A new absorbable suture

TLDR

Nonabsorbable sutures have long been available, but only collagenous absorbable sutures have been widely accepted; however, catgut and regenerated collagens suffer from variability and other drawbacks. The authors selected polyglycolic acid after screening polymers for absorbability and mechanical properties, synthesizing it via ring‑opening melt polymerization of glycolide and converting it into fibers through melt extrusion, stretching, and heat setting. Development revealed two glycolide polymorphs, and the resulting braided polyglycolic‑acid sutures show high strength, excellent handling, minimal tissue reactivity, and a reproducible absorption rate, with clinical studies underway.

Abstract

Abstract Although satisfactory nonabsorbable sutures made from a variety of synthetic and natural materials have been available for a number of years, since ancient times only collagenous absorbable sutures have found general acceptance. While adequate, catgut and the more recently developed regenerated collagens have inherent disadvantages common to many complex natural substances, particularly variability in composition and properties. A new synthetic absorbable suture has been developed from polyglycolic acid equation image . This material was chosen after testing a wide variety of polymers for the appropriate absorbability behavior in animals and for the required physical and mechanical properties. Polyglycolic acid suitable for this use was most conveniently prepared by the ring opening melt polymerization of glycolide. Development of a reliable process for this commercially unavailable monomer led to the discovery of the existence of two glycolide polymorphs one of which exhibits erratic polymerization behavior after exposure to trace amounts of moisture. Polyglycolic acid was converted into fiber by melt extrusion, stretching, and heat setting. Braided sutures prepared from these fibers exhibit high strength, excellent handling properties, minimal tissue reactivity, and a similar but more reproducible absorption rate than catgut. Clinical studies with these sutures are in progress.