It was shown that modified surgical sutures with a coreshell structure with assigned thickness and porosity of the polyhydroxybutyrate shell or mixtures with other polymers and SF additives can be fabricated. It was found that a change in the content of the modifier polymer in the fibres within the limits of up to 15% had almost no effect on their metric size and strength. The dependence of the rigidity of the sutures on the modifier polymer content is described.Surgeons now have a wide assortment of surgical sutures that differ both in the composition of the raw material (polyamide, polypropylene, poly(ethylene terephthalate), natural silk, polyglycolide, polylactide, etc.) and in the structure (monofilaments; multifilament twisted, braided surgical sutures), but only two indexes have been standardized the thickness and strength of the sutures [1,2]. According to the European Pharmacopedia, the strength is determined by the breaking load of the suture tied in a simple (single) knot and is expressed in newtons. The thickness of surgical sutures is characterized by the metric size (MS) and is determined by the range of parameters in which a suture of a given standard size falls [1].* However, such properties of sutures as pliability, elasticity, atraumaticity, low capillarity, bactericidal action, biocompatibility, and in many cases biodegradability are no less important. They ensure convenience in application of the suture and its reliability; lack of a sawing action on the tissue, sorption of wound content, and infection; correspondence of the deformation properties of the sutures to the topography of the tissues with an increase in the volume of the suture in the stage of edema and a decrease in the subsequent stages of healing. In tying knots, the surgeon must take into consideration the structure and surface properties of the suture. For example, we know that twisted and braided sutures have greater surface roughness than monofilaments and for this reason ensure a more reliable suture when less complex knots are used, but these sutures traumatize the tissue more [3]. At the same time, monofilaments and more rigid and elastic and require using more complex knots than multifilament sutures.Creating composite sutures with a coreshell structure is an effective way of fabricating surgical sutures that combine the softness of multifilament sutures and the smooth surface of monofilaments [4,5]. Application of a coating on the surface of the sutures allows regulating the flexibility, surface roughness, and knot reliability, giving multifilament sutures atraumaticity and decreased capillarity, changing the color, and incorporating drugs, antimicrobials in particular, in the suture. In this way, coated sutures represent a balance between the qualities of mono-and multifilament sutures.A biodegradable complex polyester polyhydroxybutyrate (PHB), is of some interest as a modifier polymer [6], and its production technology, developed at the A. N. Bakh Institute of Biochemistry, Russian Academy of Sciences, has now been ma...
Second-order regression polynomial mathematical models describing the characteristics of modification of sewing thread by application of coatings were constructed. The adequacy of the regression equations makes the proposed method a good tool for analysis of multifactor mechanisms with a large set of experimental data.Giving polymeric articles used in medicine, biotechnology, veterinary medicine, and cosmetology biocompatibility is an extremely important and interesting problem for chemists, biologists, and medical personnel. Biocompatibility is a set of properties that ensure the absence of any negative reaction of biological objects on contact with polymeric implants. It was previously believed that biocompatibility is determined by the inertness and hydrophoby of the materials [1], but recent studies [2,3] showed that the surface of an implant should have a certain balance of hydrophilic-hydrophobic and other properties to stimulate adhesion of cells but prevent thrombogenesis and adhesion of bacteria. Ideally, the surface of the implant should thus be a unique smart material that recognizes different cells and is adequately reconstructed. Such materials cannot be created without a detailed study of the complex and multifactor correlations of the structure, composition, external conditions, and properties conducted with modern computers and software.Modern sewing materials should have antimicrobial activity, stability in sterilization, low capillarity and porosity, high knot strength and tying capacity, and atraumaticity. Their color should differ from the color of the fabrics sewn and when drugs are incorporated in them, they should have a lasting action. Thread with a coreshell structure, obtained by application of a complex twisted or woven thread with a drug-filled coating made of a biocompatible polymer on the surface, most fully satisfies the above requirements [4][5][6]. The coating reduces the capillarity and by giving the thread the structure of a pseudomonofilament, decreases its traumaticity without worsening the capacity to tie surgical knots.We used mathematical modeling of the effect of the process parameters of modification of synthetic fibres by applying a biocompatible polymer coating on their properties to solve the problem of creating sewing thread with improved properties. Polyhydroxybutyrate (PHB) a promising polymer of microbiological origin is such a biocompatible polymer. PHB is soluble in highly volatile solvents (methylene chloride, chloroform), melts at 170°C without decomposing, and forms strong fibres in melt spinning [7]. However, fibres and films spun from solutions are characterized by high strength. Since production of this polymer is in the organizational stage, we conducted mathematical and experimental modeling of the effect of the conditions of applying the coating from polymer solutions on the properties of the fibre obtained, anticipating the introduction and use of PHB for modifying fibres made of synthetic polymers. Cellulose triacetate in the form of equiviscous (or eq...
A comparative study of the characteristics of surgical knots in the initial lavsan thread and sutures with a coating of the biocompatible and biodegradable polymer polyhydroxybutyrate showed that modification did not reduce the holding power, effectiveness, and degree of reliability of the knots. Increasing these characteristics of some knots in modified sutures allows using less complex knots in them and consequently reducing suture consumption and the risk of infection of the surgical wound.The current requirements for suture materials have now increased significantly. In generalizing the information from different sources, they can be formulated as follows: biocompatibility, surface atraumaticity, absence of wicking, good manipulation properties, high strength, ability to reliably hold knots, in many cases resorbability and prophylactic antimicrobial or other effects [1, p. 18]. Of all these requirements, knot reliability is assigned first place by surgeons [2].In continuing our studies [3-5] on creation of surgical sutures with a biocompatible and biodegradable polymer coating of polyhydroxybutyrate (PHB) [6], we investigated the properties of surgical knots in modified lavsan sutures No. 1 and 2 with PHB and PHB + stearic acid coating used as a plasticizer. Stearic acid (SA) is incorporated because crystallizable polymer coating increases the rigidity of the sutures by approximately two times [4].Polyes-PMD lavsan sutures (TU 9393-003-17328911-2004) of metric sizes (MS) 1.5 and 3 (0.19 and 0.34 mm in diameter, respectively) were used as the initial sutures. A pilot industrial sample of PHB of microbiological origin with a molecular weight of ~900 kDa was provided by the Institute of Biochemistry, Russian Academy of Sciences. The coating was applied on the suture from a solution of the polymer in chloroform in the laboratory setup in [4]. The coating content was 6.2±0.3% of the weight of the suture and the stearic acid content was 5% of the weight of the PHB. The properties of the surgical knots were investigated by the method described in [7].Surgical knots consist of several loops bound in a certain way (Table 1). The reliability of surgical knots is a function of many factors, including the chemical nature and textile structure of the suture, the functional properties of its surface, and the type of knot. Knot reliability is to some degree also a function of the length of the ends of the suture cut near the knot: the longer the ends are, the lower the probability that the knot will become untied. At the same time, excessively long ends, especially in internal sutures, increase the probability of suppuration and development of ligature fistulas.Formation of very complicated knots usually does not significantly increase the reliability of the suture but significantly increases consumption of suture material and makes the surgeons job more difficult. After suturing, successfully healing of the wound is directly dependent on the knot reliability. If an inadequate knot is selected, it can spontaneously come unt...
The effect of the conditions of storage and crystallization of polyhydroxybutyrate on the transport properties of polyhydroxybutyrate coating on surgical sutures was demonstrated. The effect of the storage conditions is leveled by incorporating a second biocompatible polymer in the coating. Storage in a freezer at -20°C is recommended for preserving the antimicrobial activity of sutures with a PHB coating.Administration of antibiotics and antiseptics postoperatively does not exclude purulent infections in the region of a surgical wound due to important dispersion of drugs in the body. High local concentrations of antimicrobials can be created by using suture material that contains these drugs. In this case, ensuring prolonged release of the drug is an important requirement imposed on biologically active sutures. Surgical sutures with a polymer coating or impregnated with a polymer the drug vehicle are used to obtain this effect [1,2]. The duration of the action of an immobilized drug is determined by diffusion to a significant degree, and diffusion is in turn a function of the amount and character of its distribution, the presence of a chemical bond between the drug and the polymer vehicle, and the phase and pore structure of the polymer.In creating surgical sutures with a drug-filled coating, we selected polyhydroxybutyrate (PHB) environmentally safe, biocompatible, biodegradable, with good physicomechanical indexes as the basic polymer vehicle [3]. The structure of the coating was regulated by altering its composition, in particular, by incorporating another polymer in it. The suture material obtained is multifilament twisted or braided thread with a corecoating structure containing furazolidone (FZ) [N-(5-nitro-2-furfurylidene)-3-aminooxazolid-2-one], previously used in fabrication of antimicrobial Ftorlon sutures [4]. Furazolidone has a broad spectrum of action, is effective against gram-positive and gram-negative microorganisms, Lamblia, pathogens of dysentery, and typhoid, and has antitrichomonal activity.The thread is given the required antimicrobial effect (minimum growth inhibition zone of 2-3 mm) and a prolonged (minimum of 7 days) effect is attained by application of polyhydroxybutyrate in the amount of 10% of the weight of the thread, where the composition includes FZ (2-6% of the weight of PHB), by two treatments of the sutures with a solution of the polymer in a specially designed laboratory unit [5][6][7]. The modification conditions developed for lavsan thread, for example, resulted in an additional positive effect consisting of an important decrease in the capillarity of the sutures, a slight increase in their strength, and improvement of the characteristics of the surgical knots [6,8].During the experiments to study the effect of the storage time on the antimicrobial activity and FZ desorption kinetics, we found that FZ was released more slowly from sutures held for 3 months than from fresh sutures. Since the crystallization temperature of PHB falls in the range of 0 to +50°C, it was hypothesi...
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