The Disintegration of Surgical Sutures on Exposure to Pancreatic Juice

Development in material engineering provide many kinds of suture materials to medical fields. The choice of utilization depends on the surgeons decision, the durability, absorbtion times, tensile strength of the suture, and operation site in means of organ and tissue. In this study we aimed to investigate 7 different suture materials in vivo and in vitro conditions to evaluate the properties and durability. Basal tensile strength (TS) values of all sutures were measured and 168 Wistar albino rats were utilised in vivo groups. The sutures were placed in the bladder, stomach, intestine and bile duct (after obstructive jaundice). Urine and bile of rat, pH 1 and pH 10 were used as in vitro conditions. Seven different suture materials (Maxon, Vicryl, Plain Catgut, Surgical Silk, Polypropylene, Caprosyn and Biosyn) were investigated in 9 different in vitro and in vivo conditions. All sutures were chosen to be in size 5/0. In the following 5th day the sutures were tested related to durability and stability. Results were compared stastically using the Mann-Whitney U test and p < 0.05 was considered as stastically significant. Among all the suture materials only polypropylene proved to preserve its stability in vivo and in vitro surveys. Cat-gut and caprosyn lost its TS in all medias. Silk and biosyn lost its TS in all conditions except the stomach and intestines. Maxon also lost its TS in all condition except urine. Utilisation of caprosyn and biosyn in urinary procedures reduces stone formation and infections. The suture of choice in biliary tract should be vicryl, maxon or biosyn since polypropylene preserves its stability that could result in stone formation. In intestinal operations polypropylene, vicryl, and silk could be preferred.

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“…Mizuma et al stated that silk maintained its strength in dog pancreatic juice for 14 days [7]. Müftüoğlu et al did not confirm their results.…”

Section: Discussionmentioning

confidence: 94%

An In Vitro and In Vivo Evaluation of Tensile Strength and Durability of Seven Suture Materials in Various pH and Different Conditions: An Experimental Study in Rats

et al. 2010

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“…There have been prior reports on the influence of digestive juices on biodegradation [1,12,13,18]. Some of the latter publications had other study designs or analyzed other suture materials (typically catgut).…”

Section: Discussionmentioning

confidence: 99%

“…The fact that canine bile seems not to have an influence on the biodegradation of polyglycolic acid sutures [18] suggests that it has to be a specific human factor.…”

Section: Discussionmentioning

confidence: 99%

Biodegradation of Absorbable Sutures in Body Fluids and pH Buffers

Freudenberg¹,

Rewerk²,

Kaess³

et al. 2004

Eur Surg Res

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Objective: This study measures the influence of body fluids on the loss of tensile strength of absorbable sutures in vitro. Methods: Nine synthetic absorbable sutures were incubated in different gastrointestinal fluids, as well as in blood and three buffers. Stretch tests were performed after days 0, 7, 14, and 21. Results: Tensile strength varied from 18.5 to 32.8 N, and elasticity varied from 9.5 to 51% of the initial length. The influence of pH, blood, and gastric juice was negligible on all sutures except PDS II^®. Except for Monocryl^®, all sutures, especially Polysorb^® and Vicryl^®, lost tensile strength much faster in bile, jejunal and pancreatic juices than in the corresponding buffers. Conclusion: The biodegradation of sutures varies greatly in different body fluids independent of differences in pH.

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“…Final¬ ly, alimentation may continue via the gastrojejunostomy. Berne 22 Using this tech¬ nique in eight patients, we had one death (12% ) and two fistulae (25% ), both of which closed spontaneously within 21 days. The addition of vagotomy to temporary pyloric exclusion for the prevention of marginal ulcération does not appear necessary.…”

Section: Duodenal Diversionmentioning

confidence: 99%

Changing Trends in the Management of Pancreatic Trauma

Cogbill¹

1982

Arch Surg

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The Disintegration of Surgical Sutures on Exposure to Pancreatic Juice

Cited by 22 publications

References 10 publications

An In Vitro and In Vivo Evaluation of Tensile Strength and Durability of Seven Suture Materials in Various pH and Different Conditions: An Experimental Study in Rats

An In Vitro and In Vivo Evaluation of Tensile Strength and Durability of Seven Suture Materials in Various pH and Different Conditions: An Experimental Study in Rats

Biodegradation of Absorbable Sutures in Body Fluids and pH Buffers

Changing Trends in the Management of Pancreatic Trauma

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