Synthetic Absorbable Suture Materials Research Articles

The effect of argon plasma coagulation on surgical suture material

Introduction. In modern surgery, there are many types of different energy used to achieve hemostasis; one of them is the energy of argon plasma coagulation. However, the impact of energy affects not only the bleeding site; it also affects the stitches lying nearby the source of bleeding. The instructions for the use of a suture material or a coagulation tool do not describe the changes that may occur when they interact. A review of the literature found a small number of publications devoted to changes in the physical properties of suture material when exposed to it. This information is not sufficient to predict the effects of argon plasma coagulation energy on the suture material and, as a result, on wound healing or the quality of the postoperative scar.The objective was to determine changes in the biodestructive properties of synthetic absorbable suture materials with argon plasma coagulation in an in vivo experiment.Methods and materials. In the experimental study, the results of biodegradation of monofilament and polyfilament sutures after exposure to argon plasma coagulation energy were analyzed in comparison with control samples in the body of laboratory mice.Results. It can be unequivocally stated that the effect of argon plasma coagulation energy has an effect on the rate of biodegradation of both monofilament and polyfilament synthetic filaments implanted in muscle tissue.Conclusions. Suture material exposed to argon plasma coagulation may not meet the terms of partial or full biodegradation stated by the manufacturer, which may affect the quality of scar formation.

The effect of medical grade honey on tensile strength, strain, and Young's modulus of synthetic absorbable suture material used in equine surgery.

Medical grade honey (MGH) has been introduced as a protective measure against surgical site infections in equine surgery, but the effect on suture material has not been investigated. To evaluate the effect of MGH on the tensile properties of three synthetic absorbable suture materials. In vitro experiments. Ten strands of Polydioxanone USP 2 (PD2), Polyglactin 910 USP 2 (PG2) and Polyglecaprone USP 2-0 (PC2-0) were incubated 1, 7, 14, 21 and 28 days in MGH, phosphate-buffered saline (PBS), equine plasma (EP) and MGH mixed with equine plasma (HP). Mechanical testing was performed recording maximum load at failure (N), strain at failure and Young's modulus (N/mm2 ). The results were reported from a Welch or regular ANOVA. PD2 in MGH had a significantly higher tensile strength compared to PD2 in EP (p < 0.05, mean difference (md) = 16.95 N, CI95% (9.19-24.70 N)) and PBS (p < 0.05, md = 14.48 N CI95% (6.73-22.23 N)) on day 7 and the remaining time points. PG2 incubated in MGH had a significantly higher tensile strength compared to EP (p < 0.05, md = 69.28 N CI95% (64.16-74.40 N)) and PBS (p < 0.05, md = 56.90 N CI95% (51.78-62.02 N)) until day 28. PC2-0 incubated in MGH had a significantly higher tensile strength compared to EP (p < 0.05 md = 12.40 N CI95% (4.59 N-20.20 N)) and PBS (p < 0.05 md = 11.23 CI95% (3.42-19.03 N)) on day 7 and the remaining time points. The sutures were unloaded during incubation and a single cycle to failure test was only performed, which does not reflect the in vivo environment where shear forces are present. MGH did not negatively affect the tensile strength of the suture material and can safely be applied in contact with suture materials commonly used in equine surgery.

Does suture material affect cesarean section scar healing?

Background: Sutures are an essential part of any major surgery which serve to hold opposing tissues together and accelerate the healing process, resulting in decreased scarring of the affected areas. In the past, gold, silver, iron, and steel wires, dried animal gut, silk, and plant fibers (e.g., linen, cotton) have been used as suture materials. Obstetricians commonly use synthetic absorbent sutures for uterine closure during CS. This study aim to evaluate the effects of different synthetic absorbable suture materials on cesarean scar defect formation.Methods: After excluding patients who did not meet inclusion criteria and those who declined to participate, the patients were randomly divided in to 2 groups: - study group І: - 35 patients and study group II: - 35 patientsPatients were subjected to the following: Ultrasound evaluation Ultrasound was done to ensure viability, determine the gestational age, the position of the placenta, the presenting part, the amniotic fluid and the estimated fetal weight using convex transducer of (Samsung Medison H60, Korea & 50/60 HZ).Results: Regarding demographic data of the studied patients, Age, gestational age and BMI there were no significant difference between both groups. Regarding time of operation and type of anesthesia there were no significant difference between both groups. There was no significant difference in the preoperative, post-operative and delta Hb concentration between both groups. Regarding post-operative pain, there was no significant difference between both groups. Regarding post-operative hospital stay was no significant difference between both groups. Regarding myometrial thickness, total and residual myometrial thickness was significantly thicker in group II compared to group I.Conclusions: Our results showed that monofilament sutures reduced pathological inflammation during wound healing without increasing costs, operation time, or intraoperative complication rates; resulting in improved uterine scar recovery; and potentially reduced CSD. These findings suggest that gynecological sequelae due to CSD and serious obstetric complications that may occur in subsequent pregnancies can be reduced.

Impact of Fluoridated Mouthwashes on Strength and Durability of Three Different Synthetic Absorbable Suturing Materials: An In Vitro Study

The aim of the current in vitro research was to assess the effect of fluoride-containing mouthwashes on the strength and durability of three different synthetic absorbable suturing materials. Three types of synthetic absorbable suture materials were employed in this research, and every group comprised 20 suture samples. These include group I: Polyglactin 910, group II: Polyglycolic acid, and group III: Poliglecaprone 25. This research utilized 4-0 gauge sutures. Each example was tied using a square surgeon's knot about elastic rubber tubing. The biology of the oral milieu was replicated in vitro through the use of artificial saliva. The medium that was subjected to test prior to inclusion were 0.2% chlorhexidine gluconate as well as 0.044% sodium fluoride. The tensile strength of the specimen suture materials was subjected to test at a particular time intervals: prior to immersion, the 1st day, the 7th day, as well as the 14th day after immersion. Tensile strength was evaluated using a Universal Ultra Test machine. Post-immersion in 0.2% chlorhexidine gluconate mouthrinse, the mean tensile strength of polyglactin (PLG) 910 sutures was 24.48 ± 0.08 at pre-immersion and 4.36 ± 0.01 on the 14th day. The mean tensile strength of polyglycolic acid (PGA) sutures was 24.04 ± 0.26 at pre-immersion and 2.10 ± 0.02 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 23.82 ± 0.11 at pre-immersion and 1.34 ± 0.08 on the 14th day. Post-immersion in 0.044% sodium fluoride mouthrinse, the mean tensile strength of PLG 910 sutures was 24.18 ± 0.02 at pre-immersion and 5.12 ± 0.21 on the 14th day. The mean tensile strength of PGA sutures was 24.88 ± 0.34 at pre-immersion and 4.58 ± 0.10 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 24.48 ± 0.27 at pre-immersion and 5.08 ± 0.14 on the 14th day. A statistically noteworthy difference was noted amid the three types of sutures at dissimilar time points evaluated with p <0.001. The current research arrived at a conclusion that there is a significant difference between the mean tensile strength and purpose of the medium used for immersion as well as the tenure. Polyglactin suture material exhibited superior strength as compared to PGA and poliglecaprone suture substances following immersion in the investigational media. Suture materials are employed in the closure of incised flaps, to aid healing by primary intention, along with control of bleeding. In oral as well as periodontal surgery, the right choice of sutures is very important for good healing. Suture choice for the mouth should be influenced by the requirements of the anticipated repair and the surgeon's fondness.

Continuous versus interrupted sutures for repair of episiotomy using monofilament versus synthetic absorbable multifilament suture materials: a randomized controlled trial

Objective To compare different repair techniques and different suture materials for episiotomy. Background Care of the perineum during and after childbirth has been a topic of considerable interest to all involved for many years. A considerable amount of research has been carried out in the area of perineal care, particularly in relation to the practice of performing episiotomy and to the methods of suturing. Patients and methods A total of 90 primigravidae were admitted for labor and underwent a mediolateral episiotomy after vaginal delivery. They were randomly allocated into four groups in which continuous and interrupted episiotomy repair techniques were performed under two different types of suture materials, that is, monofilament type in the form of poliglecaprone 25 and multifilament type in the form of polyglactin 910. Perineal pain during different activities on the first and seventh day postpartum was questioned by visual analog scale, and the presence of perineal pain after 3 months of delivery, repair time, amount of suture material, and episiotomy complications were investigated in each group. Results The results of the present study showed that the assessments of pain in the first day and after 1 week in movement, repose, sitting, urination, and defecation were insignificant regarding suture techniques and suture materials. The repair time and the length of suture material were statistically less in the continuous technique groups. The type of suture material did not show significant effect on either the length of suture material used or the episiotomy repair time. Conclusion The use of continuous technique of episiotomy repair is better than interrupted technique, because the former is quicker and cheaper as less suture material is used with no differences on either short-term or long-term morbidity.

COMPARISON TENSILE STRENGTH OF NATURAL AND SYNTHETIC ABSORBABLE SUTURES

Objective: The aim of the investigation is to evaluate and to compare the tensile strength of commercial natural and synthetic absorbable suturematerials currently used in surgery. The natural absorbable sutures of chromic catgut are prepared for this purpose as well as commercial syntheticabsorbable sutures made from polyglycolide.Methods: The analysis has been carried out following the standard test method for tensile strength and Young’s modulus of fiber ASTM C1557-03.Measuring the diameter of each suture has been carried out with an optical microscope to determine the accuracy of manufacturers’ data. Tensiletesting has been performed to evaluate the tensile strength of each type of sutures. The modulus elasticity and strain (ϵ) obtained are also presented.Results: The results show that sutures made from braided synthetic material of polyglycolide (violet coated) present a tensile strength remarkablysuperior (1070.292 MPa) to that of natural absorbable sutures of chromic catgut (392.276 MPa). Using optical macro microscope analysis,monofilament sutures present less surface irregularities than multifilament polyglycolide sutures. Chromic catgut monofilament sutures present lesssurface irregularities than multifilament polyglycolide.Conclusion: Tensile test of absorbable sutures was conducted in this research. Two types of absorbable sutures were investigated and compared. It isfound that sutures made from braided synthetic material of polyglycolide (violet coated) having much better tensile strength comparing with suturesmade from natural material (chromic catgut monofilament).

Clinical and laboratory investigation on the recurrence of the umbilical hernia after herniorrhaphy in bovine calves

This study was performed to investigate the recurrence of the umbilical hernia in bovine calves at Veterinary Teaching Hospital (VTH), Bangladesh Agricultural University, Mymensingh. A total of 34 animals were admitted to VTH diagnosed to have the umbilical hernia, among them 13 were recurrent cases. The diagnosis of umbilical hernia was based on the disease history, clinical signs, palpation, needle exploration, and auscultation. The risk factors like age, sex, breed, body weight, the season of affection, size of the hernial ring, suture materials, error in suture patterns and involvement of infections in the recurrence were considered. Infected samples were collected from recurrent patients with infected umbilicus region, and subjected to bacteriological analysis. We found the recurrence percentage was higher in the crossbred (44%) than that in the indigenous (22.22%) calves. It was also observed that recurrence percentage was higher in male (42.11%) than those in female (33.33%) patients. The recurrence percentage was also higher in calves aged below three months (40.74%) than the calves of above three months (28.57%). It was found that recurrence percentage was most frequent in summer (46.15%) and the least in the winter (30%). Among 13 recurrent bovine calves after herniorrhaphy, three calves returned to VTH with umbilical abscess, six calves recurred due to non-infectious causes like failure of suture materials, errors in suture pattern or management fault and 4 calves recurred with both umbilical abscess and non-infectious causes. From this study, it may be concluded that synthetic absorbable suture materials with secured suture pattern and good postoperative management may help in reducing the recurrence of an umbilical hernia.&#x0D; J. Bangladesh Agril. Univ. 16(3): 464–470, December 2018

Polypropylene mesh seeded with fibroblasts: A new approach for the repair of abdominal wall defects in rats.

The purpose of study was to develop bioengineered scaffolds by seeding primary mouse embryo fibroblast cells (p-MEF) on polypropylene mesh and to test its efficacy for the repair of abdominal wall defects in rats. The study was conducted on 18 clinically healthy adult Wistar rats of either sex. The animals were randomly divided into two equal groups having nine animals in each group. In both the groups a 20mm×20mm size full thickness muscle defect was created under xylazine and ketamine anesthesia in the mid-ventral abdominal wall. In group I the defect was repaired with polypropylene mesh alone and in group II it was repaired with p-MEF seeded polypropylene mesh. Matrices were implanted by synthetic absorbable suture material (polyglycolic acid) in continuous suture pattern. The efficacy of the bio-engineered matrices in the reconstruction of full thickness abdominal wall defects was evaluated on the basis of macro and histopathological observations. Macroscopic observations revealed that adhesions with skin and abdominal viscera were minimum in group II as compared to group I. Histopathological observations confirmed better fibroplasia and collagen fiber arrangement in group II. No recurrence of hernia was found in both the groups. Hernias are effectively repaired by implanting polypropylene mesh. However, this work demonstrates that in vitro seeding of mesh with fibroblasts resulted in earlier subsidization of pain, angiogenesis and deposition of collagen, increased thickness of matrices with lesser adhesions with underlying viscera. On the basis of the results p-MEF seeded mesh was better than non-seeded mesh for repair of abdominal wall defects in rats.

Sutures in abdominal surgery: biomechanical study and clinical application

Abstract The aim of this study is to improve treatment results and SSI prevention by differential usage of the contemporary suture materials and choice of proper suturing technique. To simulate suturing process and compared two suturing techniques, two FE models were developed. Finite-element analysis (FEA) was based on experimental data of contemporary commercial sutures and soft tissue properties. We applied obtained results for abdominal wall closure in rats and compared non-absorbable suture (capron) with absorbable suture (PDS Plus) for chosen technique. Cross-sections were examined by lighting electron microscope. Afterwards, the results of patients’ treatment are also presented. It was shown that running sew was more appropriate for aponeurosis suturing compared to interrupted sew. The optimal parameters of suturing techniques were computed. Single-row running sew by PDS Plus was proved to hold wound edges for 90 days with less inflammatory response compared to other suture in the result of histological analysis. Application of contemporary synthetic absorbable suture materials with antibacterial coating for laparotomic wounds closure and anastomosis decreases local inflammatory reaction and provides the successful tissue regeneration. Application of advanced SSI prophylactics algorithm was shown to decrease risk of post-operative suppurative complications from 14.2 to 1.6 %.

A Comparative Study between Inverting and Appositional Suture Patterns for Cystotomy Closure in Dog

The present study is designed to evaluate two sutures pattern techniques (inverting and appositional) for urinary bladder closure following experimental cystotomy in dogs. Thirty two adult local breed males’ dogs were enrolled for this study, aged 1-3 years and weighing 18-23 kg. Dogs were randomly allocated into two equal groups. In the first group, cystotomies were closed via double-layers of continuous inverting suture pattern (Lambert and Cushing); while, in the second group, bladders incisions were closed by single-layer appositional suture pattern (simple interrupted) which did not involve the mucosa (extra-mucosal). Synthetic absorbable suture material polydiaxnone PDS 3/0 was used to close the bladder in all experimental animal groups. Surgery was done under the effect of general anesthesia using a combination of ketamine at a dose rate of 15mg/kg and xylazine at a dose 5mg/kg B.W. Dogs were premedicated by atropine sluphate at a dose 0.03mg/kg. All drugs administered intramuscularly. There were highly significant (P &lt;0.05) differences in operative times between the two groups. In inverting group, the time was 40 ± 4.50 minutes which was higher than that recorded for appositional group 25±2.50 minutes. The animals were followedup clinically during the studied period to record the secondary complications. Results reflected hematuria n=4, swelling of the operative site n=3 and urinary incontinence n=2. These complications were transient and disappeared in a short time. Also macroscopical and microscopical examinations were performed at 3,7,14 and 21 days post-surgery. Four dogs were used for each period. The main macroscopical finding was slight to moderate adhesions n = 3 between omentum and the wall of urinary bladder in both group. Microscopical examination of urinary bladder reflected earlier urolithium formation in appositional pattern (14 days) while inverted group (21 days). In conclusion, appositional pattern is technically easier and economic. Bladder regeneration was accomplished within 14 days in comparison with inverting pattern which reflected bladder regeneration at 21 days post-surgery.

Evaluation of tensile strength of surgical synthetic absorbable suture materials: an in vitro study

PurposeThe purpose of this study was to evaluate the tensile strength of surgical synthetic absorbable sutures over a period of 14 days under simulated oral conditions.MethodsThree suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-є-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each suture material and gauge was assessed. The point of breakage and the resorption pattern of the sutures were also assessed.ResultsDuring the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P<0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P=0.003) tensile strength compared to PG.Conclusions4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. The PGA 4-0 suture showed the highest tensile strength at the end of day 10.

In Vitro Comparison of Mechanical and Degradation Properties of Equivalent Absorbable Suture Materials from Two Different Manufacturers

To compare the mechanical, knotting, and absorption properties of 3 synthetic absorbable suture materials (polyglactin 910, polydioxanone, poliglecaprone 25) from 2 different manufacturers (Huaiyin Medical Instruments Co. Ltd. and Ethicon Inc.). Suture material samples from the same manufacturing lot for each suture type and manufacturer. Part 1: 10 samples of each suture were incubated in bovine serum and tested for ultimate load and stiffness at days 0, 1, 7, 14, 21, and 28. Part 2: 10 knotted samples were similarly evaluated, without incubation. Huaiyin polydioxanone had a greater (P<.001) ultimate load on days 0, 1, and 7; and a consistently greater stiffness for the duration of the study, compared with the Ethicon polydioxanone. Ethicon poliglecaprone 25 had a greater ultimate load on days 0, 1, 7 (P<.001); on day 21 Huaiyin had a greater ultimate load. Ethicon poliglecaprone had greater stiffness on days 0, 1, 7 (P<.001). Ethicon polyglactin 910 had a greater (P<.001) ultimate load at all times and a greater stiffness (P<.001) at days 0, 1, 7, and 14 compared with Huaiyin polyglactin 910. Huaiyin polydioxanone and polyglactin 910 had greater knot breaking strengths than Ethicon equivalents (P<.001). Differences in mechanical properties exist between nominally identical suture materials from different manufacturers.

Optimal Technique for Abdominal Fascial Closure in Liver Transplant Patients

The ideal technique for abdominal closure of a Mercedes-type incision, which is still a serious issue among surgeons, has yet to be demonstrated clearly. The purpose of this study was to explain our novel technique for abdominal fascial closure in liver transplant patients. We analyzed retrospectively 180 consecutive adult-to-adult right lobe living donor liver transplants. The patients were divided into two groups based on two abdominal closure types used. Group A consisted of 78 patients who were submitted to abdominal closure with our new technique using three synthetic absorbable loop suture materials, and group B consisted of 102 patients whose abdominal closure was performed with another type of closure technique. There were no significant differences between the demographic characteristics of the two groups. The mean closure time was significantly lower in group A than in group B (p <0.05). The incidence rates of ascites leakage and hernias were also significantly lower in group A (p <0.05). Our results indicate that the novel technique used in this study contributed to overcoming early and late postoperative complications associated with closure of the abdominal fascia in liver transplant patients. In addition, this new technique has proven to be easily applicable, faster, safer and efficient in these patients; it is also potentially useful for conventional surgery.

Intracorporeal Suture Closure of the Internal Inguinal and Vaginal Rings in Foals and Horses

To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings. Case series. Foals (n=6) and geldings (n=2). After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close the internal inguinal and vaginal rings. There was no recurrence of inguinal hernia. Postoperative morbidity was minimal and cosmetic outcome was comparable to that achieved with conventional, open techniques. Laparoscopic, primary closure of the internal inguinal ring by use of intracorporeal sutures provides a secure barrier to herniation and costs considerably less than using endoscopic staples. Laparoscopic suture closure of the internal inguinal and vaginal rings provides safe and effective repair of inguinal hernia in horses.

Breaking strength and elasticity of synthetic absorbable suture materials incubated in phosphate-buffered saline solution, milk, and milk contaminated withStreptococcus agalactiae

Breaking strength and elasticity of synthetic absorbable suture materials incubated in phosphate-buffered saline solution, milk, and milk contaminated with<i>Streptococcus agalactiae</i>

Breaking strength and elasticity of synthetic absorbable suture materials incubated in phosphate-buffered saline solution, milk, and milk contaminated with Streptococcus agalactiae

To determine in vitro effects of PBSS, milk, and bacteria-contaminated milk (BCM; contaminated by Streptococcus agalactiae) on properties of 3 synthetic absorbable suture materials. 3 types of synthetic absorbable suture materials (poliglecaprone 25, polyglycolic acid, and polydioxanone). Suture materials were tested to determine breaking strength and elasticity before (day 0) and after incubation in 3 media (PBSS, milk, and BCM) for 7, 14, and 21 days. A loop of suture material was elongated at a rate of 60 mm/min until it reached the breaking point. Tensile properties were statistically analyzed among media and incubation times. Incubation in milk and BCM significantly decreased breaking strength and elasticity of poliglecaprone 25, compared with results for incubation in PBSS. Incubation in BCM significantly decreased tensile properties of polyglycolic acid suture, compared with results for incubation in PBSS and milk. After incubation for 21 days, tensile properties of polydioxanone did not differ significantly among the media but were significantly decreased from values on day 0. On the basis of this study, poliglecaprone 25 is an inappropriate suture material for use in teat surgery. Polyglycolic acid suture should be avoided in teats of cattle with mastitis. Of the suture materials tested, polydioxanone was best suited for use in teat surgery, as determined on the basis of material testing after incubation in milk, even when the milk was contaminated with bacteria.

Comparative study on biocompatibility and absorption times of three absorbable monofilament suture materials (Polydioxanone, Poliglecaprone 25, Glycomer 631)

Monofilament synthetic absorbable suture materials offer excellent glide characteristics and cause minimal tissue trauma as a result of their smooth monofilament structure and gradual bio-absorption. An investigation was conducted on 72 rats to compare three types of monofilament absorbable suture material (Polydioxanone, Poliglecaprone 25, Glycomer 631), with respect to their clinical characteristics, tissue inflammatory reaction and suture absorption times. The results identified different qualities for each suture: Poliglecaprone 25 and Glycomer 631 suture materials were found to be less reactive than Polydioxanone in rat skin. However, because of their extremely low tissue reaction values, all three materials were deemed particularly suitable for use as intracuticular sutures. Absorption times in rat skin were less than 3 months for Poliglecaprone 25, between 3 and 6 months for Glycomer 631 and 6 months for Polydioxanone. The differences in suture characteristics which were detected in our study can help in the surgical selection of the most appropriate suture material.

Comparison of Biological Changes in Absorbable Sutures in pH Buffers, Bile and Pancreatic Juice, and Evaluation of the Selection of Sutures in Biliary and Pancreatic Surgery

In this study, biological and morphological changes in three synthetic absorbable suture materials, namely poliglecaprone 25 (Monocryl), polyglactin 910 (coated Vicryl), and polydiaxanone (PDSII), in

Strength Retention of Chromic Gut and Monofilament Synthetic Absorbable Suture Materials in Joint Tissues

The rate at which absorbable sutures lose their mechanical strength in vivo is particularly important in orthopedic applications where high physical loads, often increased by early mobilization, severely test the strength of sutures. The failure load and maximum tensile strength of chromic catgut and two monofilament absorbable synthetic suture materials (polydioxanone and polytrimethylene carbonate) were measured up to six weeks after implantation in sheep as: (1) a suture securing a synovial incision and (2) coils located either within the synovial cavity of the knee or intramuscularly. Although all synovial wounds healed satisfactorily, the performances of the different materials varied. The strength of chromic gut was largely lost within a week and fragmentation occurred at Week 4. The synthetic materials lost their strength relatively slowly. Polytrimethylene carbonate degraded in a linear manner, remaining intact but with little strength by Week 6. Polydioxanone, though losing strength at a slower rate, tended to fragment early, which may be of clinical importance in situations of delayed wound healing.

The Use of Synthetic Absorbable Suture Materials (Polyglycolid Acid and Polydiocanone) in the Low Pressure Circulatory System of Growing Organisms

Synthetic absorbable sutures were used for surgery in the cardiovascular low pressure system of growing beagle dogs. Right atrial incisions were closed with this material in 20 dogs. In another 20 dogs caval anastomoses were performed in continuous suture technique. Repeated angiographies and histological examination were performed after observation periods between 5 and 180 days. No clinical complications occurred. Postoperatively patent anastomoses grew with the surrounding tissue, while stenotic anastomoses attained normal luminal diameter after suture absorption. Synthetic absorbable suture materials are recommended for use in the cardiovascular low pressure system, especially in the correction of congenital anomalies.