The use of a new absorbable suture material (polyglycolic acid) in general surgery

Anscombe, Anthony R.; Hira, N; Hunt, Brandon

doi:10.1002/bjs.1800571212

Cited by 48 publications

(16 citation statements)

References 2 publications

(1 reference statement)

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“…Although the results of the two trials are not strictly comparable, Dexon appeared to produce less tissue reaction than catgut. The relative inertness of Dexon in the tissues supports the findings of earlier published work (Anscombe et al, 1970). However, Dexon does remain in the tissues for longer than catgut, judging from the rcview period at 11-21 days (Trrblc.…”

Section: Resultssupporting

confidence: 87%

“…Dexon is thinner than catgut of equivalent strength and it feels firmer, softening slightly in contact with water or tissue fluids (Anscombe et al, 1970). It is extremely strong and easy to handle, does not fray and does not become slippery when moist (Morgan, 1969).…”

mentioning

confidence: 99%

“…The surgeon must become accustomed to the new material, for, being stronger and thinner than catgut, undue tension can cause the suture to cut through soft tissues or through the operator's glove (Anscombe et al, 1970).…”

mentioning

confidence: 99%

“…The important advantage of polyglycolic acid is that it produces no tissue reaction (Anscombe et al, 1970). The inflammatory reaction at the site of silk sutures which have been removed (from the skin) contrasts with the virtual absence of reaction around Dexon sutures still in situ (Bonnar, 1972).…”

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confidence: 99%

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The use of Dexon and plain catgut in circumcision

Mouzas

Pompa

1974

Journal of British Surgery

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Published clinical literature on the handling properties and qualities o f Dexon (polyglycolic acid) suture materid is reciewed. Of' 68 patients (aged 3 months to 56 years) requiring circumcision, 37 were sufured with Dexon and 31 with plain catgut. There was no tissue reaction to Dexon in 36 patients (97.3 per cent) nor did any infection deecelop, but there was delay in absorption. Only 7 patients (22.5 per cent) sewn up with cntgur were ,free f i o m tissue reaction, and infection occurred in 8 of these putients. Catgut was absorbed more qnickly. Dexon sutures had disappeared by the twentyfirst day in 19 pcitients (51.3 per cent) and catgut had disappeared in the same time in 19 patients (63.3 per cent). I n 5 of I2 patients photographed postoperatiarly there was a knobbly-looking ,foreskin at 19-27 days. This was associated with Dexon in 4 patients and was probably due to unabsorbed suture material. The relative lack of' tissue reaction to Dexon in comparison with catgut supports the findings of' other clinicians. A way of tying Dexon and slipping the knot into place (like catgut) is also described.

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Section: Resultssupporting

confidence: 87%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The use of Dexon and plain catgut in circumcision

Mouzas

Pompa

1974

Journal of British Surgery

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“…A suture with similar properties, DEXON (Davis and Geck), i.e. polyglycolic acid, has been used in general surgery (Anscombe, Hira, and Hunt, 1970;McCarthy, 1970;Olerud and Ponten, 1970;Miln, O'Connor, and Dalling, I972); in oral surgery by Wallace, Maxwell, and Cavalaris (1970) and Lilly, Cutcher,Jones, andArmstrong (1972); in orthopaedic surgery by Allman (I973) and Scholz, Lewis, and Bateman (1972); experimentally by Herrmann, Kelly, and Higgins (1970), Postlethwait (I970), and Capperauld (I97I); in gynaecology by Rahman and Way (1972) and Tompkins and Lea (1972). Very recently, Sugar, Lorfel, and Summer (1974) have reported the successful use of 6/o DEXON in 55 cataract extractions.…”

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confidence: 99%

Vicryl (Polyglactin 910): a new synthetic absorbable suture in ophthalmic surgery. A preliminary study.

Munton¹,

Phillips²,

Martín³

et al. 1974

British Journal of Ophthalmology

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Hospitals,4; and The Director of Surgical Research, Ethicon Limited,% Sighthill, EdinburghThe main function of a suture is to hold the wound edges in apposition until healing is sufficiently advanced for the wound to be self-supporting. In practice, as an absorbable material is losing tensile strength, the wound is gaining strength and at a particular time, which varies according to the tissue involved, equilibrium will be reached. Ophthalmic surgery presents the ideal situation where sutures implanted during operative procedures can be readily observed with regard to their tissue reactivity, biological acceptability, and loss of tensile strength. Characteristics ofknotting, tissue drag, and knot strength can also be assessed. A clinical trial of VICRYL® Synthetic Absorbable Sutures made by Ethicon was set up in three clinical centres: 27 cataract extractions and thirty squint operations were done to determine the safety and efficacy of this material.VICRYL®, or Polyglactin 9IO, is a synthetic absorbable suture which has been synthesized by the co-polymerization of a mixture of purified lactide and glycolide which are cyclic intermediates derived from lactic and glycolic acids. Glycolide and lactide are converted into a polymer in the form of uniform chips which are dyed violet. These chips are melted, and the polymer extruded to form fine filaments. These filaments are strengthened by stretching to allow molecular alignment. The resulting filaments are braided and the braid undergoes a further stretching process to increase further the tensile strength of the resulting suture. Being violet in colour, the suture is easily seen in the wound. The suture material is attached to an eyeless needle, placed dry into a foil package and sterilized by ethylene oxide. The braided VICRYL® is smaller in diameter than the corresponding size of catgut, although its "knot pull strength" is higher (Table I). Knot pull strength is recorded in pounds and is the tension at which a knotted piece of suture material breaks. This strength is always lower than the straight pull value with no knot in the material. In a comparison of VICRYLO, polyglycolic acid, and MERSILENE® it can be shown that VICRYL0 has a higher knot pull strength than any of the other materials mentioned (Table II).Extensive animal work had been performed by Ethicon with VICRYL® to show its safety and efficacy in vivo before release for clinical trial. This work included toxicity and carcinogenic studies, in-use animal work, and metabolic studies using radioactive labelled suture

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