Introduction
Historical Outline
PHA Preparation and Properties: A Primer
Production
Mechanical and Thermal Properties
Sterilization of PHA Polymers
Biocompatibility
Natural Occurrence
In vitro
Cell Culture Testing
In vivo
Tissue Responses
Biodistribution
Bioabsorption
In vitro
Degradation
In vivo
Bioabsorption
Applications
Cardiovascular
Dental and Maxillofacial
Drug Delivery
Prodrugs
Nerve Repair
Nutritional Uses
Orthopedic
Urology
Wound Management
Future Directions
Patents
Poly-4-hydroxybutyrate (P4HB) is a thermoplastic, linear polyester, produced by recombinant fermentation, that can be converted into a wide range of resorbable medical devices. P4HB fibers are exceptionally strong, and can be designed to provide prolonged strength retention in vivo. In 2007, the FDA cleared a monofilament suture made from P4HB for general soft tissue approximation and/or ligation. Subsequently, surgical mesh devices for hernia repair, tendon and ligament repair, and plastic and reconstructive surgery have been introduced for clinical use. This review describes the unique properties of P4HB, its clinical applications, and potential uses that are under development.
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