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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↗
PubMed1985

[Ligament replacement with polydioxanone (PDS)].

Experimentations on animals have been performed in order to verify the applicability of the slowly resorbable suturing material Polydioxanon (PDS) in the transposition of ligaments in general and the transposition of cruciate ligaments in particular. After six weeks, the absorption of a twisted cord of 2 mm diameter still has a traction tolerance of 58%. The experimentations made on rabbits and sheep suggest that PDS can be used to fasten ligament sutures and to reinforce ligament grafts. Under extremely favorable soft tissue conditions, the substance can even be used as ligament substitute. Good clinical results can be achieved in the problematic plastic surgery of the anterior cruciate ligament if the reinforcement of the autologous transplant is performed with PDS in the sense of an augmentation graft.

Animals↗
PubMed2006

External septal reconstruction with the use of polydioxanone foil: our experience.

We present our experience and results after using polydioxanone (PDS) foil in septal reconstruction. In a period of 2 years, 12 patients who were admitted in our department with severe septal deviation and breathing problems underwent septoplasty under general anaesthesia. The nasal septum was approached via an external approach. In all patients, after resecting and exposing the septum, the removable piece after being divided into straight pieces, was sutured onto an appropriate sized PDS foil and reimplanted together between the mucoperichondrium flaps. Sutures were placed to fixate the "new septum" to the nasal dorsum and to the anterior nasal spine. The immediate postoperative course was unremarkable and in a follow-up appointment 6 months and 1 year postoperatively, one complication occurred, with septum subluxation noted in one patient. Use of PDS foil in septal reconstruction is an important surgical option for the correction of the markedly deviated nasal septum. Fixation of the straightened and replanted septum at the nasal dorsal septum border with the upper lateral cartilages and at the nasal spine is essential.

Endoscopy↗
PubMed2002

Surgical treatment of fractures of the distal clavicle with polydioxanone suture tension band wiring: an alternative osteosynthesis.

Fracture of the distal clavicle type II (Neer) is an indication for surgical intervention. We report our experience in 12 patients with acute clavicular fractures and operative treatment with polydioxanone suture (PDS) tension band wiring. The patients were assessed 6 and 12 weeks postoperatively by radiological and clinical evaluation and with the Constant Murley score. All 12 patients had an excellent functional result 12 weeks postoperatively. The Constant Murley score was excellent in all patients. The PDS band can be considered as an alternative osteosynthesis. In the context of the current literature, the advantages and disadvantages of this new procedure are discussed.

Adult↗
PubMed1995

Morphological aspects of microarterial anastomoses: a comparison of nylon with polydioxanone.

The morphological appearance of longitudinally sectioned rat femoral arteries was determined in intact arteries and from 3 to 435 days after vessel division and anastomosis with either 9/0 gauge nylon or polydioxanone (PDS) in 26 animals. The purpose of the study was to establish the mechanisms and compare the quality of healing after microarterial anastomosis and to determine whether PDS was degraded before sufficient anastomotic healing had taken place. The results revealed that there was no difference in the process of healing or quality of anastomosis with either suture material. From 3 to 21 days post anastomosis, there was a progressive separation of the ends of vessels within the developing scar. Anastomotic patency was established and maintained at first by an adventitial overgrowth of fibroblasts and undifferentiated adventitial cells and later by the growth of a smooth myocyte scar that stretched between the cut ends of the vessel and over the intima in the form of elongated circumferential plaques. The vessel was morphologically healed by the 21st day. The sutures served little or no purpose in maintaining anastomotic integrity after the 5th day, being situated in the scar forming between the separating vessel ends. PDS was present within the vessel wall up to 120 days post anastomosis and was certainly intact at the time of morphological healing, suggesting that this material is safe as a microvascular suture.

Anastomosis, Surgical↗
PubMed1987

Preclinical evaluation of PDS (polydioxanone) synthetic absorbable suture vs chromic surgical gut in urologic surgery.

A variety of suture materials are available for use in urologic surgery. Urologists have relied on absorbable suture materials which provide transient strength in anticipation that healing will occur before the suture is absorbed. Absorbable sutures thus decrease the chance of stone formation, known to occur on suture material in direct contact with the urinary stream. This report compares the breaking strength retention of polydioxanone (PDS) suture and chronic surgical gut after in vivo residence in the urinary bladder and subcutaneous tissue of the dog.

Animals↗
PubMed1988

Polydioxanone (PDS): a new material for internal suspension and fixation.

The use of the resorbable material Polydioxanone (PDS) as an alternative to stainless steel wire in the suspension and fixation of facial fractures and osteotomies is described. Evidence of the material's persistent strength in use is presented with a discussion of its advantages over stainless steel.

Bone Wires↗
PubMed2005

Electrospinning polydioxanone for biomedical applications.

Polydioxanone (PDS) is a colorless, crystalline, bioabsorbable polymer that was first developed specifically for wound closure sutures. The compatibility, degradation rate, and mechanical properties (including shape memory) of PDS are of interest when considering the design of tissue engineering scaffolds. This research presents the electrospinning of PDS to fabricate unique nanofibrous structures for a variety of biomedical applications. Electrospinning is a polymer processing technique that utilizes an electric field to form fibers from a polymer solution or melt and allows the fabrication of nanofibrous non-woven structures. Results demonstrate the ability to control the fiber diameter of PDS as a function of solution concentrations and the fiber orientation with our prototype electrospinning apparatus. The results also show dependence between the fiber orientation and the elastic modulus, peak stress, and strain to failure of PDS in a uniaxial model.

Biocompatible Materials↗
PubMed1987

In vitro comparison of the properties of polydioxanone, polyglycolic acid and catgut sutures in sterile and infected urine.

The effect of immersion in sterile urine, infected urine and plasma on the breaking strength and stiffness of polydioxanone (PDS), polyglycolic acid (PGA) and chromic catgut was studied. Tests were done under closely controlled conditions with immersion periods varying from zero to ten days. The breaking strength and stiffness of the three suture materials was not significantly changed by immersion in plasma for periods up to ten days. In sterile urine, PDS lost all of its strength after three days of immersion while PGA lost 64% of its initial breaking strength after ten days. Catgut maintained its strength over the ten day study period. In E. coli-infected urine, PDS lost all of its strength in six days while PGA lost 71% and catgut 8% after ten days. In proteus-infected urine, PDS and PGA lost all their breaking strength after one day of immersion while catgut lost 5.8% of its initial strength after 10 days. Corresponding decreases in stiffness were also observed.

Bacteriuria↗
PubMed2002

Strength retention properties of self-reinforced poly L-lactide (SR-PLLA) sutures compared with polyglyconate (Maxon) and polydioxanone (PDS) sutures. An in vitro study.

Recent developments in manufacturing techniques have led to the development of strong bioabsorbable materials such as self-reinforced poly L-lactide (SR-PLLA) sutures. The aim of the study was to investigate the mechanical properties of SR-PLLA sutures in comparison with polyglyconate (Maxon) and polydioxanone (PDS) sutures in vitro. Sutures made of SR-PLLA (0.3, 0.5 and 0.7 mm diameter), Maxon (0.3 and 0.5 mm diameter) and PDS (0.3 and 0.5 mm diameter) were studied by immersion in phosphate-buffered distilled water (pH 7.4) at 37 degrees C for 40 weeks. The breaking force of straight sutures and suture knots was measured. Tensile strength and percentage elongation were calculated. Means, standard deviations, differences between means, and confidence intervals for differences between means were evaluated. SR-PLLA, PDS and Maxon sutures of 0.3 and 0.5 mm diameter were of comparable initial tensile strength. Initial knot tensile strength values were lower than those of their counterpart straight sutures. Maxon sutures had lost their tensile strength by 12 weeks; PDS sutures by 20 weeks. SR-PLLA sutures of 0.3 mm diameter had a strength of 161.6 MPa and those of 0.5 mm diameter had a strength of 134 MPa at 40 weeks. The highest percentage elongation of straight sutures (62.8% and 62%) was exhibited by PDS; the lowest by SR-PLLA (35.6% and 35%). In loop tests, PDS showed the highest percentage elongation (43.7% and 58.1%) and SR-PLLA had the lowest values (19.7% and 33%). SR-PLLA sutures had the most prolonged strength retention in vitro, but the lowest elongation (elasticity). Compared with straight sutures, knots had lower tensile strength and elongation values. SR-PLLA sutures can be applied to the closure of wounds that need prolonged support, such as bone.

Absorbable Implants↗
PubMed1999

The use of polyglactin 910-polydioxanon in the treatment of defects of the orbital roof.

PURPOSE: This study evaluated the use of polyglactin 910-polydioxanon (PPP) for repair of orbital roof defects. PATIENTS AND METHODS: Between 1988 and 1996, 144 patients treated in the Department of Neurosurgery, Christian-Doppler-Medical-Center Salzburg, were operated on transcranially for fractures of the orbital roof or intraorbital tumors. In 85 of these 144 patients, PPP was used for reconstruction of the orbital roof or closure of the periorbita. The postoperative results in patients in whom the PPP patch was used for reconstruction of the orbital roof were compared with the results of a group treated without PPP. RESULTS: Even in severely injured patients, the reconstruction was judged to be very good in 71 patients (83.5%). CONCLUSION: PPP is a useful material for the reconstruction of the orbital roof.

Absorbable Implants↗
PubMed1986

Integrity of polydioxanone sutures: a case report.

Certain conditions have been found to hasten the breakdown of absorbable PDS (polydioxanone) sutures. It is important that surgeons handle the sutures carefully to avoid premature breakdown.

Equipment Failure↗
PubMed1991

Reconstruction of orbital floor with polydioxanone plate.

The use of a polydioxanone (PDS) plate for orbital reconstruction was evaluated in 20 patients with various traumatic defects of the orbital floor. The follow-up time was 9 to 45 months (mean 20.4 months). A CT scan was obtained in 13 patients. Radiographic analysis showed that in 12 of the 13 patients there was new bone in the orbital floor. Clinically, most patients had transitory postoperative diplopia (lasting for a mean of 29 days) because of overcorrection. Only 2 patients, however, suffered from persistent diplopia. In one patient, abducens nerve paresis was the cause. It is concluded that PDS is suitable for orbital floor reconstruction, at least in cases in which defects do not exceed 1-2 cm in diameter. Overcorrection seems necessary. The material is well tolerated, is totally absorbed and appears to be replaced by bone in nearly all cases.

Absorption↗
PubMed1987

Absorbable polydioxanone suture for venous anastomoses: experimental studies using venography and transluminal angioscopy.

Because of their increased tendency to stenosis and spasm and thrombosis, results after venous anastomoses are often unsatisfactory. Nonabsorbable sutures and a continuous suture technique have been suggested to have a negative effect on the compliance of vascular anastomoses. Eighty venous anastomoses were performed with either an interrupted or continuous suture technique, using polypropylene or polydioxanone (PDS) sutures, according to a randomised experimental model. The anastomoses were divided in four groups: (1) Nonabsorbable suture material, continuous suture technique; (2) Nonabsorbable suture material, interrupted suture technique; (3) Absorbable suture material, continuous suture technique; and (4) Absorbable suture material, interrupted suture technique. The morphology of the anastomoses was controlled by venography directly after closure of the wound and at weekly intervals for 2 months and monthly intervals thereafter until 2 years had passed. In 10 cases venography was followed by transluminal angioscopy in the early postoperative period and after 1, 2, 4, 8 and 12 weeks. In the first 2 months moderate and high degree stenoses were found in all 4 groups by venography. After 8 weeks there was a significant decrease in the incidence of stenosis in all groups with the exception of the group, in which continuous nonabsorbable suture had been used. Using angioscopy a marked swelling of the intima at the site of the anastomoses could be detected in the early postoperative period in all experimental groups. After 2 months no significant narrowing could be identified in groups 2, 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMedDate not supplied

Breaking strength retention and histologic effects around 1.3-mm. ORTHOSORB polydioxanone absorbable pins at various sites in the rabbit.

Absorbable 1.3-mm polydioxanone (ORTHOSORB) pins were implanted in 75 New Zealand White rabbits in three sites: within the lateral subcutaneous tissue parallel to the femur, down the femoral intramedullary canal, and mediolaterally across the femoral condyles (transcondylar). Pins were harvested at periodic intervals up to 56 and 365 days for mechanical and histologic analyses, respectively. Mechanical analyses were performed by loading the pin in double shear. Histologic analyses were performed on the pin and surrounding tissue. Histologic observations revealed a typical nonspecific foreign-body reaction at all implant sites that resolved at 1 year after resorption of the pin. On histologic examination, there was complete resorption of the pin material in the subcutaneous site by day 182, and there was complete resolution of all response to the pin in six of nine rabbits by day 365. In the intramedullary site, pin material was completely resorbed, based on histologic examination, in five of six rabbits by day 182, and there was complete resolution of the response to the pin in eight of nine rabbits by day 365. The pin material was completely resorbed based on histologic examination of the transcondylar site by day 210, and there was complete resolution of the response to the pin in four of six rabbits by day 270 and in four of nine rabbits by day 365. No enlarged pin tracks or sinus formations were observed in or near the implants sites. The average initial shear strength as 171.4+/ 5.1 MPa, and the breaking strength retention decreased with increasing implantation time. Pins from the subcutaneous regions maintained above 97% of their initial strengths at 28 days, and those from the intramedullary canals maintained above 92%. At later times the strength of the pins implanted in the intramedullary canal decreased more rapidly than those from the subcutaneous region. Overall, the average breaking strength of the subcutaneous pins was significantly greater than that of the intramedullary pins at all time points beyond 14 days. These data indicate that the pins exhibited a strength retention profile sufficient to allow normal healing of bone without enlarged pin tracts, allergic reactions, or sinus formations.

Animals↗
PubMed2002

Guided tissue regeneration in intrabony defects using an experimental bioresorbable polydioxanon (PDS) membrane. A 24-month split-mouth study.

AIM: The comparison of the clinical, radiographic, and microbiological healing results in deep intrabony defects following GTR therapy with two different bioresorbable membranes in a prospective split-mouth design. MATERIAL AND METHODS: 31 pairs of contralateral intrabony defects were randomly treated with either an experimental Polydioxanon (PDS) membrane or a Polylactic acid (PLA) matrix barrier. After 6, 12 and 24 months, healing results were assessed using clinical examinations (REC, PPD, CAL, vertical relative attachment gain V-rAG), quantitative digital subtraction radiography (amount and area of bone density changes), and microbiological analysis. RESULTS: Postoperative membrane exposures occurred in 14 PDS and 2 PLA treated sites. 6, 12 and 24 months p.o., both membranes provided a significant gain in CAL [median values: 6 months (PDS vs. PLA: 3.0 vs. 3.0 mm); 12 and 24 months (PDS vs. PLA: 4.0 vs. 4.0 mm)], which corresponded to a V-rAG of 57.1% (PDS) vs. 62.5% (PLA) after 24 months. PDS and PLA treated sites revealed significant bone density gain 6, 12 and 24 months after surgery. 38.8% (PDS) vs. 41.8% (PLA) of the initial defect areas showed bone density gain. While the gain in bone density was significantly greater in PDS than in PLA sites, neither CAL gain nor the area of bone density changes revealed significant differences. Microbiological culture revealed similar bacterial loads in PDS and PLA sites during the first 12 months. CONCLUSION: This 24-month study indicates that the PDS and PLA membranes can provide similar favorable regeneration results in deep intrabony periodontal defects, although considerably more postoperative membrane exposures have to be expected in PDS treated sites.

Absorbable Implants↗
PubMed2001

Effectiveness of operative treatment of internal orbital wall fracture with polydioxanone implant.

Many implants, some made from teflon or silicone, have been used for internal orbital wall reconstruction. Late complications relating to use of such implants have been reported. In this prospective study a polydioxanone (PDS) implant absorbable in vivo was used for internal orbital wall reconstruction. Follow-up involved clinical examination, magnetic resonance imaging (MRI) and computerized tomography (CT). Clinical examinations were undertaken before operation and up to 36 weeks postoperatively. Sixteen consecutive patients (10 pure blow-out fractures, six with associated zygomatic fracture) took part in the study. Prevalences of diplopia, proptosis and enophthalmus were recorded during each follow-up examination. This study revealed no muscle entrapment within the fracture line. Although CT results confirmed bone growth in the internal orbital wall, shape was unsatisfactory, and orbital volume was not reduced. MRI revealed thick scar formations in six cases (37.5%), fibrotic sinuses filled with air or gas in three cases (19%) and a fibrotic sinus with fluid around the PDS in one case (6%). Our results suggest that use of PDS in reconstructing the internal orbital wall is inadvisable.

Absorbable Implants↗
PubMed1984

Polydioxanone in cardiovascular surgery.

Polydioxanone (PDS) suture material was used in vascular anastomoses in patients submitted to femoropopliteal bypass (10 patients), aortoiliac endarterectomy (5 patients), and aortocoronary bypass (5 patients). Clips of this material and conventional metallic clips were compared in vitro for holding-in-place properties, and PDS clips were used in ligation of branches of the autologous vein grafts in femoropopliteal bypass (10 patients) and aortocoronary bypass (10 patients). There were no complications related to the PDS material either intraoperatively or during the follow-up from 3 to 6 months. The PDS clips did not slip when burst-tested in vitro. The material is suitable and advantageous in cardiovascular operations where autologous tissue is handled.

Adult↗