Synthetic Absorbable Suture Materials

Absorbable sutures belong to the group of surgical sutures that degrade over time and lose their tensile strength. Absorbable sutures are used in internal tissues and for tissue approximation during the healing process. They can be evaluated by their sensitivity to moisture and high tensile strength. There are two characteristics that determine the behaviour of absorbable sutures in living tissue: resorption rate and mass loss, as well as the maintenance of tensile strength. After resorption, which occurs due to the loss of tensile strength of absorbable sutures, the sutures remain in the tissue for a period of time and do not disappear completely. Depending on suture quality and structure, this resorption period varies.

There are suture structures that cause differences in certain characteristics, namely monofilament and multifilament. Monofilament sutures minimize tissue trauma during tissue passage/penetration and, through their monofilament structure, minimize infection formation within the body. Multifilament sutures with high knot security have a braided structure that increases strength.

Synthetic absorbable sutures are hydrolyzed by body fluids secreted from the lungs or kidneys. Hydrolysis, an organic chemical reaction in which water is used to break some of the molecules, also causes less tissue reaction than enzymatic action.

Synthetic absorbable surgical sutures are available in various types depending on the materials they contain:

PGA (Polyglycolic Acid)

This surgical suture, which has the characteristics of the first valid synthetic absorbable suture, is a homopolymer of glycolic acid (hydroxyacetic acid) that was introduced to the market in 1970. For the braided structure of absorbable and multifilament PGA sutures, a mixture of calcium stearate and polycaprolactone is used as a coating.

PGAR (Polyglycolic Acid Rapid) – Degraded PGA

The coating of PGAR absorbable sutures is based on a coated suture structure, and the coating material consists of a mixture of calcium stearate and polycaprolactone. It has a structure that does not cause excessive tissue irritation. This provides safe use.

PGLA (Poly(glycolide (90%)- co -lactide(10%))

The surgical sutures of this structure consist of a copolymer synthesized from 90% polyglycolic acid and 10% L-lactic acid, provide the tensile strength required during wound healing and do not cause tissue irritation. The coating material of these non-antigenic and non-pyrogenic absorbable sutures consists of a mixture of calcium stearate, polyglycolic acid (30%) –L-lactic acid (70%).

PGLAR (Poly(glycolide (90%)- co -lactide(10%)) Rapid – Degraded PGLA

The synthetic sterile absorbable suture produces only slight tissue reactions during resorption. This braided suture coated with coating material has a coating material consisting of a mixture of calcium stearate, polyglycolic acid (30%) –L-lactic acid (70%). Its structure, which does not cause excessive tissue irritation, is neither antigenic nor pyrogenic.

PGCL (Poly(glycolide(75%)- co –caprolactone (25%))

PGCL sutures with synthetic structure produce minimal tissue reactions during resorption without causing tissue irritation. Absorbable PGCL sutures consist of a copolymer synthesized from 75% polyglycolic acid and 25% caprolactone.

PDO (Polydioxanone)

These PDO sutures are absorbable sutures that, in contrast to other absorbable sutures, are manufactured sterile to keep the wound closed for an extended period. These smooth-walled sutures with increased tensile strength in a biological environment facilitate suture placement, reduce the likelihood of tissue injury, and cause very little reaction.