The disintegration of absorbable suture materials on exposure to human digestive juices: an update. 1994

F Tian, and H E Appert, and J M Howard
Department of Surgery, Toledo Hospital and Medical College of Ohio.

This is a comparative study of the disintegration of absorbable sutures when incubated in human gastric juice, bile, pancreatic juice, and their mixture. Plain catgut rapidly lost its strength in each of these digestive fluids. Chromic catgut was susceptible to digestion although it retained most of its strength in bile for two weeks. Synthetic absorbable sutures, polyglycolic acid or its derivatives (Dexon "S", Dexon Plus, and Maxon), maintained most of their strength for 2 weeks, disintegrating only after 5 to 8 weeks. Controls of saline or human plasma had little demonstrable effect. As a further control, silk maintained its strength under each exposure. Although catgut is widely used, the study suggests that it disintegrates too rapidly, at least under the conditions tested, to be appropriate for alimentary tract surgery, whereas the synthetic sutures maintained their integrity rather well for the 2 to 3 weeks needed for visceral wound healing. The data suggest that slowly absorbed synthetic sutures may be particularly useful in pancreatic or biliary anastomoses where a single layer is preferable and where a nonabsorbable suture offers inherent disadvantages.

UI MeSH Term Description Entries
D010189 Pancreatic Juice The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. Juice, Pancreatic,Juices, Pancreatic,Pancreatic Juices
D011100 Polyglycolic Acid A biocompatible polymer used as a surgical suture material. Polyglycolide,Biofix,Dexon (Polyester),Dexon-S,Dexon S,DexonS
D011108 Polymers Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., BIOPOLYMERS; PLASTICS). Polymer
D002398 Catgut Sterile collagen strands obtained from healthy mammals. They are used as absorbable surgical ligatures and are frequently impregnated with chromium or silver for increased strength. They tend to cause tissue reaction. Catguts
D005750 Gastric Juice The liquid secretion of the stomach mucosa consisting of hydrochloric acid (GASTRIC ACID); PEPSINOGENS; INTRINSIC FACTOR; GASTRIN; MUCUS; and the bicarbonate ion (BICARBONATES). (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p651) Gastric Juices,Juice, Gastric,Juices, Gastric
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001646 Bile An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum. Biliary Sludge,Sludge, Biliary
D001673 Biodegradation, Environmental Elimination of ENVIRONMENTAL POLLUTANTS; PESTICIDES and other waste using living organisms, usually involving intervention of environmental or sanitation engineers. Bioremediation,Phytoremediation,Natural Attenuation, Pollution,Environmental Biodegradation,Pollution Natural Attenuation
D013505 Digestive System Surgical Procedures Surgery performed on the digestive system or its parts. Gastrointestinal Surgical Procedures,Digestive System Surgical Procedure,Gastrointestinal Surgical Procedure,Procedure, Digestive System Surgical,Procedure, Gastrointestinal Surgical,Procedures, Digestive System Surgical,Procedures, Gastrointestinal Surgical,Surgical Procedure, Digestive System,Surgical Procedure, Gastrointestinal,Surgical Procedures, Digestive System,Surgical Procedures, Gastrointestinal
D013537 Sutures Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed) Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture

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