Purpose of ReviewThis review provides an overview of the STRATAFIX™ SYMMETRIC PDS™ Plus Knotless Tissue Control Device design and performance characteristics and highlights the device’s relevance for use in gynecological procedures. Various device testing was conducted on tensile strength, fixation tab mass comparison to conventional suture knot tower, initiation stitch strength, and wound holding strength to highlight the STRATAFIX™ SYMMETRIC PDS™ Plus Device’s key product attributes that may benefit general and minimally invasive gynecological procedures.Recent FindingsThis article serves as a technological assessment of the latest barbed suture offered by Ethicon—STRATAFIX™ SYMMETRIC PDS™ Plus Knotless Tissue Control Device. This device is indicated for soft tissue approximation and can be used to close high tension areas, such as fascia.SummaryBarbed sutures were successfully introduced to gynecologic surgery many years ago, and their safety and effectiveness have been demonstrated in a variety of gynecological surgical procedures. By eliminating the need to tie surgical knots, barbed suture provides a few key advantages over conventional suture, such as reducing operating room time, eliminating potential knot-related complications, and reducing suturing difficulty in open and minimally invasive gynecological procedures. Additionally, there are tensile strength and wound holding strength advantages (vs. conventional PDS™ Plus Suture) described in the product testing highlighted in this review that may be relevant for gynecological procedures.

The tempering behavior of simulated coarse-grained (CG) heat-affected zones (HAZs) in two ferritic alloy steels, 2.25Cr-1Mo and HCM2S, was investigated. The hardness of HCM2S was found to be stable at longer times and higher temperatures than the 2.25Cr-1Mo steel, even though the "aswelded" hardnesses were approximately equal. Both materials reached a peak secondary hardness after tempering for 5 hours at 575 ЊC. The increase in hardness of the 2.25Cr-1Mo steel was due to precipitation of Fe-rich M 3 C carbides within the prior-austenite grains, whereas the secondary hardening in HCM2S was due to a fine dispersion of intragranular, W-rich carbides. The HCM2S steel retained its hardness at longer times and higher temperatures than 2.25Cr-1Mo steel, because of the precipitation of intragranular, W-rich carbides and V-rich MC carbides that stabilized the lath structure. This study shows that HCM2S should not be heat treated in the same way as 2.25Cr-1Mo steel and also provides a basis for defining the postweld heat treatment (PWHT) of HCM2S.

The STRATAFIX Symmetric PDS Plus Knotless Tissue Control Device demonstrated in vitro anti-bacterial activity against all test organisms. This activity was maintained for 11 and 23 days when tested against E. coli and S. aureus, respectively. The device was not colonized by test bacteria in vitro. The anti-bacterial activity remained stable for as long as 36 months of storage at 30°C and 75% relative humidity. In vivo evaluation in animal models demonstrated a 1.16-log reduction in S. aureus and a 1.83-log reduction in E. coli relative to the control device. (p < 0.05) Conclusion: The STRATAFIX Symmetric PDS Plus Knotless Tissue Control Device exhibited anti-bacterial efficacy in vitro against a wide range of clinically significant bacterial species with long-lasting inhibition of colonization by S. aureus, and E. coli. It inhibited colonization by S. aureus and E. coli in vitro and in vivo. Thus, the STRATAFIX Symmetric PDS Plus Knotless Tissue Control Device represents a powerful technology to help mitigate one of the risk factors for surgical site infections.

No abstract