Bezwada R S, Jamiolkowski D D, Lee I Y, Agarwal V, Persivale J, Trenka-Benthin S, Erneta M, Suryadevara J, Yang A, Liu S
Research and Development Division, Ethicon, Inc., Somerville, NJ 08876-0151, USA.
Biomaterials. 1995 Oct;16(15):1141-8. doi: 10.1016/0142-9612(95)93577-z.
Synthetic absorbable sutures are available as braided constructions or as monofilaments. Braided absorbable sutures are made either from 90:10 poly(glycolide-co-L(-)-lactide), sold by Ethicon, Inc. under the trade name Vicryl, or from polyglycolide, as sold, for instance, by Davis and Geck under the trade name Dexon. There are, however, some concerns with braided sutures that relate to tissue drag and the trauma this may cause, as well as the possible potentiation of infection through the interstices of the braid structure. Absorbable monofilaments, such as the monofilament sutures derived from p-dioxanone homopolymer (PDS II, an Ethicon, Inc. product), or a copolymer of trimethylene carbonate and glycolide (Maxon, a Davis and Geck product), eliminate many of these concerns, but generally monofilaments do not handle as well as braids. This paper describes the research leading to the introduction of Monocryl (poliglecaprone 25) monofilament sutures, based on segmented block copolymers of epsilon-caprolactone and glycolide. Monocryl sutures will be shown to display excellent handling properties, minimal resistance during passage through tissue and excellent tensile properties. These sutures provide an in vivo breaking strength retention of approximately 20-30% after 2 weeks, considered by many to be the critical wound healing period. Absorption data on these sutures are presented; absorption is complete between the 91st and 119th days of implantation, with slight or minimal tissue reaction.
合成可吸收缝线有编织结构和单丝两种形式。编织可吸收缝线要么由90:10的聚(乙交酯 - 共 - L(-)-丙交酯)制成,由Ethicon公司以Vicryl商标出售;要么由聚乙交酯制成,例如由Davis and Geck公司以Dexon商标出售。然而,编织缝线存在一些问题,涉及组织牵拉及其可能造成的创伤,以及通过编织结构间隙可能增强感染的风险。可吸收单丝,如由对二氧杂环己酮均聚物制成的单丝缝线(PDS II,Ethicon公司产品),或碳酸三亚甲基酯与乙交酯的共聚物(Maxon,Davis and Geck公司产品),消除了许多这些问题,但一般来说,单丝的操作性能不如编织缝线。本文描述了导致引入Monocryl(聚乙交酯己内酯25)单丝缝线的研究,该缝线基于ε - 己内酯和乙交酯的嵌段共聚物。Monocryl缝线将显示出优异的操作性能、穿过组织时的最小阻力以及出色的拉伸性能。这些缝线在2周后体内断裂强度保留约20 - 30%,许多人认为这是关键的伤口愈合期。文中给出了这些缝线的吸收数据;吸收在植入后第91天至119天之间完成,组织反应轻微或极小。