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2006 Abstracts: Evaluation of the physical properties of a new fully degradable suture material with a shape memory effect for visceral surgery
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Evaluation of the physical properties of a new fully degradable suture material with a shape memory effect for visceral surgery
Christoph Reissfelder1, Joerg-Peter Ritz1, Steffen Kelch2, Andreas Lendlein2, Heinz Buhr1; 1Department of General Surgery, Charite, Campus Benjamin Franklin, Berlin, Germany; 2Institute of Chemistry, GKSS Research Center Geesthacht GmbH, Teltow, Germany

Introduction: The insufficiency rate of colorectal anastomoses decisively influences the results and prognosis of colonic operations. The suturing and knotting technique is a major risk factor due to the possible induction of microcirculatory disturbances and/or inadequate adaptation. Novel suture materials with a shape memory effect are potentially able to offset such risk factors by readaptation (self-knotting). Suitable new polymer-based suture materials were evaluated for their biocompatibility, anastomotic bursting pressure, mechanical and shape memory properties and compared with conventional suture materials. Materials and Methods: Linear multiblock copolymers were chosen for the shape memory material (SMM). Apart from the crystallizing oligo(p-dioxanone)diol for the hard segment, oligo(ς-caprolactone)diol was used as the precursor for the switch segments. The SMM was programmed for 25% shortening. The physical properties (shape memory effect with temperature elevation) of the SMM were examined in various solutions (0.9% NaCl, blood, air) at 38° and 45° C and compared with conventional suture material. 3T3 fibroblasts, human fibroblasts and umbilical endothelial cells (HUVEC) are used for biocompatibility testing with respect to cytotoxicity, adhesion, proliferation, morphology, and functional activity. Hemocompatibility is assessed by evaluating coagulation and complement activation of normal pooled human plasma after material contact. To measure the bursting strength, a descendorectostomy was created with 4-0 Vicryl and SMM 25% sutures in rats. Between day 1 - 28 anastomotic bursting pressure was measured on narcotised rats. Results: Compared with room temperature, rising temperatures led to shortening of the SMM up to 25% (p<0.05) in all solutions. There was no reduction in the length of conventional suture material (Vicryl®, PDS®). The materials tested according ISO 10993-5 caused no cytotoxic effects. By using SMM the anastomotic bursting pressure was 33% higher compared to Vicryl® (p<0.007) within the first 4 days. Discussion: 1. The newly developed SMM shows a significant length reduction under physiological conditions. 2. The materials tested according ISO 10993-5 caused no cytotoxic effects. 3. The anastomotic bursting pressure was higher under the use of SMM during the first 4 days. 4. This novel suture material is potentially able to ensure temporarily juxtapositioned self-knotting in the interval (tightening effect) and to thus possibly improve the suture insufficiency rate.


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