8/8/2019 Wound Closer Bio Materials
1/14
1. Suture Materials
2. Tissue Adhesives3. Staplers
8/8/2019 Wound Closer Bio Materials
2/14
Suture is a strand of textilematerial ,natural or syntheticused to ligate blood vesselsand to draw tissue together.
8/8/2019 Wound Closer Bio Materials
3/14
Absorability --- 1)Absobable , 2)NonabsorbablePhysical Configuration 1Mono filament,2)Multifilament ,3)Braided
Origin ---- 1)Natural 2)SyntheticUSP CLASSIFICATIONCLASS I --- SILK OR SYNTHETICCLASS II -- COTTON OR LINEN FIBERS OR
COATED NATURAL FIBER OR SYNTHETICFIBERS
CLASS III --- METAL WIRE OF MONOFILAMENT
OR MULTY FILAMENT CONSTRUCTION
8/8/2019 Wound Closer Bio Materials
4/14
Handle comfortabilityMinimal tissue Reaction
Adequate tensile strengthKnot securityUfavorable for bacterial grothEasily sterilisedNonelectrolytic ,NoncapilaryNonallergenic and noncarcinogenic
8/8/2019 Wound Closer Bio Materials
5/14
Surgical suture
Absorption ability Origin ConfigurationAbsorbable Natural polymers
(derived fromanimals),synthetic
polymers
Monofilament,multifilament(braided or twisted)composite
Non-absorbable Silk, synthetic
polymers (nylon),stainless steel
Monofilament,
multifilament(braided or twisted)composite
8/8/2019 Wound Closer Bio Materials
6/14
A bsorbable suture
G eneric name Raw materials
NaturalNatural1. P lain gut2. Chromic gut3. Collagen (plain &
chromic)
1. Submucosa sheep intestine2. Serosa of beef intestine+ buffer chromicizing3. Beef flexor tendon
SyntheticsSynthetics1. Polyglycolic acid2. Polyglycolic acid
3. P
olyglactine (Vicryl),19744. Polydioxanone ( PD S),
198 3
5. Polyglyconate (Maxon)
1. H omopolymer of glycolic acid2. H omopolymer of glycolic acid coated with
polycaprolate3. Copolymer lactide-glycolic acid coated with
Calcium stearate , polyglactine 3 70; braided4. Polymer of paradioxanone ; monofilament (less affi
for bacteria, higher disso time, but stiff, difficultto tie)
5. Copolymer of trimethylene carbonate & polyglycolic acid ; monofilament, better tying
8/8/2019 Wound Closer Bio Materials
7/14
PGA degradable suture
8/8/2019 Wound Closer Bio Materials
8/14
A romatic polyester PET (Dacron) is used to make vascular graft
8/8/2019 Wound Closer Bio Materials
9/14
N on-absorbable sutureG eneric name Raw materials
Natural fibresNatural fibres1. Surgical cotton2. Surgical linen3. Virgin silk ; surgical silk
1. Twisted natural cotton2. Twisted long-staple flax3. Natural as spun, untreated ;
twisted, silicon-impregnated
Synthetic fibresSynthetic fibres1. Nylon
Polyamide 6,6- monofilPolyamide 6,6- braidedPolyamide 6-twisted fibres enclosedin a polyamide sheath
Polyamide 6,6-silicon treated2. Polypropylene ( P rolene)
3. Polyester
Ethibond
; stiff, untying of knot,cuttinMonofilg of tissuesMonofil, braided, silicon treated,teflon-coatedPolyester coated with Polybutylate
8/8/2019 Wound Closer Bio Materials
10/14
P roperties of SutureP roperties of Suture
1. Phy sical c h aracteristics: material, surface, length, dia, knot-pull strength,needle attachment force
2 . Handling c h aracteristics: mechanical behaviour before, during , after woundclosure
3 . Biological c h aracteristics: biological responses during, after wound healing
USPUSP
8/8/2019 Wound Closer Bio Materials
11/14
8/8/2019 Wound Closer Bio Materials
12/14
E lasticit y:E lasticit y: ability of the suture to return to its original state after stretching
P lasticit y:P lasticit y: ability of the suture to retain its new, deformed state
Me m or y:Me m or y: depends on elastic-plastic properties of suture
Sutures with high memory (nylon) tends to unite, so their knot security is lowSutures with low memory (silk) tends to unite.
8/8/2019 Wound Closer Bio Materials
13/14
Handling c h aracteristicsHandling c h aracteristics >
K nottabilit y: ability to be tied with relative ease by surgeon, & difficulty to unknot
flexibility/ pliability, smoothness, coeff of friction, memory
Biological c h aracteristicsBiological c h aracteristics
Possibility of infection/ inflammation
Braided/ multifilaments > monofilamentCoated > uncoated
Natural > synthetic
Allergy: silk, nylon, Chromate allergy
8/8/2019 Wound Closer Bio Materials
14/14
Disadv of Sutures :
1. risk of infection: The mere act of penetrating the skin opens an avenue for
infection, and the presence of a suture further increases the tissuessusceptibility to contamination. The sutures least likely to provoke infectionare composed of absorbable polymer and animal gut or nonabsorbable nylonand polymers. Nonabsorbable Dacron, stainless steel, and cotton or silksutures generally carry a greater chance for infection .
2. Sutures can unravel or become loose if they are not tied properly. Successfulsuturing is heavily dependent on the skill of an individual surgeon