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Related Experiment Videos

Polydioxanone suture in the gastrointestinal tract.

D A Gillatt, A P Corfield, R E May

    Annals of the Royal College of Surgeons of England
    |March 1, 1987
    PubMed
    Summary

    Polydioxanone suture (PDS) showed a high stricture rate in colonic anastomoses, leading to trial discontinuation. However, PDS proved a safe alternative to chromic catgut in gastric and small bowel anastomoses.

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    Area of Science:

    • Surgical Innovation
    • Gastrointestinal Surgery
    • Biomaterials in Medicine

    Background:

    • Suture material selection is critical for gastrointestinal anastomotic integrity.
    • Polydioxanone suture (PDS) offers extended tensile strength, prompting investigation into its efficacy.
    • Conventional suture materials like silk and chromic catgut have established safety profiles.

    Purpose of the Study:

    • To compare the efficacy and safety of polydioxanone suture (PDS) against conventional materials for gastrointestinal anastomoses.
    • To evaluate the incidence of anastomotic complications, specifically strictures, associated with PDS use.
    • To determine the optimal application of PDS in different segments of the gastrointestinal tract.

    Main Methods:

    • A randomized prospective trial involving 98 patients undergoing gastrointestinal anastomoses.

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  • Comparison of single-layer interrupted PDS versus silk for colonic anastomoses.
  • Comparison of two-layer continuous PDS versus continuous chromic catgut for gastric and small bowel anastomoses.
  • Follow-up included sigmoidoscopy and barium enemas to assess anastomotic healing and complications.

    • Main Results:

    • A significantly higher rate of benign anastomotic strictures (19%) was observed with PDS in colonic anastomoses compared to silk.
    • The colonic arm of the study was halted due to the unacceptable stricture rate with PDS.
    • No significant differences or anastomotic strictures were found when comparing continuous PDS and chromic catgut in gastric and small bowel anastomoses.

    Conclusions:

    • Polydioxanone suture (PDS) is associated with an unacceptably high rate of stricture formation in large bowel anastomoses.
    • PDS appears to be a suitable and safe alternative to chromic catgut for anastomoses in the stomach and small intestine.
    • Further research is needed to elucidate the reasons for PDS-induced strictures in the colon.