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Journal of Environmental Pathology, Toxicology and Oncology
Fator do impacto: 1.241 FI de cinco anos: 1.349 SJR: 0.519 SNIP: 0.613 CiteScore™: 1.61

ISSN Imprimir: 0731-8898
ISSN On-line: 2162-6537

Journal of Environmental Pathology, Toxicology and Oncology

DOI: 10.1615/JEnvironPatholToxicolOncol.v29.i4.60
pages 339-361

Wound Closure Sutures and Needles: A New Perspective

Richard Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
K. Dean Gubler
Surgical Critical Care, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emanuel Hospital, Portland, OR, USA
Anne G. Wallis
Brush Prairie, WA, USA
Jamie J. Clark
Brush Prairie, WA, USA
Jill J. Dahlstrom
Legacy Verified Level I Shock Trauma Center, Legacy Emanuel Hospital, Portland, OR, USA
William B. Long III
Trauma Specialists LLP, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emmanuel Hospital Portland, OR, USA

RESUMO

Ideally, the choice of the suture material should be based on the biological interaction of the materials employed, the tissue configuration, and the biomechanical properties of the wound. Measurements of the in vivo degradation of sutures separate them into two general classes: absorbable and nonabsorbable sutures. The nonabsorbable sutures and absorbable sutures are classified according to their origin. When considering an absorbable suture’s tensile strength in vivo, we recommend that the manufacturer provides specific recommendations of its holding strength, rather than the percentage retained of its initial tensile strength. The newest advance in nonabsorbable sutures is polybutester suture, which is a block copolymer that contains butylene terephthalate (84%) and polytetramethylene ether glycol terephthalate (16%). The expanded polytetrafluoroethylene (ePTFE) suture has been expanded to produce a porous microstructure that is approximately 50% air by volume. The clinical performance of polybutester suture has been enhanced by coating its surface with a unique absorbable polymer. A search for a synthetic substitute for absorbable collagen sutures led to the development of the POLYSORBTM sutures that can reliably approximate tissues with a low risk for infection. The latest innovation in the development of monofilament absorbable sutures has been in the rapidly absorbing CAPROSYNTM suture. A new high-nickel stainless steel, SURGALLOYTM, has been used recently to manufacture surgical needles. Biomechanical performance studies of cutting edge needles made of S45500 stainless steel alloy and SURGALLOYTM stainless steel demonstrated that needles made of SURGALLOYTM had superior performance characteristics over those made of S45500.


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