Problems and prospects for development and production of surgical suture materials

Abstract

The assortment and user qualities of biologically inert, synthetic, absorbable, and nonabsorbable thread has approached the limit of the requirements imposed by modern surgery. Further progress in this area can be anticipated if manufacturing processes for production of strong and elastic thread made of biocompatible absorbable natural polymers -polyoxyalkanoates (polyoxybutyrate, polyoxyvalerate and their copolymers), collagen, chitin, chitosan, alginate, etc., are developed. The attention of investigators is increasingly focusing on suture materials with both individual and comprehensive biological activity. Creation of thread containing native biological structures (cell growth factor, blood plasma proteins, cells of different organs and tissues, and other cells, including those that increase biocompatibility) and self-regulating materials with biologically active molecules in their structure capable of markedly altering their properties under small external physical or chemical effects, is promising.The basic functions of any surgical suture is to ensure relatively tight, hermetic, and reliable joining of sutured tissues and keep them in a fixed position with constant compression for all stages of wound healing, including postoperative edema. This predetermines special requirements for the strength and elasticity of suture materials and the ability to be reliably fixed with a surgical knot. Moreover, suture material must be biocompatible, pass atraumatically through tissues, have no capillarity and wicking, and retain its properties during sterilization and storage [1][2][3][4].After the wound margins have grown together, the function of the sutures is frequently exhausted and the foreign material must be removed from the body by operative removal of the sutures or preferably, as a result of biodegradation and absorption of the surgical sutures. However, in organ and tissue prosthetics in cardiovascular, plastic, and other areas of surgery, the sutures must guarantee reliable joining of synthetic prostheses and biological tissues for a very long time, i.e., bioresistant surgical thread is required. In many surgical situations, it is expedient to use antimicrobial and other biologically active sutures.The periodically discussed concept of creating a unified universal suture material for any surgical intervention is thus essentially groundless. Each concrete operation requires use of adequate suture material with consideration of the concrete situation -the patient's general condition and age, presence of infection, inflammatory processes, etc. For this reason, one problem that will determine the further progress of modern medicine is the creation of the most rational suture materials for surgery.It should be noted that the science school in the Department of Chemical Fibre Technology and the Problem Laboratory for Special-Application Fibres, created by the USSR scientists Professors A. I. Meos and L. A. Vol'f, made a serious contribution to the creation of domestic fibre materials for medical applications [5]...

Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI)

“…Especially, absorbable braided sutures are using coatings consisting of calcium stearate formulations to improve handling [ 49 ] and to smoothen the surface. Thus, the tissue damage by braided sutures during suturing, the so-called “sawing action” is reduced [ 50 ]. Calcium stearates consist of stearic acid, a fatty acid with an 18-carbon chain that is comparable to palmitic acid.…”

Review Paper: Absorbable Polymeric Surgical Sutures: Chemistry, Production, Properties, Biodegradability, and Performance

“…The importance of chitin suture materials is on the increase as can be witnessed by several publications [78,[273][274][275][276][277][278][279][280]. Biodegradable polyurethane (PU) elastomers with potential for biomedical application as nonabsorbable sutures with improved hydrophobic properties were synthesized by modification of chitin by the reaction of CL and 4,4 0diphenylmethane diisocyanate, extended with different mass ratios of chitin and/or 1,4-butanediol (BDO) [280].…”

“…Zhukovskii [273] in a recent review has discussed the problems and prospects for development and production of surgical suture materials. According to him, the assortment and user qualities of biologically inert, synthetic, absorbable, and nonabsorbable threads have approached the limit of the requirements imposed by modern surgery.…”

Nitric oxide-releasing vehicles for biomedical applications

“…80,82 Chitosan is another broadly biodegradable and biocompatible polymer that can enhance the transport of polar drugs across epithelial surfaces for several biomedical applications. 83 Diethylenetriamine (DETA) and propionic aldehyde (PA) were employed individually to modify the primary amine groups on chitosan. Two diazeniumdiolates (chitosan/NO adducts) were prepared by suspending the chitosan derivatives in a sodium methoxide-methanol solution under 6 atm of NO for seven days.…”