Advanced Technologies and Polymer Materials for Surgical Sutures

Description

Polymeric materials offer a high level of versatility due to the range of applications possible within the biomedical and clinical fields – including wound closure - particularly in comparison to metals or ceramics. These specialised materials also allow for a diverse array of therapeutic effects. Although there have been advances in improving polymeric materials for surgical sutures, there is little information available regarding improving the therapeutic value of sutures, and advanced technologies used to implement this improvement. Advanced Technologies and Polymer Materials for Surgical Sutures provides thorough coverage on suture materials with improved mechanical and therapeutic properties that can improve quality of life; chapter topics include drug-releasing kinetics of sutures, shape memory polymer sutures and future trends. This book is a useful resource for academics and researchers in the materials science and biomedical engineering fields, as well as professionals in biomaterials and biotextiles development and clinicians looking to learn more about suture material properties and suture/body interactions. Advanced Technologies and Polymer Materials for Surgical Sutures Copyright Contributors 1 . Advances in biopolymer based surgical sutures 1.1 Introduction 1.2 Polymers as suture materials 1.3 Biopolymers 1.4 Biopolymers for sutures 1.4.1 Collagen 1.4.2 Polylactic acid (PLA) 1.4.3 Silk 1.4.4 Chitin & chitosan 1.4.5 Polyhydroxyalkanoate (PHA) 1.4.6 Cellulose 1.5 Sterilization of sutures 1.6 Conclusion and future perspectives References 2 . Functionalization of sutures 2.1 Introduction 2.2 Suture materials: from hairs to antibacterial biopolymers 2.3 Suture types 2.4 Biocompatibility studies for functionalized sutures 2.5 Functionalization 2.5.1 Coating in fibers 2.5.1.1 Dip-coating 2.5.1.2 Electrodeposition 2.5.2 Grafted sutures 2.5.2.1 Monomer 2.5.2.2 Solvent 2.5.2.3 Temperature of reaction 2.5.3 Stimuli-responsive polymers on sutures 2.6 Functionalization of nonabsorbable sutures 2.6.1 Polypropylene sutures 2.6.1.1 Functionalization with azoles 2.6.1.2 Functionalization with Ag 2.6.2 Modified silk sutures 2.7 Functionalization of absorbable sutures 2.7.1 Functionalization with silver 2.7.2 Chitin sutures 2.7.3 Caprolactam sutures gentamicin/silver loaded 2.7.4 Drug-loading on absorbable sutures 2.8 Conclusions Acknowledgments References 3 . Improving the therapeutic value of sutures 3.1 Content 3.2 General concepts 3.2.1 History of sutures 3.2.2 Characteristics and classification of sutures 3.2.3 Characteristics of commercial sutures 3.3 Suture modification: bioactive devices as the future of the suture technology 3.3.1 Structural modification 3.3.1.1 Fiber dimensions 3.3.1.2 Topography and microstructure of the suture 3.3.2 Chemical modification 3.3.2.1 Antimicrobial sutures 3.3.2.2 Incorporation of antimicrobial agents in sutures 3.3.2.3 Surface incorporation of antimicrobial agents in sutures 3.3.3 Drug delivery sutures 3.3.4 Stimuli responsive systems 3.3.4.1 pH-responsive polymers 3.3.4.2 Thermo-responsive polymers 3.3.4.3 Stimuli responsive sutures 3.4 Conclusion Acknowledgments References 4 . Evaluating the mechanical properties of sutures 4.1 Introduction 4.2 Mechanical properties 4.2.1 Tensile strength 4.2.2 Knot strength 4.2.3 Breaking strength 4.2.4 Knot-pull tensile strength 4.2.5 Wound breaking strength 4.2.6 Elasticity 4.2.7 Plasticity 4.2.8 Memory 4.2.9 Pliability 4.2.10 Capillarity 4.2.11 Abrasion 4.3 Characterization techniques 4.3.1 Universal testing machine (UTM) 4.3.2 Abrasive testing 4.4 Effect of antibacterial coating on mechanical properties 4.5 Conclusion References 5 . Polymers for surgical sutures 5.1 Introduction 5.2 Types of polymeric surgical sutures and their applications 5.2.1 Natural polymers 5.2.1.1 Gut 5.2.1.2 Silk 5.2.2 Synthetic and absorbable polymers 5.2.2.1 PGA-PCL blend 5.2.2.2 PGA-PLA blend 5.2.2.3 P4HB 5.2.2.4 PDS 5.2.3 Synthetic and nonabsorbable polymers 5.2.3.1 Nylon 5.2.3.2 PP 5.2.3.3 PET 5.2.3.4 Polybutester 5.2.3.5 PVDF and PTFE 5.3 Tissue adhesive polymers as suture candidate 5.4 Challenges with current technologies 5.4.1 Bioactive sutures 5.4.2 Smart sutures 5.4.3 Biomimetic sutures 5.4.4 Translation of basic discoveries in clinical applications 5.5 Future perspective and remarks 5.6 Conclusion Acknowledgments References 6 . Smart sutures 6.1 Introduction 6.2 Base material of smart suture 6.2.1 Paper 6.2.2 Polyglycerol sebacate 6.2.3 Polycaprolactone 6.2.4 PCL/PGS blend 6.2.5 Cotton 6.2.6 Carbon nanotubes 6.2.7 Wicking 6.2.8 Polyurethane 6.3 Temperature sensors for smart sutures 6.4 pH sensor smart sutures 6.5 Strain smart sutures 6.6 Glucose smart sutures 6.7 Microfluidic analysis smart sutures 6.8 Resorbable smart sutures 6.9 Future smart sutures 6.9.1 Bacterial detection sensors 6.9.2 Neutrophil sensor 6.9.3 Colorimetric smart sutures 6.10 Conclusions References 7 . Bioactive sutures: advances in surgical suture functionalization 7.1 Introduction 7.2 Suture structure 7.2.1 Absorbable sutures 7.2.2 Nonabsorbable sutures 7.2.3 Monofilament sutures 7.2.4 Multifilament sutures 7.3 Fabricating bioactive suture methods 7.3.1 Fiber level 7.3.2 Cell and gene activators 7.3.3 Stimuli responsive 7.3.4 Researched bioactive suture 7.4 Cell based bioactive sutures 7.4.1 Stem cells 7.4.2 Stem cells for wound healing 7.4.3 Stem cells – cardiovascular application 7.4.4 Stem cells – tendon repair 7.4.5 Stem cell suture conclusions 7.4.6 mRNA suture 7.4.7 Gene regulation 7.4.8 Growth factor bioactive suture 7.5 Incorporated bioactive material 7.5.1 Chitin bioactive sutures 7.5.2 Bioactive glass for antibacterial sutures 7.6 Future developments of bioactive sutures 7.6.1 Surface architecture sutures 7.7 Conclusion References 8 . Engineering aspects of suture fabrication 8.1 Introduction 8.1.1 Surgical sutures 8.1.2 The association of surgical sutures with wound healing cascade 8.2 Why is the engineering of suture fabrication important? 8.2.1 Suture design parameters 8.2.1.1 Structural attributes 8.2.1.1.1 Suture size 8.2.1.1.2 Suture configuration/geometry 8.2.1.1.3 Needle type 8.2.1.1.4 Surface features 8.2.1.1.5 Surface coatings 8.2.1.2 Physical attributes 8.2.1.2.1 Absorbability of sutures 8.2.1.2.2 Engineering of mechanical performance 8.2.1.2.2.1 Tensile strength. 8.2.1.2.2.2 Knot strength. 8.2.1.2.2.3 Stiffness and flexibility. 8.2.1.2.2.4 Elasticity and plasticity. 8.2.1.2.2.5 Coefficient of friction. 8.2.1.2.2.6 Capillarity. 8.2.1.2.2.7 Memory. 8.2.1.2.2.8 Comparisons of mechanical performances of few sutures. 8.2.1.3 Biological attributes 8.2.1.3.1 Capillarity, biofilms and bacterial attacks 8.2.1.3.2 Tissue responses and adhesions 8.2.1.3.3 Influence of pH of body fluid 8.3 Broadening the functionality of sutures 8.3.1 Engineering drug-eluting sutures 8.3.1.1 Choosing the right technique of fabrication 8.3.1.2 Choosing the right polymer 8.3.1.3 Choosing the right technique of postprocessing 8.4 Conclusions References 9 . Revisiting the properties of suture materials: an overview 9.1 Introduction 9.1.1 Characteristics of sutures 9.2 Types of suture materials and examples 9.2.1 Absorbable sutures 9.2.2 Non-absorbable sutures 9.2.2.1 Silk suture 9.2.2.2 Nylon 9.2.2.3 Polypropylene 9.2.2.4 Polybutester – novafil 9.2.2.5 Stainless steel non-absorbable sutures 9.2.3 Emerging alternatives to conventional sutures 9.2.3.1 Staples 9.2.3.2 Absorbable staples 9.2.3.3 Non-absorbable staples 9.2.3.4 Tissue adhesives 9.3 Suture materials and their properties: recent advances 9.3.1 Silk-based sutures 9.3.2 Poly(ε-caprolactone) based sutures 9.3.3 Polyamide-based sutures 9.3.4 Collagen-based sutures 9.3.5 Polyurethane-based sutures 9.3.6 Polypropylene sutures 9.3.7 Chitosan-based sutures 9.3.8 Bio-based sutures 9.4 Properties of suture materials: comparative analysis 9.4.1 Physico-mechanical properties 9.4.2 Biological properties 9.5 Micro and nanotechnology-enabled suture materials 9.6 Conclusions and future outlook References 10 . Suture materials, emerging trends 10.1 Introduction 10.2 Taxonomy of sutures 10.3 Absorbable and nonabsorbable suture materials 10.4 Monofilament, multifilament sutures and barbed sutures brands 10.5 Categories of absorbable sutures 10.5.1 Catgut sutures 10.5.2 Chromic gut sutures 10.5.3 Polyglycolic acid sutures 10.5.4 Polydioxanone sutures 10.5.5 Poliglecaprone sutures 10.5.6 Polyglactin sutures 10.6 Slowly absorbable sutures 10.6.1 Polydioxanone (PDS II) 10.6.2 Polyglyconate (Maxon) 10.6.3 Nonabsorbable sutures 10.6.4 Silk suture 10.6.5 Polymerized caprolactum suture (Supramid) 10.6.6 Polyester suture (Mersilene, Ethibond) 10.6.7 Nylon (Dermalon or Ethilon) 10.6.8 Polybutester (Novafil) 10.6.9 Polypropylene (Prolene) 10.6.10 Structurally coated and un-coated sutures 10.6.10.1 Coated sutures include 10.6.10.2 Un-coated sutures include 10.6.11 Application-based suture categories 10.7 New trends in sutures 10.7.1 Knotless barbed sutures 10.7.2 Antibacterial sutures 10.7.3 Stem cell seeded suture 10.7.4 Smart sutures: electronic/elastic sutures 10.8 Conclusion References Further reading 11 . Biocompatibility and cytotoxicity of polymer sutures 11.1 Introduction 11.2 Classification of sutures 11.2.1 Origin based classification 11.2.2 Material based classification 11.2.3 Classification based on size 11.2.4 Classification based on physical configuration 11.3 Necessary characteristics of suture materials 11.3.1 Physical and mechanical properties 11.3.2 Handling properties 11.3.3 Biological properties 11.4 Biocompatibility of sutures 11.4.1 Measuring biocompatibility 11.4.1.1 In vitro tests 11.4.1.2 In vivo tests 11.4.1.3 Usage tests 11.4.1.4 Standards that regulate the measurement of biocompatibility 11.5 Cytotoxicity of sutures 11.6 Conclusion References 12 . Shape memory polymers as sutures 12.1 Introduction 12.2 Sutures 12.2.1 SMP sutures 12.2.1.1 Main factors for SMPs sutures 12.2.1.1.1 Importance of polyurethane based sutures 12.2.1.1.2 Applications of SMPs sutures 12.3 Conclusion References 13 . Drug release kinetics of sutures 13.1 Introduction 13.2 Surgical sutures 13.3 Drug release from antiinflammatory sutures 13.4 Drug release from growth factor embedded sutures 13.5 Drug release from antithrombotic sutures 13.6 Drug release kinetics of antibacterial sutures 13.7 Oxygen release from sutures 13.8 Conclusion References Index A B C D E F G H K L M N O P Q R S T U V W Y Z