Product Manual

slightly, machine ground, and polished, yielding a relatively smooth surface that
is monofilament-like in appearance. Salthouse and colleagues
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demonstrated
that the mechanism by which gut reabsorbs is the result of sequential attacks
by lysosomal enzymes. In most locations, this degradation is started by acid
phosphatase, with leucine aminopeptidase playing a more important role later in
the absorption period. Collagenase is also thought to contribute to the enzymatic
degradation of these collagen sutures.
Natural fiber absorbable sutures have several distinct disadvantages. First,
these natural fiber absorbable sutures have a tendency to fray during knot
construction. Second, there is considerably more variability in their retention of
tensile strength than is found with the synthetic absorbable sutures. A search for
a synthetic substitute for collagen sutures began in the 1960s. Soon procedures
were perfected for the synthesis of high molecular weight polyglycolic acid, which
led to the development of the polyglycolic acid sutures (Dexon™ II, Dexon™ S).
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These sutures are produced from the homopolymer, polyglycolic acid. Because
of the inherent rigidity of this homopolymer, monofilament sutures produced
from polyglycolic acid sutures are too stiff for surgical use. This homopolymer
III. scientific basis for the selection of surgical sutures (cont’d)
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