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PubMed2004

Skin closure in carpal tunnel surgery: a prospective comparative study between nylon, polyglactin 910 and stainless steel sutures.

OBJECTIVE: To compare the cosmetic outcome, pain and tenderness around the operation scar of carpal tunnel syndrome surgery using either nylon, polyglactin 910 or stainless steel sutures for skin closure. METHODS: A randomised clinical trial comparing nylon, polyglactin 910 or stainless steel sutures for skin closure in 61 patients undergoing carpal tunnel syndrome surgery was performed. Pain, tenderness, scar hypertrophy, redness and the presence of granulomas were assessed in all patients at ten days and six weeks after surgery and compared by non-parametric statistical tests. RESULTS: Adequate surgical decompression of the median nerve could be achieved in all patients. All but two patients experienced significant relief of tingling of the fingers. Nearly all patients reported some degree of discomfort around the scar. At ten days, the mean pain score was 1.7 (+/-2.2), 3.1 (+/-2.3) and 1.9 (+/-2.3) for the nylon, vicryl and steel groups, respectively. At six weeks, the pain score was 3.6 (+/-3.1), 3.4 (+/-2.6) and 2.7 (+/-2.1) for the nylon, vicryl and steel groups, respectively. The infection rate was 0%, 8% and 0% for the nylon, vicryl and steel groups, respectively. Suture granulomas were significantly more present in the vicryl group (p<0.05). There were no statistical differences in redness or hypertrophy of the wound between the three groups. CONCLUSIONS: Nylon and stainless steel sutures are both suitable for skin closure after carpal tunnel surgery. Based on this study, absorbable vicryl sutures should not be used, since the incidence of infections and the presence of suture granulomas was much higher than in the nylon and steel suture groups.

Adult↗
PubMed1979

A comparative evaluation of 9-0 monofilament and 9-0 braid polyglactin 910 in cataract surgery (intracapsular, extracapsular, and phacoemulsification).

This study describes the operative and postoperative performance of 9-0 monofilament and 9-0 braid Polyglactin 910 synthetic absorbable sutures in cataract surgery. The evaluation represents a clinical comparison of the sutures in 150 cataract surgical procedures. In a comparative evaluation each suture provided specific performance advantages: (table: see text). To date, the 9-0 monofilament and 9-0 braid Polyglactin 910 sutures are the smallest useful absorbable sutures developed for cataract surgery. While these sutures seem safe for use with phacoemulsification as sole wound closure materials, we recommend the use of nylon stints for intracapsular and extracapsular procedures until further experience is gained.

Cataract Extraction↗
PubMed1999

Outcomes of irradiated polyglactin 910 Vicryl Rapide fast-absorbing suture in oral and scalp wounds.

BACKGROUND: This study evaluated the outcome of wounds closed with irradiated polyglactin 910 (IRPG) Vicryl Rapide (Ethicon, Somerville, N.J.). METHOD: Seventy-one patients with 80 oral wounds and 42 patients with 42 scalp wounds closed with IRPG were evaluated on the day of surgery, then one, seven, 14, 28 and 90 days following surgery. The incidence of inflammation, suppuration and hypertrophic scarring was recorded, along with the timing of spontaneous suture disappearance. This suture material was compared with polytetrafluoroethylene (PTFE) sutures used in dental implant patients, traditional polyglycolic acid (PGLA) sutures used in osteotomy patients and skin staples used in patients with scalp wounds. RESULTS: In the group with intraoral wounds, there were two cases of suppuration with no inflammatory reactions or hypertrophic scarring when IRPG sutures were used, compared to three cases of suppuration with the traditional PGLA sutures. In the group with scalp wounds, there was no suppuration or hypertrophic scarring with IRPG sutures and one inflammatory reaction with skin staples. IRPG sutures never required removal, while all staples, PGLA and PTFE sutures eventually required separate removal. CONCLUSION: Irradiated polyglactin 910 Vicryl Rapide is a useful suture material with both intra- and extraoral applications in the pediatric and adult populations.

Adult↗
PubMed2005

Comparison of gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs.

OBJECTIVE: To assess gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs. ANIMALS: 8 purpose-bred disease-free pigs. PROCEDURE: Pigs were randomly allocated to 1 of 4 groups from which tissues were collected after death on postoperative days (PODs) 7, 14, 21, or 42. In each pig, 4 incisions were made; 1 was closed subcuticularly with 3-0 polyglactin 910 suture, 1 was closed with metal staples, and 2 were closed with absorbable subcuticular staples. Incision sites were grossly evaluated every 3 days after closure. At necropsy, incision sites and surrounding tissues were examined histologically; a histopathologic scoring system was used to quantitate healing and tissue response directed against the closure material. RESULTS: Postoperatively, the metal staples induced a severe inflammatory response, compared with minimal inflammation associated with the suture or absorbable subcuticular staples. Histologic evaluation of incisions on PODs 7, 14, and 21 revealed less severe inflammation associated with absorbable subcuticular staples than that associated with the other materials. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that absorbable subcuticular staples induced a less severe inflammatory response in the early stages of healing in pigs, compared with other commonly used methods of wound closure. Use of absorbable staples potentially combines the benefits of subcuticular closure with the speed and precision of staple placement.

Animals↗
PubMed1984

[Pelvic peritonization with a polyglactin 910 mesh].

The authors, who have a long experience of polyglactin 910 mesh advocate its use for pelvic peritonization in two different situations and with two different techniques. The "lower controlled peritonization" technique aims at obtaining rapid and satisfactory healing of the peritoneum in wide resections or resections in high risk patients. The "upper controlled peritonization" technique creates a "hammock" across the upper pelvic inlet, thus protecting intestinal loops against post-operative irradiations.

Female↗
PubMed1988

Absorbable synthetic mesh (910-polyglactin) intestinal sling to reduce radiation-induced small bowel injury in patients with pelvic malignancies.

Absorbable synthetic mesh (910-polyglactin) was used to create an intestinal sling in six patients undergoing surgical staging of pelvic malignancies prior to radiation therapy. All patients had effective compartmentalization of small intestine out of the pelvis which persisted throughout the duration of radiation therapy. None of the patients developed complications related to the intestinal sling. This technique is well tolerated and has the potential to minimize chronic small intestinal complications caused by radiation therapy for pelvic malignancies.

Aged↗
PubMed1989

A comparative study of polydioxanone (PDS) and polyglactin 910 (Vicryl) in colonic anastomoses in rats.

The use of polyglactin 910 (Vicryl) in colonic anastomoses is theoretically undesirable because its short dissolution time and multifilament structure may lead to local sepsis and anastomotic leakage. We have compared Vicryl with a newly introduced monofilament absorbable suture which has a longer dissolution time than Vicryl. In a study of 98 rat colonic anastomoses no difference was found in complication rates or cellular reaction to the suture material between Vicryl and polydioxanone (PDS). The use of monofilament suture with longer dissolution time does not necessarily imply added security for colonic anastomoses.

Anastomosis, Surgical↗
PubMed1994

Immediate implant placement using a biodegradable barrier, polyhydroxybutyrate-hydroxyvalerate reinforced with polyglactin 910. An experimental study in dogs.

The purpose of this study was to evaluate the use of a biodegradable membrane of polyhydroxybutyrate-hydroxyvalerate copolymer reinforced with polyglactin 910 fibers, as an occlusive barrier over implants placed into fresh extraction sockets. Ten dogs had the 3rd and 4th mandibular premolars extracted bilaterally. Each dog had 4 Astra Dental Implants placed directly into the fresh extraction sockets. The top of the fixtures was placed at the same level as the top of the buccal cortical bone. The two implants in the right side were covered with the hydrolyzable polyester material (polyhydroxybutyrate-hydroxyvalerate reinforced with polyglactin 910 fibers; PHB-HV/PG), and the 2 implants in the left side were controls without occlusive membranes. Soft tissue dehiscences were registered for half of the implants in the test side but were not noted in the control side. The histomorphological measurements after 12 weeks showed that the mean distance from the top of the fixtures to the first bone-to-implant contact was significantly greater than for the control side. The membrane-covered implants without dehiscences showed also significantly less bone fill compared with the control side. Inflammatory cell infiltrates were seen adjacent to all PHB-HV/PG membranes, and frequently the membrane material was surrounded by a fibrous tissue capsule. The polyester membranes used in this study interfered with the marginal bone healing adjacent to the immediately placed implants. An increased inflammatory reaction and significantly less marginal bone healing was registered in the membrane side compared with the control side.

Animals↗
PubMed2000

Cerebrospinal fluid seepage through polyglactin 910 dura substitute manifested as spinal extradural collection of fluid.

Following excision of pilocytic astrocytoma, a 12-year-old girl underwent posterior cranial fossa synthetic duraplasty with polyglactin 910 mesh. On the 8th postoperative day, unusual extradural collection was diagnosed by spinal magnetic resonance imaging. On the 14th postoperative day, cerebrospinal fluid leakage in the upper part of the postoperative wound was noticed. Unusual extradural collection detected by spinal magnetic resonance imaging was assumed to be the consequence of cerebrospinal fluid seepage and a warning sign of cerebrospinal fluid leakage following synthetic posterior fossa duraplasty. This case shows that polyglactin 910 mesh may be ineffective when used for posterior cranial fossa duraplasty in children, although it is considered as valuable as autologous tissue.

Astrocytoma↗
PubMed1995

Irradiated polyglactin 910: a new synthetic absorbable suture.

Two hundred and thirty-six patients had a variety of skin and mucosal wounds sutured with a new rapidly absorbed suture material (irradiated polyglactin 910). No wound complications could be attributed to the material. These included 62 patients with scalp wounds, taking part in a comparative trial with traditional interrupted, monofilament, non-absorbable suturing. No difference in the cosmetic result could be detected three months later. The irradiated polyglactin disappeared from the wound surface spontaneously and suture removal was not normally required. Irradiated polyglactin 910 is suitable for closure of wounds where rapid suture absorption is desirable, particularly for wounds in the scalp, scrotum, and perineum and is an ideal material for mucocutaneous anastomosis at stoma surgery. Loss of suture strength is so rapid that suture removal is unnecessary, eliminating the need for further medical or paramedical care. As absorption is by hydrolysis rather than enzymatic digestion, stitch abscesses are not seen.

Humans↗
PubMed1993

[Treatment of postoperative incisional hernias by a composite prosthesis (polyester-polyglactin 910). Clinical and experimental study].

Because of complications resulting from the use of intraperitoneal prosthetic materials, the authors studied a new double Layered composite mesh (formed by a Dacron mesh, and a polyglactin 910 mesh). The experimental study (40 rats) compared the composite mesh with Dacron mesh. Statistical analysis demonstrated the following conclusions. At 6 months, the poor fibroblastic activity with the composite mesh, indicated the absence of replacement of the polyglactin 910 mesh by a neo-tissue. The Dacron mesh remained in contact the abdominal viscera and contracted with them as many adhesions as when Dacron mesh was used alone. The composite mesh showed poor biological tolerance, lower than that of Dacron mesh. The clinical study concerned 24 patients, 3 recurrences were observed. In one case, we observed migration of the mesh in the small bowel. The unfavorable results of the experimentation, and the risk of visceral migration lead us to avoid the use of composite mesh in intraperitoneal sites.

Animals↗
PubMed1979

Coated Vicryl (polyglactin 910) suture in extraocular muscle surgery.

A newly available coated Vicryl (Polyglactin 910) suture was evaluated in laboratory and clinical trials for use in extraocular muscle surgery. The suture retains the increased strength and low antigenicity of uncoated Vicryl suture, while providing easier passage through tissue and improved tying characteristics. The improved handling properties result from the coating which produces a smoother suture surface.

Adolescent↗
PubMed1984

[Protection of sutures of the injured esophagus using polyglactin 910 (Vicryl) mesh].

Dehiscence of suture after operative treatment of esophageal rupture is a quite frequent and dangerous complication. Several methods of reinforcement of suture with autologus material have been suggested of which the use of a pleura flap was the most successful one. After experimental investigations in the Department of Surgery of the University Hospital of Münster the securing of suture was performed by using Polyglactin 910 (Vicryl) meshgrafts. In 8 patients where the mesh grafts were used, a secondary leakage could be avoided. Considering our experiences, securing of suture by the use of Polyglactin 910 mesh-grafts is a recommendable method.

Animals↗
PubMedDate not supplied

[Trial of a synthetic absorbable suture, Polyglactin 910, in 100 urologic patients].

The authors studied the clinical tolerance of Polyglactine 910 (Vicryl) in 100 patients operated upon for urological disorders. The operations were mostly for ureterovesical reimplantations to treat reflux, pyelocaliceal kidney stones and ureteral calculi, and prostatic adenomectomy. The suture appears to be solid, and the knots do not loosen. It slides badly however and is not easy to manipulate. When used to close cavity walls this solid suture did not cause a higher percentage of abscess than catgut, when used to suture the urinary excretory tract the authors observed, in one case only, multiple calcification around the ureterovesical suture points and those used to close the bladder. The suture is not suitable for vaginal repair operations during the surgical treatment of incontinence. The authors conclude by defining the properties of a suture they would like to see become available: one which has the same solidity, is easier to manipulate, slides more easily, and, above all, has a different texture: a monofilament rather than a braided suture.

Catgut↗
PubMed1989

Repair of spinal dural defects with vicryl (polyglactin 910) mesh.

This study examined and compared the effectiveness of woven vicryl (polyglactin 910) mesh and lyophilized cadaver dura (Lyodura) for the repair of spinal dural defects. A woven vicryl mesh was used to repair spinal dural defects in 16 mongrel dogs. As an internal control, all animals had a separate dural incision that was closed with 9-0 vicryl suture. Animals were killed, and results were evaluated at 4, 8, 12, and 24 weeks. The repair of dural defects was achieved in all animals, and there were no cases of pseudo-meningocele formation, cerebrospinal fluid leakage, or postoperative infection. The vicryl mesh served as a latticework for formation of a neodural membrane. Inflammatory or reactive response to vicryl mesh was minimal, and no adhesion to underlying neural structures was noted. The neodural membrane formed in the animals in which lyophilized dura was employed was usually thicker than those in which vicryl mesh was used and was associated with thick arachnoid-neural adhesions in two of eight animals. We believe vicryl mesh is a suitable dural substitute and offers promise for use in clinical situations.

Animals↗
PubMed1975

A biologic comparison of polyglactin 910 and polyglycolic acid synthetic absorbable sutures.

Two synthetic absorbable sutures were implanted in rats for a comparative evaluation of breaking strength, tissue reaction and absorption. Polyglactin 910 suture was stronger than polyglycolic acid suture in both sizes tested and at all time periods from zero to 35 days. Both suture types elicited minimal tissure response. Based upon histologic examination, virtually all remnants of the polyglactin 910 were absorbed by 90 days, while considerable quantities of polyglycolic acid persisted at 120 days. The difference in absorption rates was a highly significant feature of the comparative biologic profiles of the two suture materials.

Animals↗
PubMedDate not supplied

Prevention of postoperative wound dehiscence in high risk patients. A randomized comparison of internally applied resorbable polyglactin 910 mesh and externally applied polyamide fiber mesh.

This randomized prospective study was undertaken to compare the effectiveness of two methods used to prevent post-operative wound dehiscence in 100 high risk patients. Fifty patients were treated with a polyamide fiber mesh applied externally to the skin using a topical glue, while the other 50 patients were treated with a resorbable intraperitoneal mesh of polyglactin 910. Each patient had at least one of the following risk factors for wound dehiscence: undernutrition, malignancy, ascites, peritoneal infection, immunodepression, abdominal irradiation, repetitive surgical procedures through the same incision, or pulmonary disease. Judging criteria consisted of the development or absence of dehiscence and the frequency of abdominal wall complications. The percentage of wound dehiscence was significantly increased in patients with externally applied polyamide fiber mesh as compared to those with intraperitoneal polyglactin 910 mesh (p less than 0.01). Abdominal wall complications and the duration of healing did not vary significantly in frequency between the two groups. The intraperitoneal placement of a polyglactin mesh was more effective and better tolerated than external application of a polyamide fiber mesh.

Adult↗