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Results for “Polydioxanone”

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At least 19 recordsLinked to original sources

PubMed1991

Initial evaluation of absorbable polydioxanone suture for peripheral vascular surgery.

The long-term integrity of an autogenous vascular anastomosis is primarily dependent on the strength of tissue healing; therefore permanent mechanical support of an autogenous anastomosis with sutures is unnecessary. In this study we evaluated monofilament absorbable polydioxanone as an alternative to polypropylene for suturing autogenous vascular tissue during adult peripheral vascular operations. We used polydioxanone suture for 21 vascular procedures in 20 patients. We evaluated suture handling characteristics during operation and then followed patients with clinical assessments and serial duplex scans to monitor for pseudoaneurysms, anastomotic narrowing, and vessel patency. Indications for surgery included limb salvage (67%), dialysis access (23%), traumatic arteriovenous fistula and claudication (5% each). The operative procedures included infrainguinal bypass (57%), arteriovenous fistula formation (24%), thromboembolectomy (14%), and arteriovenous fistula repair (5%). Polydioxanone sutures were placed in 39 separate test sites (35 arterial, 4 venous). No deaths occurred during operation. Polydioxanone suture was found to have handling characteristics similar to polypropylene. During mean patient follow-up of 7.2 +/- 0.6 months, we found no cases of anastomotic narrowing or pseudoaneurysms. Actuarial test site patency at 1, 3, and 6 months was 97%, 97%, and 86%, respectively. Polydioxanone suture has handling properties that are acceptable for use in vascular applications, and it provides adequate mechanical support for sutured vessels to heal. A randomized trial comparing polydioxanone with polypropylene suture will be necessary to determine whether the lack of permanent foreign material in vascular anastomoses can improve long-term patency.

Anastomosis, Surgical↗

PubMed1991

End-to-end repair of aortic coarctation using absorbable polydioxanone suture.

Based on previous laboratory work, we have used polydioxanone absorbable suture in a variety of vascular and cardiac repairs in pediatric patients. However, some investigators have expressed concern about the potential for aneurysm formation at the anastomotic site. Between March 1983 and June 1989, 15 patients (7 male, 8 female) aged 2.5 months to 9.2 years (mean, 3.7 years) had resection of coarctation of the aorta and end-to-end anastomosis with polydioxanone absorbable suture. Thirteen patients have returned for routine postoperative evaluation, the follow-up time ranging from 11 to 49 months (mean, 23 months). Noninvasive two-dimensional, pulsed-wave Doppler and color echocardiography and magnetic resonance imaging studies demonstrated good anatomical repair and no anastomotic aneurysm formation or residual coarctation of the aorta in any patient after end-to-end anastomosis with polydioxanone. In summary, this intermediate follow-up study has revealed no vascular complications related to the repair of coarctation with absorbable polydioxanone suture.

Abnormalities, Multiple↗

PubMed1992

Histology and fertility effects of polydioxanone on rat reproductive tissue.

This prospective study compares the histology and fertility effects of the microsuture polydioxanone to nylon and polyglactin-910. Twelve rats underwent uterine horn microroeanatomoses with nylon (6 right horns), polyglactin-910 (6 right horns), and polydioxanone (12 left horns). After mating, there were no significant differences in gestational implantations or adhesions per uterine horn. Postoperative histologic evaluation of nylon showed persistent histiocytic reaction and fibrosis, occasional giant cells, and suture persistence at 100 days. Polyglactin-910 had initial histiocytic responses, no giant cells or fibrosis, and was resorbed by 60 days. Polydioxanone had initial histiocytic reaction and giant cells, no fibrosis, and was resorbed by 100 days. Our findings, and a review of the literature, confirmed mixed histologic reactions but no difference in fertility with these three microsutures. Because of its low reactivity and great strength, polydioxanone may be a good alternative suture material in reproductive microsurgery.

Animals↗

PubMed1990

Suture material in bladder surgery: a comparison of polydioxanone, polyglactin, and chromic catgut.

A comparison of polydioxanone, polyglactin, and chromic catgut suture was performed in 120 rat bladders studying propensity for infection, degree of inflammation, calculogenic potential, changes in urine pH, and suture absorption. None of the sutures predisposed to infection and there was wide variability but no correlation in urine pH. Although initially the polydioxanone incited a greater inflammatory response, by six months all three sutures were similar. The absorption of polydioxanone was slower than chromic catgut suture, but similar to the absorption of polyglactin. There was no significant difference in calculogenic potential between the suture materials tested over a six-month period. Based on this study in rats, polydioxanone suture would appear to be equal to catgut and polyglactin suture in bladder surgery.

Animals↗

PubMed1986

Polydioxanone in digestive surgery. An experimental study.

An experimental study was carried out to analyze the reaction of polydioxanone suture. Two hundred ten single layer colonic anastomoses were performed in rats and histopathologically studied at nine different times between the 2nd and 180th postoperative days. Eighteen of 105 abdominal wound closures were studied in the same way between the 7th and 90th days. Polydioxanone was resorbed slowly in approximately 6 months with minimum inflammation. We believe that polydioxanone is actually the suture material of choice for all biliary and biliodigestive sutures.

Abdominal Muscles↗

PubMed1990

Results of aortic anastomoses made under tension using polydioxanone suture.

After early repair of congenital cardiovascular defects, such as coarctation of the aorta, late stenosis may become a problem. Use of absorbable sutures has been shown to be superior to use of nonabsorbable sutures in allowing growth of an anastomotic site along with the individual. Some concern has been raised, however, about the potential for aneurysm formation at the site of anastomosis when absorbable sutures are used. This study was undertaken to observe the effects of longitudinal tension on anastomoses made with absorbable polydioxanone suture in growing animals. Six piglets (aged 3 to 4 weeks) underwent a 1-cm resection of the infrarenal aorta and reanastomosis with polydioxanone suture. One animal died prematurely of respiratory illness. The 5 remaining animals were killed after 6 months. The excised aortas demonstrated no stenosis, no dilatation, and no burst-test failure to 250 mm Hg. Histological examination showed disrupted elastic laminae without thinning of aortic wall in all samples of aorta. We conclude that polydioxanone suture is a suitable suture material for vascular anastomoses made under tension where growth of the anastomotic site is expected.

Anastomosis, Surgical↗

PubMed1991

Mechanical knot performance of a new generation polydioxanon suture (PDS-2).

To improve the handling characteristics of synthetic resorbable monofilament PDS (polydioxanon), a second-generation (PDS-2) suture has been developed. The mechanical knot performance of this suture was tested in square knots and sliding knots and compared with other monofilament suture materials. Knot performance was defined by the loop holding capacity (LHC) and expressed in Newton's (N). Maxon (polyglycolid-three-methylene carbonate) had significantly better knot performance than the other sutures. Knot performance of Prolene (polypropylene) was significantly poorer than that of the other sutures. Ordinary PDS (polydioxanon) and PDS-2 (polydioxanon) showed intermediate results. Knot performance of PDS-2 was similar to (square knots) or poorer than (sliding knots) that of ordinary PDS. It was concluded that knot performance of ordinary PDS is not improved by the introduction of PDS-2. It is emphasized that surgeons should be aware of the mechanical properties of newly developed suture materials. Underlying factors and clinical implications of the mechanical performance of PDS-2 are discussed.

Humans↗

PubMed1991

A prospective randomized comparison of continuous polydioxanone and interrupted Neurilon for neurosurgical wound closure.

A prospective, randomized study of continuous Polydioxanone with subcuticular vicryl closure is compared to interrupted Neurilon in a general neurosurgical practice. Ninety-nine patients were studied with 49 closed with Polydioxanone and 50 by Neurilon. The two groups were comparable with respect to risk factors and general composition. There was no significant difference in the rate of infection, wound dehiscence, CSF leak or suture protrusion, but Neurilon had a significantly higher incidence of palpable knots. Wound closure time was compared with no overall difference being found. We conclude that continuous Polydioxanone closure with subcuticular vicryl is an acceptable form of closure for neurosurgical wounds.

Adult↗

PubMed1986

Use of polydioxanone absorbable monofilament sutures in orthopedic surgery.

The safety and efficacy of polydioxanone absorbable monofilament sutures was documented in 57 orthopedic surgery patients (32, dyed sutures; 25, undyed sutures), 55 of whom were followed for at least 42 days postoperatively. The other two patients were lost to follow up prior to 42 days. The final clinical outcome was excellent in all completed study subjects. No suture-related adverse effects were reported. Both dyed and undyed sutures were consistently better than surgical gut with respect to pliability, strength, ease of passage, ease of tying, fraying, knot security, and overall handling. Intraoperative visibility of dyed polydioxanone sutures was consistently superior to that of surgical gut. The visibility of undyed sutures was rated better than surgical gut in 16 cases, equal in 8, and worse in 1. Both the overall handling of the polydioxanone monofilament sutures and performance as it affected wound healing were significantly superior to those of surgical gut.

Adolescent↗

PubMed1988

Polydioxanone and polypropylene suture material in free internal mammary artery graft anastomoses.

An experimental study with six beagle dogs was conducted to evaluate a new monofilamentous absorbable suturing material--polydioxanone. Free internal mammary artery grafts, 3 cm long, were harvested via a median sternotomy and were implanted as arterial bypasses in femoral arteries (12 end-to-end anastomoses) and as arteriovenous shunts in the carotid artery-contralateral jugular vein position (12 end-to-side anastomoses). Twenty-four anastomoses were made with monofilamentous nonabsorbable suturing material, polypropylene (12 arterial, 12 shunts), to serve as control grafts. At 6 months the grafts and anastomoses were explanted and studied with light and scanning electron microscopes. Macroscopically, the polydioxanone sutures had disappeared. The major histologic finding was the foreign body reaction around the polypropylene sutures. In the electron microscopic study the endothelial line covered the anastomotic site and in the polypropylene anastomoses the suture material was bulging up from the anastomoses. No aneurysms or dilatations were seen. According to this study, polydioxanone is a suitable suturing material for small luminal arterial anastomoses and is superior to polypropylene suturing material because it causes no tissue or other late changes on the flow surfaces.

Animals↗

PubMed1987

Arterial regeneration over polydioxanone prostheses in the rabbit.

We analyzed histologic, ultrastructural, and functional characteristics of rabbit aortic conduits regenerated over absorbable polydioxanone prostheses. Twenty-eight polydioxanone-elicited prosthesis/tissue complexes harvested two weeks to 12 months following implantation were analyzed grossly; photographed; sectioned for light, scanning, and transmission electron microscopy; and studied for compliance, bursting strength, and prostacyclin and thromboxane metabolite contents. No aortic-related deaths or hemorrhages occurred. Smooth regenerated conduits without stenoses were seen in 27 of 28 specimens, with one small aneurysm. Transprosthetic myofibroblast migration and proliferation paralleled the kinetics of macrophage-mediated prosthetic dissolution, which was consequently delayed compared with polyglycolic acid prostheses. Confluent endothelial-like luminal surfaces were present after two weeks. Progressive inner capsular thickening ended after three months at 420 micron. Ex vivo compliance curves resembled arterial elasticity. Regenerated tissue withstood 1200 mm Hg of systolic pressure, and 6-keto-prostaglandin F1 alpha to thromboxane B2 ratios did not differ from normal control specimens.

6-Ketoprostaglandin F1 alpha↗

PubMedDate not supplied

Calcinosis circumscripta associated with polydioxanone suture in two young dogs.

Calcinosis circumscripta associated with polydioxanone suture material was diagnosed in two young dogs. In each case, the owner noticed a firm mass at the site of a previous surgical incision. Mineralization of soft tissues was visible radiographically. At excision, multiple chalky white nodular masses within the subcutis extended in a linear pattern the length of the sutured incision, but not beyond it. Polydioxanone suture was identified within the center of the nodules, which were identified histologically as calcinosis circumscripta.

Animals↗

PubMed1989

[Initial results following implantation of resorbable micro-patches of polydioxanone in the rat aorta].

Polydioxanon micro-patches were inserted into the infrarenal aorta of 21 rats by means of microsurgical techniques. Histologic characteristics were analysed by light microscopy up to 8 weeks after implantation. The following observations were made: After 4 weeks a regenerated artery with different layers could be seen: Neo-Endothelium-, Neo-Media-, Neo-Adventitia-Patch-layer. Two different proliferation zones were evaluated: the anastomotic adventitial layer, responsible for regenerating the Neo-Adventitia-Patch-layer as a chronic foreign body reaction, the anastomotic intima layer, responsible for regenerating the Neo-Media with differentiation of cells into smooth-muscle-like cells. The lining cells appeared like endothelium-like cells. These study demonstrates the possibility of regenerating arterial tissue over polydioxanon patch in the rat aorta.

Animals↗

PubMed1988

Closure of abdominal wounds with polydioxanone. A prospective study.

Polydioxanone, an absorbable synthetic monofilament suture, was used to close abdominal wounds in 200 consecutive operative procedures. All patients were followed up for one year. Despite a high incidence of risk factors for impaired wound healing, the incidence of dehiscence and evisceration was zero; incisional hernia occurred in 2.9% of vertical midline wounds and in 3.6% of transverse incisions. This new suture material is safe and effective for closure of abdominal wounds.

Abdominal Muscles↗

PubMed1987

Polydioxanone or polypropylene for closure of midline abdominal incisions: a prospective comparative clinical trial.

Seven hundred and fifty-seven consecutive patients undergoing a midline abdominal incision were stratified according to age, sex, type of operation and degree of operative contamination and were randomly allocated to mass closure of the abdominal wall with continuous 4 metric polydioxanone (PDX; 374 patients) or continuous 4 metric polypropylene (PPL; 383 patients). Wound infection was less common with PDX (PDX 3.5 per cent; PPL 7.0 per cent; P less than 0.05) and there was one dehiscence in each group. The incidence of defective wounds in patients surviving 1 year was similar (7.7 per cent PDX; 9.7 per cent PPL) but the PPL suture had to be removed because of persisting wound pain or sinus formation in five patients. PDX is the preferred suture material for closure of midline abdominal incisions.

Clinical Trials as Topic↗

PubMed1992

Microsurgical use of polydioxanone (PDS) suture: an experimental report.

Although many technological advances have been made in surgical materials, nylon is still the main suture material use for microvascular surgery. This study sought to evaluate polydioxanone (PDS) sutures for use in microvascular anastomoses. Twenty-eight male Sprague-Dawley rats were used in this experiment. Spatula-type needles with 9-0 PDS suture were used to anastomose the right femoral arteries, with 9-0 nylon used on the left side. The arteries were observed for 1, 2, 3, 4, 8, 12, and 16 weeks after surgery to determine arterial patency and to evaluate vascular pathology. Results were comparable between PDS and nylon. We suggest that if the suture material is redesigned to allow smooth passage through the tissue, and if the needle used in conjunction with the suture is improved, PDS may offer an excellent material for microvascular anastomosis.

Anastomosis, Surgical↗

PubMed1989

A comparative study of polydioxanone (PDS) and polyglactin 910 (Vicryl) in colonic anastomoses in rats.

The use of polyglactin 910 (Vicryl) in colonic anastomoses is theoretically undesirable because its short dissolution time and multifilament structure may lead to local sepsis and anastomotic leakage. We have compared Vicryl with a newly introduced monofilament absorbable suture which has a longer dissolution time than Vicryl. In a study of 98 rat colonic anastomoses no difference was found in complication rates or cellular reaction to the suture material between Vicryl and polydioxanone (PDS). The use of monofilament suture with longer dissolution time does not necessarily imply added security for colonic anastomoses.

Anastomosis, Surgical↗

PubMed1987

Preclinical evaluation of PDS (polydioxanone) synthetic absorbable suture vs chromic surgical gut in urologic surgery.

A variety of suture materials are available for use in urologic surgery. Urologists have relied on absorbable suture materials which provide transient strength in anticipation that healing will occur before the suture is absorbed. Absorbable sutures thus decrease the chance of stone formation, known to occur on suture material in direct contact with the urinary stream. This report compares the breaking strength retention of polydioxanone (PDS) suture and chronic surgical gut after in vivo residence in the urinary bladder and subcutaneous tissue of the dog.

Animals↗