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PubMed1993

Maxon is an optimal suture for bile duct anastomoses in pigs.

BACKGROUND: Three commonly used sutures were tested in a pig model of bile duct anastomosis to assess their relative contributions to inflammation and scarring. METHODS: Thirty pigs were randomised to bile duct division and anastomosis with either polyglyconate (Maxon), polyglactin 910 (Vicryl) or polypropylene (Prolene). Half the animals were sacrificed at two weeks and the remainder at 23 weeks. Anastomoses were assessed by cholangiography, scanning electron microscopy and light microscopy. RESULTS: There was less short term histological reaction with the two monofilament materials, Prolene and Maxon, compared to the braided suture Vicryl. Maxon was associated with less long term inflammation than Prolene, was found to handle better, and has an advantage over Prolene by being absorbable. CONCLUSION: Maxon is an optimal suture for bile duct anastomoses. Its long term absorption characteristics make it suitable for situations where bile duct healing may be delayed.

Anastomosis, Surgical↗
PubMed1996

Contaminated wounds: infection rates with subcutaneous sutures.

STUDY OBJECTIVE: To determine whether buried absorbable subcutaneous sutures (BASS) increase the infection rate in irrigated contaminated wounds. METHODS: This was a randomized, prospective trial in a rat model, with the histologist blinded to treatment group. A single 2-cm dorsal incision was made on each of 30 anesthetized 250-g Sprague-Dawley rats and inoculated with approximately 10(8) organisms of Staphylococcus aureus. After irrigation, 15 wounds were closed with running 4-0 nylon transdermal sutures, and 15 were closed with three interrupted 4-0 coated polyglactin 910 (Vicryl) subcuticular sutures (BASS) and running 4-0 nylon transdermal sutures. On day 7, wounds were scored on a scale of 0 to 3 in six categories: inflammatory infiltrates, fibroplasia and capillary proliferation, necrosis, exudates, giant cells, and edema. The possible range for the cumulative wound score was 0 (no inflammation) to 18 (severe inflammation and infection). RESULTS: The median total wound score in wounds closed with BASS was 14 (range, 7 to 16); it was 8 (range, 5 to 15) for wounds closed without BASS (P = .0004). The subscores for inflammation, necrosis, exudate, and edema were also significantly higher in wounds closed with BASS. CONCLUSION: BASS increase the infection rate and the degree of inflammation in contaminated wounds, despite through irrigation.

Animals↗
PubMed1999

Material properties of ophthalmic sutures after sterilization and disinfection.

PURPOSE: To assess the effects that sterilization and disinfection have on the tensile properties of commonly used ophthalmic sutures. SETTING: University of Bristol, Bristol, United Kingdom. METHODS: The sutures 10-0 nylon, 10-0 polypropylene (Prolene), 8-0 virgin silk, and 8-0 polyglactin 910 (Vicryl) were subjected to thermal or chemical sterilization/disinfection including autoclaving, boiling, and immersion in alcohol or glutaraldehyde. Measurements of tensile strength, suture extension to the point of failure, and suture stiffness were then performed. RESULTS: Nylon and Prolene were little affected by all sterilization and disinfection methods. Virgin silk and Vicryl were weakened by thermal methods of sterilization and disinfection. Both Vicryl, and to a lesser extent virgin silk, appeared to be strengthened by immersion in alcohol or glutaraldehyde. CONCLUSION: The casual reuse of ophthalmic sutures is not recommended. However, when there is no alternative, nylon and Prolene monofilaments can be autoclaved or immersed in fresh activated glutaraldehyde, and Vicryl and virgin silk can be immersed in fresh activated glutaraldehyde without significant loss of tensile strength.

Disinfection↗
PubMed1980

Thrombogenicity of different suture materials as revealed by scanning electron microscopy.

The thrombogenicity of five suture materials--polypropylene (Prolene), polyester (Mersilene), polyglactin 910 (Vicryl), nylon (Tthilon), and silk--was examined in vivo by scanning electron microscopy. The most blood-compatible material appeared to be Prolene. A rather satisfactory antithrombogenciity was shown by Mersilene, in comparison with which Ethilon and Vicryl provided less thromboresistance. The possible connection between the chemical changes which occur during the hydrolysis of Vicryl and its blood compatibility is discussed. Of the tested materials, silk proved to be the most thrombogenic. This study shows that the thrombogenicity of a suture material could be easily and conveniently tested in an experimental model by scanning electron microscopy, thus enabling the first choice of a suitable suture for the cardiovascular surgery, before one continues with other more sophisticated methods for the evaluation of thromboresistance.

Animals↗
PubMed2001

Affinity of Staphylococcus epidermidis to various prosthetic graft materials.

BACKGROUND: Abdominal wall hernias have always been a major problem for general surgeons. The techniques of repairing primary, recurrent, and incisional hernias have evolved throughout the years at an accelerating trend, especially after production of prosthetic graft materials. Although looked upon with suspicion due to infection, fistula formation, and foreign body reaction, prosthetic graft materials are used deliberately in primary and recurrent hernias. The present study was designed to evaluate bacterial adherence to frequently used prosthetic graft materials. MATERIALS AND METHODS: The study was carried out in five different groups with each group consisting of 10 identical samples of the same kind of prosthetic graft material. The prosthetic graft materials used in the study were polypropylene, polyglactin 910, polyester fibers, steel, and polytetrafluoroethylene (PTFE). These prosthetic graft materials were incubated in vitro with a Staphylococcus epidermidis strain which was ++++ adhesion positive. The degree of adhesion of S. epidermidis to prosthetic graft materials was assessed by the ELISA method. RESULTS: Vicryl grafts showed significantly minimal bacterial adhesion whereas PTFE grafts tended to have more adhesion but this did not reach a statistical significance. Other graft materials did not show any difference for bacterial adhesion (Table 3). CONCLUSION: These results suggest that in vitro S. epidermidis adhesion to Vicryl grafts is less than other types of prosthetic graft materials (P < 0.05 for all comparisons). Further in vitro and in vivo studies are required to confirm these results and to understand the complex interactions among bacteria, graft material, microenvironment, and surgical technique.

Bacterial Adhesion↗
PubMed1981

"Staying power"--absorbable vs. nonabsorbable.

An experiment was designed to compare the "holding power" or "staying power" of absorbable (polyglycolic acid and polyglactin 910) and nonabsorbable (nylon) suture. The aim of this experiment was to determine what provides the lasting strength of the bond between soft tissues that are approximated or plicated. When correcting the rectus diastasis during abdominoplasty, we used nylon sutures in 15 patients and absorbable synthetic sutures in 15 other patients. We then marked the closed folds of the rectus sheath with small metal vascular clips. Two days later and approximately 6 months after operation an upright anteroposterior abdominal x-ray was taken and the position of the metal clips was compared in the test groups. Although there was usually slight separation of the clips after 6 months, no significant difference between the two groups was noted, thereby indicating that holding power is not related to type of suture material but more likely to fibroplasia.

Abdominal Muscles↗
PubMedDate not supplied

Biomaterial-induced macrophage activation and monokine release.

This study quantifies macrophage acid phosphatase release as a marker of cell activation when cultured with or without biomaterials. Peritoneal macrophages were harvested from six New Zealand White rabbits and cultured in minimum essential media with 10% equine serum. After cell identification by morphology, nonspecific esterase, and RAM 11 immunoperoxidase, cells were passaged twice, and second-passage macrophages were seeded in 96-well plates (5,000 cells/well) and grown to confluence. After collection of day zero media, circular disks of polyglactin 910 and two types of commercially available polyethylene terephthalate with different construction and sterilization characteristics were placed on the cell monolayer. Controls without biomaterials were also established. Media was collected and pooled for each group and time point beginning on day 2 and continuing every other day for 22 days. Conditioned media were quantitatively assayed for acid phosphatase colorimetrically at 402 nm using p-nitrophenylphosphate as the substrate. Acid phosphatase activity increased progressively at late time points for each group but no difference was noted between groups at any time point. These data show that the activation of cultured macrophages with time is not altered differentially by the presence of biomaterials. The previously demonstrated monokine release following biomaterial exposure is therefore a specific event and not simply part of the generalized activation phenomenon.

Acid Phosphatase↗
PubMedDate not supplied

Kinetics of collagen deposition within bioresorbable and nonresorbable vascular prostheses.

This study compares the kinetics of collagen deposition within the prosthesis/tissue complexes formed following implantation of either polyglactin 910 (PG910), polydioxanone (PDS), or Dacron prostheses into rabbit infrarenal aortas. The grafts were explanted in triplicate at 1, 3, and 12 months, and then processed for spectrophotometric hydroxyproline quantitation. A 2 mm longitudinal strip from each sample was processed for histologic evaluation by light and electron microscopy. Results showed more extensive collagen deposition within the prosthesis/tissue complexes of both PG910 and PDS continuing throughout 3 months, as compared to less collagen deposition in Dacron grafts at all time points. Differences between PG910 and Dacron, and between PDS and Dacron at each time point were statistically significant. When correlated with previous related studies done in our laboratory, data showed that in resorbable grafts the rate of collagen deposition parallels the kinetics of cellular proliferation, tissue thickening, and graft resorption.

Animals↗
PubMed1998

Shrinking of polypropylene mesh in vivo: an experimental study in dogs.

OBJECTIVE: To assess the extent of shrinkage of meshes used for hernia repair. DESIGN: Experimental study in dogs. SETTING: University hospital, Germany and University Research Centre, Moscow. ANIMALS: 10 dogs had monofilament polypropylene meshes that weighed 95 g/m2 (Marlex) or multifilament reduced polypropylene meshes combined with polyglactin 910 that weighed 55 g/m2 (Soft Hernia Mesh) implanted for either 3 or 6 months. MAIN OUTCOME MEASURES: Histological appearance and radiological assessment of the position and area of the mesh. RESULTS: After 4 weeks the area of mesh in the monofilament group was reduced from to 139 (11) to 75 (8) cm2 (54%) and that of the multifilament from 116 (18) to 77 (20) cm2 (66%). The multifilament mesh with the reduced amount of polypropylene showed less inflammatory response and less shrinkage. The mesh did not seem to have moved. CONCLUSION: Meshes that contain a lot of polypropylene shrink to about 30%-50% of their original size after 4 weeks, requiring an overlap of at least 3 cm if implanted subfascially. Reduction in the polypropylene content decreases both the inflammatory response and the shrinkage. Meshes with big pores are less likely to fold and improve compatibility.

Animals↗
PubMed1987

Suture materials in contaminated wounds: a detailed comparison of a new suture with those currently in use.

The relationship between five different suture materials (expanded polytetrafluoroethylene (PTFE), polypropylene, polyglycolic acid, polydioxanone and polyglactin 910) and infection has been studied in 540 guinea-pig wounds contaminated with synergistic enteric organisms. The recently introduced expanded PTFE suture has been studied because, unlike the others, it has not previously been studied under these contaminated conditions. The incidence of wound infection in the control series was 26 per cent and all suture materials increased this figure significantly. The infection rate using expanded PTFE of 51 per cent was similar to all other sutures except polyglycolic acid, which produced an infection rate of 41 per cent. This difference was not statistically significant at the 5 per cent level. This confirms other studies including our own which show that the presence of most suture materials in contaminated wounds increases the incidence of infection. It further demonstrates that expanded PTFE is no different from other materials in this regard.

Animals↗
PubMed1994

[Formation of a neofascia after implantation of a composite patch in the inguinal region].

In this study, a novel patch material composed of polyglactin 910 and polydioxanon was tested in animal experiments for its use in the surgical repair of hernias. The material was implanted laparoscopically into the inner inguinal region of three hybrid running-pigs. No postoperative complications were observed. The animals were killed 14 and 48 days after surgery. Both the macroscopic and microscopic examination showed a de novo formation of connective tissue at the site of implantation, which may be regarded as a new fascia. Due to the cooperation of fibroblasts and free cells of the connective tissue, new intercellular matrix was formed after the resorption of the implanted material. A model of this cell cooperation is outlined in the study. The technical advantages of the implantation material are demonstrated and its benefits for minimally invasive surgery emphasized. Because of its special properties, the material may be recommended for later clinical traits in the surgery of fascia.

Animals↗
PubMedDate not supplied

Prostacyclin production by blood-contacting surfaces of endothelialized vascular prostheses.

This study examines prostacyclin production by blood-contacting surfaces within woven vascular prostheses of polydioxanone (PDS), polyglactin 910 (PG910), or Dacron interposed into rabbit infrarenal aortas. Grafts and normal aortic segments were explanted after 1, 3, and 6 months for pulsatile perfusion with Medium-199 for 60 minutes. Aliquots were removed serially for 6-keto-PGF1 alpha assay. After 30 minutes sodium arachidonate (10 micrograms/ml) was added. Specimens were studied by light microscopy, SEM and TEM. Patency in all three groups exceeded 90%. All three showed re-endothelialization at one month. Normal aorta produced low basal 6-keto-PGF1 alpha with a marked evanescent post arachidonate increase. Dacron did not differ from normal aorta. PG910 and PDS both produced significantly less 6-keto-PGF1 alpha post arachidonate at one month but both increased to normal by three months.

6-Ketoprostaglandin F1 alpha↗
PubMed2006

The novel use of resorbable Vicryl mesh for in vivo tendon reconstruction to a metal prosthesis.

We examined the mechanical properties of Vicryl (polyglactin 910) mesh in vitro and assessed its use in vivo as a novel biomaterial to attach tendon to a hydroxyapatite-coated metal implant, the interface of which was augmented with autogenous bone and marrow graft. This was compared with tendon re-attachment using a compressive clamp device in an identical animal model. Two- and four-ply sleeves of Vicryl mesh tested to failure under tension reached 5.13% and 28.35% of the normal ovine patellar tendon, respectively. Four-ply sleeves supported gait in an ovine model with 67.05% weight-bearing through the operated limb at 12 weeks, without evidence of mechanical failure. Mesh fibres were visible at six weeks but had been completely resorbed by 12 weeks, with no evidence of chronic inflammation. The tendon-implant neoenthesis was predominantly an indirect type, with tendon attached to the bone-hydroxyapatite surface by perforating collagen fibres.

Animals↗
PubMed1988

Histologic response to microsuture materials.

Long- and short-term reactions of reproductive tract tissue to microsurgical suture materials were compared. The five materials were: polyglactin 910 (Vicryl), polyglycolic acid (Dexon-S), polypropylene (Prolene), nylon (Ethilon and Dermalon) and chromic catgut; the calibers ranged from 6-0 to 10-0. Sixteen days after suture placement the smallest tissue reaction was seen with 9-0 and 10-0 suture materials; Dexon-S caused a slightly greater reaction than did Vicryl. Prolene, 8-0 and 9-0, produced the smallest tissue response when compared to other sutures of similar size. Larger sutures incited greater tissue reactions. Forty-two days after placement, each suture was associated with similar or lower reaction scores than those observed at 16 days. At 90 days all the Dexon-S sutures had been absorbed. Vicryl had less of a late reaction as compared to the other sutures. Reactions persisted longer with nonabsorbable suture, and the tissue response depended on both the suture material and caliber. Vicryl, 8-0 to 10-0, incited the smallest short- and long-term tissue reaction; at those sizes it seems optimal for reconstructive tubal surgery.

Animals↗
PubMed1995

Subcuticular sutures and the rate of inflammation in noncontaminated wounds.

STUDY OBJECTIVE: To determine whether buried, absorbable, subcuticular sutures increase the degree of inflammation in noncontaminated wounds. DESIGN: Randomized, blinded, prospective trial. SETTING: Laboratory. PARTICIPANTS: Eleven Sprague-Dawley rats weighing 300 to 325 g. INTERVENTIONS: Four wounds were made on each rat. Two wounds on each were closed with three interrupted buried, absorbable, subcuticular sutures 6-0 polyglactin 910 and running 5-0 nylon skin sutures. The other two wounds were closed with running 5-0 nylon skin sutures alone. RESULTS: Fourteen days after the sutures were placed, the animals were killed, and histologic preparations were made from each wound. Each sample was scored on a scale of 0 to 3 for the presence of inflammatory infiltrates, fibroplasia and capillary proliferation, necrosis, exudates, giant cells, and edema. We determined a total wound score by adding the scores from each category. The mean total wound score was 4.46 +/- 2.92 for those closed with buried, absorbable, subcuticular sutures and 4.91 +/- 2.56 for those closed without buried, absorbable, subcuticular sutures. Using the Wilcoxon rank-sum test, we found no statistically significant difference in mean total wound score of wounds closed with and without buried, absorbable, subcuticular sutures (alpha = .01). The probability of detecting a twofold difference in total wound scores was 60% (beta = .40). CONCLUSION: Buried, absorbable, subcuticular sutures do not significantly increase the degree of inflammation in noncontaminated wounds.

Animals↗
PubMedDate not supplied

Comparison of resorbable and nonresorbable guided bone regeneration materials: a preliminary study.

The purpose of this study was to compare bone regeneration within a surgically created defect using three different resorbable membranes (polyglactin 910 knitted mesh/Vicryl, freeze-dried fascia lata, and crosslinked bovine type I collagen/BioMend) and two nonresorbable membranes (expanded polytetrafluoroethylene/Gore Tex, and polytetrafluoroethylene/Millipore). Each of three adult male dogs underwent surgical preparation of six bicortical defects of the calvarium, each 1.5 cm in diameter. The experimental barrier membranes were placed on both sides of the defects (inner and outer cranial tables). Five of the six defects were covered randomly by one of the five membrane materials, and one was left uncovered to serve as a negative control. The animals were sacrificed 10 weeks after membrane placement. Bone response was measured clinically, as well as radiographically, via densitometric examination. All surgical sites healed uneventfully. Variable degrees of new bone growth were present at all sites when evaluated by both clinical and radiographic examination. The general trend of observed osseous response indicates a greater, although not statistically significant, degree of bone growth using nonresorbable membranes. The animal model employed appears to be an efficient and reliable means of evaluating guided bone regeneration membranes.

Animals↗
PubMed2001

Comparative study of three different membranes for guided bone regeneration of rat cranial defects.

The purpose of the study was to compare the efficacy of a non-resorbable polytetrafluoroethylene (e-PTFE) membrane (Gore-Tex) versus a resorbable polyglactin membrane (Vicryl) and a newly designed collagenic membrane for enhancing bone regeneration on rat skull defects. The study was conducted on 30 adult Wistar rats. On each animal, two symmetrical, 6 mm wide, full-thickness, skull defects were created in the parietal regions. The right defect was chosen as the experimental site and the left one was left empty as a control. Each experimental site was covered by an inner and outer membrane. The 30 rats were divided into three groups: In group 1 (n=10), a non-resorbable polytetrafluoroethylene (e-PTFE) membrane was used. In group 2 (n= 10), a resorbable polyglactin 910 membrane was used. In group 3 (n= 10), a collagen membrane processed from avian eggshell was used. In each group, the animals were euthanized at 60 days. The harvested specimens were processed for contact radiography and standard histological examination. The results were assessed by a Fisher's exact test. In group 1, partial bone healing was observed in seven out of 10 animals and complete in three out of 10 animals (P<0.001). In group 2, no or minimal bone healing was observed in seven out of 10 animals and partial bone healing was observed in three out of 10 animals. In group 3, no or minimal bone healing was observed in nine out of 10 cases and partial bone healing in only one animal. In conclusion, only the non-resorbable e-PTFE membrane group exhibited a favourable result in this study. This study suggests that the structure of the membrane is at least as important as its composition.

Absorbable Implants↗
PubMed1979

[Synthetic resorbable and synthetic non-resorbable suture materials in microvascular surgery. Animal experimental study].

In a series of experiments on the aorta of the rat, the behaviour of an absorbable monofilament suture VICRYL (Polyglactin 910) was compared to that of a non-absorbable suture ETHILON (Polyamide 6/6). A total of 86 rats was operated upon and examined over a period of 70 days. The report includes a complete description of experimental procedures and techniques used during the operations. The evaluation of the experiments took place after completion of the mechanical, histological and scanning electron microscopical tests. It has been proven that under similar conditions, the 0,2 metric suture VICRYL has adequate tensile strength to withstand the intravascular pressure in a vessel with an outer diameter of approx. 1,5 mm. Aneurysm, stenosis and dehiscence of the anastomosis did not occur. The VICRYL suture showed no reactive processes after a period of 42 days. With the suture ETHILON the inflammation of the media and the hyperplasia of the intima persisted even after 70 days, at the end of the experiment. It is therefore shown in microsurgery, the monofilament absorbable suture VICRYL and the non-absorbable monofilament suture ETHILON are equal in their mechanical qualities, but that the suture VICRYL has by far the better tissue compatibility.

Animals↗