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PubMedDate not supplied

[Experimental evaluation of 4 different suture materials in colo-colic anastomoses (in the rat)].

The Authors carry out an experimental comparative study on four different suture materials (collagen cromic, polyglactin 910, PDS and nylon), used to perform end-to-end colonic anastomoses. They assess the resistence to the endoluminar pressure. The results show that during the first four days the anastomoses performed with PDS display a vere high resistence, while those with collagen cromic exhibit still lower value than Vicryl and nylon. After eleven days the anastomoses with the PDS show most resistence again, but the other three materials get similar value.

Anastomosis, Surgical↗
PubMed1982

[Repair of loss of substance of the thoracic wall and pericardium using a net of resorbable material].

After wide excision of the chest wall for primary tumour or bronchopulmonary carcinoma involving the ribs, the gap must be filled to prevent paradoxical respiration and its immediate functional consequences during the post-operative period. This can easily be achieved by using a polyglactin 910 piece of net cut to size out of a 25 X 25 cm plaque and sutured between the ribs under tension. The prosthesis ensures thoracic stability and acts as support for re-adherence of the lung to the chest wall. It resists coughing and is well tolerated. The indications of choice are respiratory failure and excision performed in varying degrees of septic condition which make non-absorbable material unsuitable. Another indication is wide excision of a tumour-invaded pericardium with herniation of the heart.

Bone Neoplasms↗
PubMedDate not supplied

Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds.

BACKGROUND: There is long-standing disagreement among facial plastic surgeons as to the ideal suture material for closing skin wounds of the face. Many surgeons believe that nonabsorbable suture material is preferable, as it is easier to tie, is unlikely to break prematurely, and elicits a minimal inflammatory response. Others feel that these issues are of minor importance and prefer absorbable sutures because they do not have to be removed, thus saving the surgeon time and decreasing patient anxiety and discomfort. PATIENTS AND METHODS: Facial skin cancers were removed from 41 patients. The length of closure ranged from 3.5 to 12.0 cm. All wounds were closed with rotational advancement flaps. Deep tissues were closed with 4-0 poliglecaprone 25 (Monocryl; Ethicon Inc, Somerville, NJ). One half of each wound was randomly closed with 5-0 coated polypropylene (Prolene; Ethicon Inc), while the other half was closed with 5-0 coated irradiated polyglactin 910 (Vicryl Rapide; Ethicon Inc). No wound infections or premature rupture of sutures occurred. All patients were followed up for 6 months after surgery. The photographs of the results were reviewed, and no difference was noted in scar formation. CONCLUSIONS: In adults with clean wounds of the face or neck, there is no difference in long-term cosmetic results of repairs with permanent or absorbable suture material. We prefer absorbable sutures, as they do not have to be removed, saving the surgeon time and lessening patient anxiety and discomfort.

Adult↗
PubMed1989

Use of Vicryl mesh in the reconstruction of the pelvic floor following exenteration.

Thirteen patients underwent reconstruction of the pelvic floor following pelvic exenteration using polyglactin 910 (Vicryl) mesh with omentum. One patient developed a conduit leak in the early postoperative period and one patient developed an enterocutaneous fistula at the time of recurrence. There were no other gastrointestinal or urinary tract complications. Six patients developed significant postoperative pelvic infections, four of which manifest as abscesses below the mesh. Vicryl mesh with omentum appears to be a reasonable method for reconstruction of the pelvic floor following exenteration. The postoperative infectious morbidity in this series is concerning, however.

Abscess↗
PubMed1994

Treatment of hepatic trauma with perihepatic mesh: 35 cases.

In a series of 61 trauma cases, 35 liver injuries (Moore's classes 2 to 5) were repaired using a polyglactin 910 perihepatic prosthesis. Two deaths (one coma, one avulsion of the inferior vena cava) were observed. Two centrohepatic hematomas were successfully treated by percutaneous needle aspiration. No hemobilia and no abscess of the liver occurred. Rapidly obtained hemostasis and cholestasis result in a large savings of blood. Progressive disappearance of the lesions was observed with repeat CT scanning until full recovery of the parenchyma was achieved. This was verified by biopsy and histologic examination and also by means of specific hepatic function tests.

Adult↗
PubMedDate not supplied

Tied and tidy: closing the conjunctiva over adjustable sutures.

BACKGROUND: Adjustable sutures have revolutionized strabismus surgery. Numerous techniques have been described that aim to facilitate postoperative adjustment. Nevertheless, some sort of procedure is always necessary following adjustable suture surgery and has to be arranged within 24 hours. Where no adjustment is required, the muscle needs to be secured at the existing position and the conjunctiva, sometimes left on a loop, has to be tidied up and sutured. METHODS: As fewer than half of the operated on eyes need a final adjustment, we describe a technique whereupon the muscle is left on a loop and the conjunctiva is closed over it with two interrupted polyglactin 910 sutures. If an adjustment is deemed necessary, one of the sutures has to be cut and replaced at the end of the procedure. When the result of squint surgery is satisfactory and no muscle movement is needed, no further manipulation of the conjunctiva is required. CONCLUSIONS: In a series of 17 patients, we have found this technique to be excellent for patient comfort and time efficiency. We have not encountered any muscle slippage. We think that the ease of postoperative management may tend to bias the surgeon against adjustment.

Adolescent↗
PubMed1987

[Behavior of modern suture materials in infected urine].

The recently developed absorbable materials demonstrate a constant and reproducible high quality when compared with the resorbable suture materials. However, based on in vitro studies by different authors the use of these materials in infected urine is not recommended. We investigated in vivo in infected urines the stability of the suture materials composed of polyglycolic acid, and compared the results obtained in vitro and in vivo. In a controlled study the stability of the absorbable suture materials polyglycolic acid, polyglactin 910 and polydioxanon 4/0 USP were tested in infected urine in vivo and in vitro. In 21 patients with infected urine the suture materials were placed into the bladder for 7 days. In another experiment these materials were incubated up to 7 days in culture flasks with infected urine. After that the suture materials were examined by densitometry and electrone microscopy. When using the results obtained in vitro in clinical work caution is recommended. However, the in vivo tests show that the stability of the newly developed absorbable materials is not influenced dramatically by the infected urine.

Bacteriuria↗
PubMed1995

[The repair of extensive evisceration using an absorbable prosthesis].

The use of an absorbable material in the form of a permeable mesh of polyglactin 910 is proposed for the treatment of extensive evisceration regardless of etiology. Its strength and excellent tolerance by the body even in the presence of infection justify its intraperitoneal placement on the deep surface of the peritoneum, in contact with the viscera and in reconstruction of the parietal wall. Perfect retention of the viscera in place is assured and the reconstructed parietal wall seems solid and stable, the absorbable mesh being rapidly replaced by host connective tissue of good quality. This technique, applicable to all cases of evisceration, is valuable in the surgical treatment of such patients, which is frequently difficult at best.

Abdominal Muscles↗
PubMed1994

Periodontal regeneration with bioresorbable membranes.

A critical point for the success of guided tissue regeneration is the rate of degradation of the bioresorbable membrane. An ideal bioresorbable membrane must allow selective repopulation of the root surface by cells from the periodontal ligament before it is degraded and replaced by the healing connective tissues of the periodontium. Freeze-dried dura mater, microfibrillar collagen, bovine type I collagen, human type I collagen, polylactic acid, and polyglactin 910 have been used in clinical human studies. Microfibrillar collagen did not form an effective barrier to epithelial migration. Freeze-dried dura mater has shown limited improvement in the treatment of proximal infrabony defects and equal results to expanded polytetrafluorothylene in the treatment of mandibular class II furcations. Cross-linked type I collagen and polylactic acid have shown significant improvement in the treatment of proximal infrabony lesions and class II furcations. More clinical studies done by independent investigators are needed to support the value of these bioresorbable materials in the regeneration of the periodontal tissues.

Animals↗
PubMed1985

Vicryl mesh in pelvic floor reconstruction.

A new synthetic absorbable mesh made of polyglactin 910 (Vicryl) fiber was used to reconstruct the pelvic floor in seven women undergoing pelvic exenteration. The technique is described. The follow-up ranged from three to 31 months and no patient developed a bowel problem. The material seems to be appropriate for this use, is completely absorbed, and acts as a latticework for the deposition of granulation tissue. The technique can be applied in patients requiring pelvic irradiation following surgery for malignant neoplasms of the gastrointestinal or genitourinary tracts. The small bowel is effectively held out of the pelvis and the radiation field, and is spared the effects of the radiation beam.

Adult↗
PubMed1984

The evaluation of various bioabsorbable materials on the titanium fiber metal tracheal prosthesis.

A new type of tracheal prosthesis was studied. It consists of a rigid, porous cylinder of titanium fiber metal coated with a polymer that provides an initial air seal and then is absorbed to permit subsequent fibrous tissue ingrowth and reepithelialization. Fifteen such cylinders measuring 50 mm by 26 mm were coated with one of the following polymers: polycaprolactone 700 (3 coated internally and 3 externally); a copolymer of 75% poly-L-lactic acid and 25% polyglycolic acid (3 coated internally and 3 externally); and polyglactin 910 (3 coated externally). Fifteen kennel-conditioned mongrel dogs, each randomly assigned to one of these five groups, underwent implantation of the prosthesis through a right thoracotomy into a 5-cm defect in the distal intrathoracic trachea. There were no immediate postoperative deaths, and no instances of major air leak from the prosthesis. One animal died after two weeks secondary to a lower respiratory tract infection. Bronchoscopic evaluation revealed varying degrees of tissue ingrowth into the prostheses, with no evidence of infection or distal accumulation of secretions. Histological evaluation showed superior tissue ingrowth and reepithelialization with internally coated prostheses; two out of three polymers gave good results.

Animals↗
PubMed2005

Tissue integration and tolerance to meshes used in gynecologic surgery: an experimental study.

OBJECTIVE: To evaluate the tissue integration of and tolerance to five different mesh types used in genital prolapse surgery to provide mechanical support. STUDY DESIGN: We placed five different meshes (Vicryl, Vypro, Prolene, Prolene soft, and Mersuture) on the peritoneums of 12 pigs. After 10 weeks, we used light microscopy to analyze the tissue integration of and tolerance to these meshes. We looked for inflammation, vascularization, fibroblasts, collagen fibers and the organization of connective tissue. RESULTS: The absorbable prostheses made of polyglactin 910 (Vicryl) and the non-absorbable prostheses made of polypropylene (Prolene and Prolene soft) induced the least severe inflammatory reactions. Tissue integration was best with the polypropylene meshes, which allowed the development of a well-organized, fibrous, mature, connective tissue. CONCLUSION: The tissue response to prosthetic meshes depends on the material used and its structure. This work highlights the feasibility of carrying out experimental studies to test the tolerance to and integration of biomaterials used in gynecology. Such studies need to be carried out whenever new prostheses become available to validate their use in common practice.

Absorbable Implants↗
PubMed1978

Comparison of a polyglycolic-polylactic acid suture to black silk and plain catgut in human oral tissues.

A polylactic-polyglycolic acid synthetic absorbable suture material (Vicryl, Polyglactin 910) was compared with black silk and plain catgut in human oral tissues. Inflammation was graded clinically and histologically after seven days. Handling characteristics, including suture retention, were evaluated. Vicryl and black silk sutures produced comparable inflammation after seven days. Plain catgut sutures were usually absorbed before seven days, but when retained generally produced a more severe reaction. The polylactic-polyglycolic acid suture is braided and dyed, and has handling characteristics similar to those of black silk. Although they are absorbable, Vicryl sutures may be retained longer than desired and probably should be used like silk when exposed to the oral cavity.

Adult↗
PubMed1982

[Behavior of resorbable and nonresorbable suture material in lymph vessel suture].

After transverse division of the abdominal thoracic duct of the rat, 14 anastomoses were performed using synthetic absorbable (Polyglactin 910, Vicryl) and synthetic non-absorbable (Polyamid 6.6, Ethilon) suture material. The anastomoses were achieved by means of a tension-free technique using interrupted sutures. The follow-up period was from 28 to 133 days. Clinical observation showed that all anastomoses were patent. However, with the aid of staining methods only five out of seven anastomoses were shown to be patent. Using absorbable suture material, a lumen was demonstrable at all anastomoses, while using non-absorbable suture material this could be proved in only four out of seven anastomoses. The foreign body reaction diminished with time when absorbable material was employed, whereas it persisted with non-absorbable material.

Animals↗
PubMed1993

Clinical and functional results of abdominal rectopexy with absorbable mesh-graft for treatment of complete rectal prolapse.

OBJECTIVE: To report the long term results of abdominal rectopexy in patients with complete rectal prolapse. DESIGN: Ongoing prospective randomised study. SETTING: Department of Surgery, Westfälische Wilhelms-University, Münster. SUBJECTS: 47 patients with complete rectal prolapse operated on between 1982 and 1989. INTERVENTIONS: Abdominal rectopexy with absorbable mesh made of either polyglycolic acid (n = 17) or polyglactine 910 (n = 30). MAIN OUTCOME MEASURES: Postoperative complications and late results at a mean of 50.5 (range 2-102) months after operation. RESULTS: Thirteen patients (28%) developed postoperative complications, most of them minor; there was one enterocutaneous fistula. Thirty five patients (74%) were available for late follow up. There were no case of recurrent prolapse and 5 (14%) had developed mucosal prolapse. Of the 22 patients who had been incontinent before operation, 8 had become totally continent and 6 partially continent Overall continence improved in 18 (51%) of the 35 patients. Three patients who were continent before operation had become incontinent. CONCLUSION: Absorbable mesh is a suitable material for abdominal rectopexy.

Absorption↗
PubMed2001

Use of absorbable mesh in the treatment of parenchymal liver injuries during orthotopic liver transplantation.

OBJECTIVE: To find out whether packing or wrapping with polyglactin 910 mesh was more effective in stopping bleeding in livers that had been damaged during transplantation. DESIGN: Retrospective study. SETTING: University hospital, Austria. SUBJECTS AND INTERVENTIONS: 15 of 27 livers that had been damaged during transplantation bled sufficiently to warrant either packing (n = 6) or wrapping (n = 9). MAIN OUTCOME MEASURES: Arrest of bleeding; other complications. RESULTS: Both packing and wrapping succeeded in stopping the bleeding, and neither caused infections. Packing may theoretically cause an increase in intra-abdominal pressure and impair organ function. CONCLUSION: It is preferable to wrap rather than pack a bleeding liver that has been damaged during transplantation.

Adult↗
PubMed1986

Dacron inhibition of arterial regenerative activities.

These biocompatibility studies evaluate the effects of Dacron, absorbable polymeric, and compound prostheses containing both elements in various constructions on the migration, proliferation, and functional characteristics of regenerating endothelial and smooth muscle-like cells in the rabbit aorta model. Prosthesis/tissue complexes explanted after 2 weeks to 9 months were studied grossly, photographed, sectioned for light microscopy and scanning and transmission electron microscopy, and assayed for 6-keto-PGE1 alpha contents in inner capsular tissues. Polyglycolic acid, polyglactin 910, or polydioxanone prostheses elicited a transinterstitial migration and proliferation of primitive mesenchymal cells that differentiated into smooth muscle-like myofibroblasts and a surface repopulation of confluent endothelial-like cells paralleling the time course of macrophage-mediated prosthetic dissolution. Even small Dacron components (20%) woven into or surrounding the absorbable polymer significantly inhibited these processes, yielding significantly thinner, less cellular inner capsules with lower 6-keto-PGF1 alpha contents. These studies show the augmentation of clinically efficacious arterial regenerative activities by polymers phagocytosed by macrophages and the inhibition of these activities by Dacron.

6-Ketoprostaglandin F1 alpha↗
PubMed1982

The effect of pH on the in vitro degradation of poly(glycolide lactide) copolymer absorbable sutures.

The pH effect on the hydrolytic degradation of Polyglactin 910 copolymer was studied in terms of the tensile properties of the suture specimens. The use of a cord/yarn grip, newly designed specifically for fibrous materials, eliminated the grip-induced failure. Different degrees of hydrolytic degradation of this copolymer at 3 different pH levels were observed. The suture specimens exhibited the best retentions of breaking strength at the physiological pH of 7.44, while the specimens at pH = 10.09 showed the fastest loss of breaking strength. Thus, a maximum retention of tensile properties occurred around the pH level of 7.0, whereas smaller percentages of retention of tensile properties were observed at both acidic and strong alkaline solutions. This synthetic absorbable suture material exhibits the basic characteristic of hydrolysis which is catalyzed by both acid and base.

Biodegradation, Environmental↗