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Tissue reactions to absorbable ligating clips.

N Chegini1, J A von Fraunhofer, D L Hay

  • 1Department of Obstetrics and Gynecology, School of Medicine, University of Louisville, Kentucky 40292.

The Journal of Reproductive Medicine
|February 1, 1988
PubMed
Summary
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Biodegradable ligating clips showed varying breakdown rates. Lactomer clip residues persisted for 25 weeks, while pouched clips degraded completely, indicating pouch material influences degradation.

Area of Science:

  • Biomaterials Science
  • Surgical Device Research
  • Tissue Engineering

Background:

  • Biodegradable ligating clips are used in surgery to ligate vessels.
  • Understanding their degradation and tissue interaction is crucial for clinical application.
  • Polydioxanone (Absolok) and glycolic-lactic acid copolymers (Lactomer) are common biomaterials for such devices.

Purpose of the Study:

  • To comparatively evaluate the ultrastructural tissue response and degradation of Absolok and Lactomer ligating clips.
  • To assess the influence of encapsulation (nylon pouches) on clip breakdown and tissue reaction.

Main Methods:

  • Scanning electron microscopy (SEM) was employed for ultrastructural analysis.
  • Absolok and Lactomer clips were implanted subcutaneously in rabbits.

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  • Tissue reactions and clip degradation were observed over a 25-week period.
  • Comparison was made between non-pouched and nylon-pouched clips.

    • Main Results:

    • Early inflammatory cell adherence to clips was observed, followed by fibroblast proliferation and encapsulation.
    • A fibrous capsule formed around the clips, increasing in thickness over time.
    • Lactomer clip residues were detectable at 25 weeks post-implantation.
    • Clips enclosed in nylon pouches showed complete degradation with no detectable residues at 25 weeks.
    • Tissue reactions around the pouches mimicked those of non-pouched clips.

    Conclusions:

    • The material composition of biodegradable ligating clips influences their degradation rate and tissue interaction.
    • Encapsulation within a nylon pouch significantly enhances the complete degradation of these clips.
    • Further research into pouch materials could optimize biodegradable surgical device performance.