Wound Closer Bio Materials

8/8/2019 Wound Closer Bio Materials

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1. Suture Materials

2. Tissue Adhesives3. Staplers


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Suture is a strand of textilematerial ,natural or syntheticused to ligate blood vesselsand to draw tissue together.


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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


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Handle comfortabilityMinimal tissue Reaction

Adequate tensile strengthKnot securityUfavorable for bacterial grothEasily sterilisedNonelectrolytic ,NoncapilaryNonallergenic and noncarcinogenic


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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


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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


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PGA degradable suture


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A romatic polyester PET (Dacron) is used to make vascular graft


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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


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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


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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.


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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


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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

Wound Closer Bio Materials

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