Rupture of a polypropylene suture after aortic operation: a scanning electronic microscopical assessment of potential mechanisms

Huber, Christoph; Eckstein, Friedrich S.; Halbeisen, Marcel; Carrel, Thierry

doi:10.1016/s0003-4975(02)04679-9

Cited by 9 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Isotactic polypropylene (iPP) is a commodity semi‐crystalline polymer [1] of great commercial importance used in packaging, carpeting, automotive industry, home appliances, electronics, sporting goods, and medical disposables [2]. Crystalline structure of PP controls its mechanical and other physical properties directly [3, 4].…”

Section: Introductionmentioning

confidence: 99%

On the differences in micro‐deformation mechanism between isotactic polypropylene and β‐nucleated isotactic polypropylene as revealed by the confocal laser scanning microscopy

Jančář

Kalfus

Bálková

2011

Polymer Engineering & Sci

View full text Add to dashboard Cite

To understand the toughness enhancement of β‐nucleated isotactic polypropylene (iPP) in comparison with iPP, the differences in the micro‐deformation mechanisms between the neat iPP and β‐nucleated iPP were visualized using the confocal laser scanning microscopy (CLSM). Structure of the α‐ and β‐spherulites situated close to the tip of the sharp starter crack has been investigated during tensile deformation in the viewing field of the CLSM. In the α‐spherulite of the neat iPP, highly localized inter‐ and intra‐spherulitic micro‐shear bands have been observed. In the β‐nucleated iPP, relatively uniform distribution of diffuse shear bands has been observed in the β‐phase, while the α‐phase remained relatively undeformed exhibiting only narrow intra‐spherulitic shear bands in the direction perpendicular to the loading direction. Delocalization of plastic deformation into diffuse shear bands in β‐nucleated iPP can explain its enhanced crack resistance compared with the neat iPP exhibiting highly localized shear banding. POLYM. ENG. SCI., 2011. © 2011 Society of Plastics Engineers

show abstract

Section: Introductionmentioning

confidence: 99%

On the differences in micro‐deformation mechanism between isotactic polypropylene and β‐nucleated isotactic polypropylene as revealed by the confocal laser scanning microscopy

Jančář

Kalfus

Bálková

2011

Polymer Engineering & Sci

View full text Add to dashboard Cite

show abstract

“…However, the hydrophobic nature of the polymer restricts its application in a number of technologically important areas, such as in composites, packaging materials, and biomaterials. The medical applications of PP in surgery as suture or as prosthetic implant are due to its optimum tensile strength and low level of tissue reaction 1, 2. However, the microbial infection on the implanted site often has been observed to lead deterioration of the wound and related complications 3.…”

Section: Introductionmentioning

confidence: 99%

Plasma induced graft polymerization of acrylic acid onto polypropylene monofilament

Gupta

Saxena

Ray

2007

J of Applied Polymer Sci

View full text Add to dashboard Cite

Plasma induced graft polymerization of acrylic acid onto polypropylene (PP) monofilament was carried to introduce carboxyl functionality on its surface. The monofilament was treated with oxygen plasma to create hydroperoxide groups and subsequent graft polymerization was initiated on this exposed monofilament. It was observed that in the absence of an added inhibitor, the grafting did not proceed because of the extensive homopolymerization which left behind hardly any monomer for the grafting reaction. The addition of ferrous sulfate to the grafting medium led to the homopolymer free grafting reaction. The addition of organics, such as methanol, butanone, and acetone led to complete inhibition of the homopolymerization at 60% content. However, the addition of butanone led to much lower degree of grafting than methanol and acetone. The contact angle of the monofilament showed drastic reduction by plasma treatment and by the subsequent grafting of acrylic acid. The grafting in ferrous sulfate medium showed higher contact angles as compared to the grafting in organic medium. The surface morphology was significantly influenced by the nature of the additive in the grafting medium.

show abstract

“…In a review on aortic valve repair, Carr and Savage found the incidence of suture line dehiscence was 1.4% (11 of 761), but the types of suture material were not specified. In literature, the surgical procedures included mitral valve replacement ( 22 , 23 , 26 ), aortic valve repair ( 19 ), closure of atrial septal defect ( 20 , 21 ) or patent ductus arteriosus ( 27 ), coronary artery bypass grafting ( 26 ), femoro-popliteal bypass ( 24 , 27 ), and ascending aortic replacement ( 25 ). Suture breakage or rupture may occur as early as intraoperatively or in the immediate postoperative period, or as late as 5.3 years after surgery ( 19 ), leading to severe bleeding, failed valve repair ( 19 ), periprosthetic leakage ( 26 ), or anastomotic false aneurysm ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…The sizes of broken sutures ranged from 5–0, 4–0 to 2–0, with 5–0 being the most common. The breakage may be located at the atrial septal defect ( 20 , 21 ), aorto-to-coronary graft anastomosis ( 27 ), valve annulus ( 19 , 22 ), aortotomy ( 27 ), arteriotomy ( 24 ), left atriotomy ( 23 ), graft-to-graft anastomosis ( 24 ), or distal aortic anastomosis ( 25 ), either close (at the base of) or at some distance to the knots.…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact mechanisms remain largely unclear, various factors from production and packaging process to intraoperative handling may cause or contribute to the breakage or fracture of polypropylene sutures after cardiovascular surgery ( 24 , 25 , 29 ). In an analysis of suture fracture morphology, Karaca and Hockenberber found that the polymer type, size of suture, and knot security played important roles in the breaking process ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

BioGlue® is not associated with polypropylene suture breakage after aortic surgery

Pacini

Murana

Hollinworth³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

ObjectiveWe have encountered broken or damaged polypropylene sutures (Prolene®) at the anastomotic sites during aortic reoperations. Because a surgical sealant, bovine serum albumin-glutaraldehyde (BioGlue®), was used in previous aortic surgery in some of these cases, we undertook this in vitro study to evaluate whether the use of BioGlue® was associated with breakage of polypropylene sutures at the aortic anastomosis.Materials and methodsThe broken polypropylene sutures, anastomotic sites and aortic tissue at the location of suture breakage were visually inspected and evaluated intraoperatively. Six human cadaveric aortic samples were incised circumferentially and anastomosed proximally to a valved conduit with running 4–0 polypropylene sutures (Prolene®). In the test group (n = 3), BioGlue® was applied directly to the Prolene® sutures at the anastomotic sites, while in the control group (n = 3) the anastomoses were not sealed with any surgical adhesive. The six samples were immersed in Dulbecco's phosphate buffered saline solution and mounted on a M-6 Six Position Heart Valve Durability Testing System and tested up to 120 million cycles for a 2-year period. During and upon completion of the testing, the integrity of Prolene® sutures, the anastomosis and aortic tissues was regularly assessed by visual inspection.ResultsIntraoperative findings included a stretched and thin aortic wall (some with thrombus), a small cleft between the aortic tissue and the Dacron vascular graft. An excessive amount of BioGlue® was often found around the anastomosis, with cracking material, but no signs of mechanical damage were observed in these cases. Upon visual inspection during and after in vitro testing, there was no apparent damage to the polypropylene sutures on the interior or exterior of the aortic anastomoses in any of the samples. No difference was observed in the physical integrity of the polypropylene sutures at anastomotic lines, the anastomoses and aortic tissues between the test and control samples.ConclusionsThe results of this study suggest that the use of BioGlue® was not associated with breakage of the polypropylene sutures at the anastomotic sites after aortic dissection repair.

show abstract

Rupture of a polypropylene suture after aortic operation: a scanning electronic microscopical assessment of potential mechanisms

Cited by 9 publications

References 4 publications

On the differences in micro‐deformation mechanism between isotactic polypropylene and β‐nucleated isotactic polypropylene as revealed by the confocal laser scanning microscopy

On the differences in micro‐deformation mechanism between isotactic polypropylene and β‐nucleated isotactic polypropylene as revealed by the confocal laser scanning microscopy

Plasma induced graft polymerization of acrylic acid onto polypropylene monofilament

BioGlue® is not associated with polypropylene suture breakage after aortic surgery

Contact Info

Product

Resources

About