MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate
MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate
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DOI：
10.1155/2012/216137
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发表时间：
2012-01-01
影响因子：
3.3
通讯作者：
Williams, Simon F.
中科院分区：
文献类型：
--
作者：
Odermatt, Erich K.;Funk, Lutz;Williams, Simon F.
使用聚4-羟基丁酸酯（P4 HB）开发了一种长期可吸收单股缝线，该聚4-羟基丁酸酯（P4 HB）由天然代谢物4-羟基丁酸酯的生物合成均聚物制成。这种称为MonoMax的缝线具有较长的强度保持能力。在12周时，3-0号MonoMax缝线在体内保留约50%的初始抗张强度，并在一年内大幅降解，组织反应极小。相比之下，PDS II单股缝线（Ethicon，Inc.，萨默维尔，新泽西州）在体内12周后没有剩余强度。在体内，MonoMax缝线主要通过本体水解进行水解，然后通过Krebs循环降解。MonoMax的顺应性明显高于其他单股缝线，并包含弹性元素。其拉伸模量为0.48 GPa，约为PDS II纤维值的三分之一，提供了一种非常柔韧的纤维，具有出色的打结强度和安全性。纤维的弹性进一步增强了这些功能，这也提高了结的安全性，并有助于防止伤口裂开。由于其性能优势，该缝线可能在需要长期强度保持和更大柔韧性的应用中具有临床实用性，特别是在伤口裂开仍是严重术后并发症的腹壁闭合等手术中。
A long-term absorbable monofilament suture was developed using poly-4-hydroxybutyrate (P4HB) made from a biosynthetically produced homopolymer of the natural metabolite 4-hydroxybutyrate. The suture, called MonoMax, has prolonged strength retention. At 12 weeks, a size 3-0 MonoMax suture retains approximately 50% of its initial tensile strength in vivo and is substantially degraded in one year with minimal tissue reaction. In contrast, PDS II monofilament suture (Ethicon, Inc., Somerville, NJ) has no residual strength in vivo after 12 weeks. In vivo, the MonoMax suture is hydrolyzed primarily by bulk hydrolysis, and is then degraded via the Krebs cycle. MonoMax is substantially more compliant than other monofilament sutures, and incorporates an element of elasticity. Its tensile modulus of 0.48 GPa is approximately one-third of the value of the PDS II fiber providing an exceptionally flexible and pliable fiber with excellent knot strength and security. These features are further enhanced by the fiber's elasticity, which also improves knot security and may help prevent wound dehiscence. Because of its performance advantages, this suture may find clinical utility in applications where prolonged strength retention, and greater flexibility are required, particularly in procedures like abdominal wall closure where wound dehiscence is still a significant post-surgical complication.