. Mechanically, all tendon repairs had sufficient tensile strength to enable active mobilization. Polyglycolide-trimethylene carbonate (Maxon) repairs were initially superior in gap and ultimate strength to polydioxanone (PDS2) repairs. However, the gap and ultimate tensile strength of polyglycolide-trimethylene carbonate (Maxon) repairs had decreased significantly at day 14, whereas polydioxanone (PDS2) repairs maintained their strength throughout the 28-day observation period.

Minimally invasive coronary revascularization through parasternal incisions without cardiopulmonary bypass

We report the results of minimally invasive coronary revascularization without cardiopulmonary bypass through miniparasternal incisions. This procedure was performed in 40 patients with disease in the left anterior descending, first diagonal, and right coronary arteries. After a 5- to 7-cm left vertical parasternal incision and removal of two costal cartilages, the left internal mammary artery was harvested up to the 2nd rib. The left anterior descending artery was occluded by means of two polydioxanone monofilament sutures. The anastomosis was performed with one 7-0 Prolene suture while the heart was beating. In 4 cases the left internal mammary artery was used as a sequential graft to the left anterior descending artery and the first diagonal artery. In 14 cases the right coronary artery was grafted with the right internal mammary artery through a right parasternal incision. Postoperatively, 95% of the patients underwent angiographic assessment of the anastomoses. We performed 52 anastomoses (34 to the left anterior descending artery, 4 to the first diagonal artery, and 14 to the right coronary artery). The mortality was 0% and the morbidity included postoperative bleeding (5%), acute renal failure (2.5%), atrial fibrillation (2.5%), and wound infection (5%). No patient had ventricular arrhythmias or circulatory problems during or after the operation. Two patients (5%) with right internal mammary artery-to-right coronary artery grafting had graft failure that required a redo operation. Small vertical parasternal incisions may be an alternative approach for single and multiple coronary revascularization, with a low incidence of intraoperative cardiac complications. The application of this approach to the right coronary artery, however, carries additional technical difficulties, and careful patient selection may be required to achieve optimal results.

Comparison of Absorbable Sutures Used in Largemouth Bass Liver Biopsy Surgery

Abstract Longevity of and healing response to absorbable sutures made of natural gut, chromic-acid-treated gut, polyglactin 910, and polydioxanone monofilament were evaluated for 8 weeks following liver biopsy surgery on largemouth bass (Micropterus salmoides). Gut sutures were absorbed in 5 weeks and incisions healed in 6 weeks (at 18°C water temperature). Polyglactin 910 sutures were absorbed in 7 weeks and incisions healed in 8 weeks. Monofilament sutures were intact after 8 weeks but incisions healed in 3 weeks. Chromic gut sutures are suitable when healing is expected to be rapid ( 8 weeks), the most rapid healing (3 weeks), and the greatest economy.

Initial evaluation of absorbable polydioxanone suture for peripheral vascular surgery

The long-term integrity of an autogenous vascular anastomosis is primarily dependent on the strength of tissue healing; therefore permanent mechanical support of an autogenous anastomosis with sutures is unnecessary. In this study we evaluated monofilament absorbable polydioxanone as an alternative to polypropylene for suturing autogenous vascular tissue during adult peripheral vascular operations. We used polydioxanone suture for 21 vascular procedures in 20 patients. We evaluated suture handling characteristics during operation and then followed patients with clinical assessments and serial duplex scans to monitor for pseudoaneurysms, anastomotic narrowing, and vessel patency. Indications for surgery included limb salvage (67%), dialysis access (23%), traumatic arteriovenous fistula and claudication (5% each). The operative procedures included infrainguinal bypass (57%), arteriovenous fistula formation (24%), thromboembolectomy (14%), and arteriovenous fistula repair (5%). Polydioxanone sutures were placed in 39 separate test sites (35 arterial, 4 venous). No deaths occurred during operation. Polydioxanone suture was found to have handling characteristics similar to polypropylene. During mean patient follow-up of 7.2 +/- 0.6 months, we found no cases of anastomotic narrowing or pseudoaneurysms. Actuarial test site patency at 1, 3, and 6 months was 97%, 97%, and 86%, respectively. Polydioxanone suture has handling properties that are acceptable for use in vascular applications, and it provides adequate mechanical support for sutured vessels to heal. A randomized trial comparing polydioxanone with polypropylene suture will be necessary to determine whether the lack of permanent foreign material in vascular anastomoses can improve long-term patency.

The use of absorbable monofilament polydioxanone suture in pediatric cardiovascular operations: J.L. Myers, D.B. Campbell, and J.A. Waldhausen. J Thorac Cardiovasc Surg 92:771–775, (October), 1986

The use of absorbable monofilament polydioxanone suture in pediatric cardiovascular operations: J.L. Myers, D.B. Campbell, and J.A. Waldhausen. J Thorac Cardiovasc Surg 92:771–775, (October), 1986

Use of polydioxanone absorbable monofilament sutures in orthopedic surgery.

The safety and efficacy of polydioxanone absorbable monofilament sutures was documented in 57 orthopedic surgery patients (32, dyed sutures; 25, undyed sutures), 55 of whom were followed for at least 42 days postoperatively. The other two patients were lost to follow up prior to 42 days. The final clinical outcome was excellent in all completed study subjects. No suture-related adverse effects were reported. Both dyed and undyed sutures were consistently better than surgical gut with respect to pliability, strength, ease of passage, ease of tying, fraying, knot security, and overall handling. Intraoperative visibility of dyed polydioxanone sutures was consistently superior to that of surgical gut. The visibility of undyed sutures was rated better than surgical gut in 16 cases, equal in 8, and worse in 1. Both the overall handling of the polydioxanone monofilament sutures and performance as it affected wound healing were significantly superior to those of surgical gut.

The use of absorbable monofilament polydioxanone suture in pediatric cardiovascular operations

Growth of suture lines and anastomoses is required for long-term success after the repair of congenital cardiovascular anomalies. Polydioxanone, an absorbable monofilament suture material, has been used in a variety of operations since April, 1983. Twenty-two of the 46 procedures were coarctation repairs. Complete repairs for anomalous pulmonary veins and transposition of the great arteries, as well as Fontan procedures and systemic-pulmonary shunts, have been performed. Angiographic, gross, and microscopic examination showed good healing. There was no anastomotic disruption or aneurysm formation. The results with this absorbable vascular suture have been uniformly encouraging in a follow-up of up to 30 months.

Vascular evolution of single-layer end-on colonic anastomosis

One hundred eighty left colonic single-layer end-on anastomoses performed on 90 rats by microsurgical techniques, using polydioxanone monofilament absorbable sutures, were examined histopathologically and microangiographically at nine different times, from two to 180 days. There was no anastomotic leakage. The vascular state after suturing and the evolution of the neovascularization are described. The neovascularization appeared to follow the same process of evolution as tissue restoration. It began early, was greatest on the seventh day, and diminished thereafter. When granulation tissue was narrow, the anastomoses were barely hypervascular, the neovascularization assured by submucosal plexus. A voluminous granulation tissue was hypervascular, had a slower evolution, and neovascularization was then assured above all by the peritoneal formations adherent to the suture.

Clinical Experience with Polydioxanone Monofilament Absorbable Sutures in Plastic Surgery

Clinical Experience with Polydioxanone Monofilament Absorbable Sutures in Plastic Surgery

9-0 Monofilament Polydioxanone (PDS): A New Synthetic Absorbable Suture for Cataract Wound Closure

This study describes the intraoperative and postoperative performance of 9-O monofilament Polydioxanone (PDS) suture for cataract wound closure. This newly developed synthetic absorbable suture is designed to meet the need for a "long-term" absorbable suture material suitable for cataract wound closure following intraocular lens implantation. Polydioxanone's advantages over currently used "short-term" absorbables and biodegradable nylon are described in this report.