Journal of Textile Research ›› 2024, Vol. 45 ›› Issue (01): 230-239.doi: 10.13475/j.fzxb.20221102502

• Comprehensive Review • Previous Articles     Next Articles

Research progress in absorbable surgical sutures

YANG Zhichao, LIU Shuqiang, WU Gaihong, JIA Lu(), ZHANG Man, LI Fu, LI Huimin   

  1. College of Textile Engineering, Taiyuan University of Technology, Taiyuan, Shanxi 030024, China
  • Received:2022-12-01 Revised:2023-11-10 Online:2024-01-15 Published:2024-03-14

Abstract:

Significance Biomedical textiles are one of the most innovative and technologically advanced research fields in the textile industry today. Surgical sutures are one of the most used medical devices in clinical surgery, and research and development of sutures have been active worldwide. As a new generation of surgical sutures, absorbable surgical sutures are the ″darling″ of the medical community, with extremely important applications in obstetrics and gynecology, surgery, otolaryngology, ophthalmology, dentistry, and so on. Absorbable surgical sutures have become the first choice of surgeons in surgical procedures by virtue of their self-degrading, non-removable and less painful properties, and patients using absorbable surgical sutures are benefitted from having minimal visible scarring on the skin after healing, enhancing patient satisfaction. Although the development of absorbable surgical sutures is now at a relatively mature stage, many high value-added absorbable surgical sutures with excellent functionality are still in the laboratory stage and cannot be industrially produced and marketed for clinical applications. Therefore, this paper focuses on the analysis of various raw materials for preparation of absorbable surgical sutures based on the latest relevant research literature to systematically summarize the current research status of absorbable surgical sutures, promote the innovative development of absorbable surgical sutures and enhance the industrial production of absorbable surgical sutures.

Progress The development of absorbable sutures and their performance requirements, the history of the development of absorbable surgical sutures from ancient times to the present day are introduced first. The development of the raw materials for their preparation from single to diversified are elaborated. The specific development history is shown, and the mainstream products on the market today are shown. In addition, the properties of absorbable surgical sutures, such as good biocompatibility and good knot strength, as well as the smoothness of the suture surface, are systematically reviewed. The four natural materials used for natural absorbable suture applications, namely catgut, collagen, chitin and alginate, are scutinised and the latest research in this area is summarized and analyzed. Four types of synthetic polymers, i.e., polylactic acid, polyglycolic acid, polycaprolactone and polyvinyl alcohol, are reviewed for making absorbable sutures and the latest research is summarized and analyzed. The advantages and disadvantages of developing absorbable surgical sutures from various materials are systematically studied and compared, and the analysis focused on three important indicators which are the mechanical properties, degradation properties and additional antibacterial properties of absorbable sutures. The overview of antimicrobial immune novel absorbable surgical sutures is also summarized the relevant mechanisms of action is described. Finally, the article concludes with an analysis and summary of the problems of today's absorbable surgical sutures and the trends of future development.

Conclusion and Prospect The paper analyzes the current status of research on surgical sutures in recent years, starting from the materials used for the preparation of absorbable sutures. The technology for the development of absorbable surgical sutures is becoming more mature, but some problems still need research attention. 1) Relatively little research has been conducted on natural type of absorbable surgical sutures, and the initial catgut have disadvantages such as poor mechanical properties and tendency to trigger tissue reactions, which require further modification of the material. Chitin is commonly used as a functional coating finishing material to impart antimicrobial properties in recent years due to its excellent broad-spectrum antibacterial properties, but little research has been conducted on the preparation of sutures using chitin fibers for development. 2) The development of synthetic polymeric materials has provided more possibilities for the preparation of new absorbable surgical sutures. However, the degradation cycles of various materials are different, resulting in a mismatch between wound healing time and suture degradation time, which affects wound healing. Therefore, the controlled degradation of synthetic polymers is particularly important, so the research of absorbable sutures made of synthetic polymers should be enhanced in terms of the regulation of degradation properties. 3) Wound infection is a persistent problem in surgical procedures, and therefore the development of absorbable surgical sutures with excellent antimicrobial properties is the main theme in suture preparation. Tthe selection of suitable antimicrobial agents, the enhancement of antimicrobial agent loading fastness, and the long-lasting and stable action of antimicrobial agents are issues requiring future research attention.

Key words: biomedical textile, absorbable surgical suture, natural material, synthetic polymer, degradation performance, antibacterial property

CLC Number: 

  • TS102.5

Tab.1

History of absorbable suture materials"

时间 材料
公元前1800年~1500年 肠线[8?-10]
19世纪末 消毒的肠线[8?-10]
20世纪60年代 可控制体内吸收速率的胶原线[11-12]
20世纪70年代 甲壳素可吸收缝合线[8?-10]
19世纪90年代末 海藻酸盐纤维[11]
20世纪60年代 PGA可吸收缝合线[11-12]
20世纪60年代末 PPDO缝合线的开发[8?-10]
20世纪70年代初 PLLA纤维[11-12]
20世纪70年代末~80年代 PDS缝合线和Maxon[8?-10,12]
20世纪90年代 PLA缝合线及相关改性处理[8?-10,12]
20世纪90年代末 PDO缝合线[12]

Tab.2

Partial commercially available absorbable surgical suture products"

商品名称 年份 材质 功能 应用领域
Vicryl?缝合线(爱惜康) 1974年 聚糖乳酸910(乙交酯与丙交酯) 用于组织的闭合处理 眼科手术、软组织缝合或结扎
PDS?Ⅱ缝合线 1982年 聚对二氧环己酮聚合物(PPDO) 用于软组织缝合 小儿心血管手术和眼科手术
Monocryl?缝合线 1993年 聚卡普隆25(75%聚乙交酯和25%ε-己内酯) 用于软组织缝合 软组织缝合和结扎,不能用于显微外科手术
古氏SA+抗菌线 2016年 乙交酯-左旋丙交酯共聚物 用于各类组织缝合 皮下组织缝合、胃肠道手术以及血管手术
VelosorbTM快速编织缝合线(柯惠) 乙交酯和丙交酯组成 用于组织的闭合处理 皮肤和黏膜的软组组织闭合
BiosynTM单丝缝合线
(柯惠)
由乙交酯、二氧环己酮以及三亚甲基碳酸脂组成 用于软组织的闭合处理 适用于眼科以及皮肤黏膜的结扎处理
MONOCRYL* Plus抗菌缝合线(爱惜康) 乙交酯和25%ε-己内酯,外加三氯生涂层 用于软组织的闭合处理 适用于皮肤黏膜结扎处理,不适用眼科以及神经组织手术
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