Comparison of seven different suture materials in the feline oral cavity.

Seven different suture materials were implanted into the oral tissues of 12 cats. The sutures and surrounding tissues were retrieved en bloc from each of two cats on days one, three, seven, 14, 21, and 28 postimplantation. Tissue reaction and suture duration were evaluated by gross visual observation and histological examination. Chromic gut disappeared between days three and seven; polyglactin 910 disappeared between days 14 and 21; and polyglycolic acid disappeared as early as seven to 14 days. Polydioxanone still was intact at day 28 and is recommended as an absorbable material for procedures in which longer healing time is anticipated. All the nonabsorbable suture materials (i.e., polypropylene, stainless steel, and nylon) were intact at day 28 postimplantation. Visual inspection showed polypropylene to have the least tissue reaction.

Monocryl suture, a new ultra-pliable absorbable monofilament suture.

Synthetic absorbable sutures are available as braided constructions or as monofilaments. Braided absorbable sutures are made either from 90:10 poly(glycolide-co-L(-)-lactide), sold by Ethicon, Inc. under the trade name Vicryl, or from polyglycolide, as sold, for instance, by Davis and Geck under the trade name Dexon. There are, however, some concerns with braided sutures that relate to tissue drag and the trauma this may cause, as well as the possible potentiation of infection through the interstices of the braid structure. Absorbable monofilaments, such as the monofilament sutures derived from p-dioxanone homopolymer (PDS II, an Ethicon, Inc. product), or a copolymer of trimethylene carbonate and glycolide (Maxon, a Davis and Geck product), eliminate many of these concerns, but generally monofilaments do not handle as well as braids. This paper describes the research leading to the introduction of Monocryl (poliglecaprone 25) monofilament sutures, based on segmented block copolymers of epsilon-caprolactone and glycolide. Monocryl sutures will be shown to display excellent handling properties, minimal resistance during passage through tissue and excellent tensile properties. These sutures provide an in vivo breaking strength retention of approximately 20-30% after 2 weeks, considered by many to be the critical wound healing period. Absorption data on these sutures are presented; absorption is complete between the 91st and 119th days of implantation, with slight or minimal tissue reaction.

Microsurgical anastomosis of rat carotid arteries with the CO2 laser.

In order to further evaluate the role of lasers in microvascular tissue closure, we modified an existing CO2 surgical laser (Xanar XA-20) by adding a partially reflecting mirror to attenuate the beam. This allowed the laser to operate at an output of approximately 100 mW, which was appropriate to achieve microvascular closures. In each of 43 rats, one carotid artery was transected and then anastomosed with standard suture technique with 10 to 12 simple interrupted sutures of size 10-0 Ethilon nylon suture (Ethicon, Inc.). The opposite carotid in each rat was anastomosed by the placement of three stay sutures followed by the application of laser irradiation to the tissue between the stay sutures at 90 to 100 mW, spot size of 0.2 mm, pulse duration 0.2 seconds, approximately 20 to 30 pulses per anastomosis. In vivo test periods were 1 hour, 1 day, 3 days, 7 days, 10 days, 14 days, 28 days, 91 days, and 180 days. All anastomoses were evaluated for patency, and selected samples were utilized for light microscopy, and mechanical testing (intraluminal pressure raised to 300 mmHg). It was determined that similar patency rates and slightly faster time to perform the same procedure could be achieved with the use of the low-powered CO2 laser. However, histologic evidence of significant medial damage raises concern about the long-term risk of a higher aneurysm rate. Vessel damage and the lack of simple intraoperative methods to verify the quality of the laser technique restrict these authors from advocating the clinical introduction of the procedure until further advances are made.(ABSTRACT TRUNCATED AT 250 WORDS)