Macroscopic and histologic tissue reaction to polydioxanone, a new, synthetic, monofilament microsuture

A major contributing factor to failure in reconstructive tubal surgery is adhesion formation. It can be due to the presence of a foreign body primarily represented by suture material. A new, synthetic, absorbable suture material, Polydioxanone (PDS), was compared to polyglactin -910 (Vicryl). Microsurgical anastomosis of the bicornuate rat uterus served as a model. The right horn was anastomosed with 6-0 or 8-0 PDS and the left horn with Vicryl of the same diameter. At 3, 7, 14, 30 and 60 days after the procedure three to four animals were killed and the histologic reaction estimated and compared between the two horns. At 60 days the remaining animals were killed, and adhesion formation around the anastomosis site was recorded. PDS was found to be histologically more inert than Vicryl and was associated with a less intense acute and chronic inflammatory response than Vicryl. Similarly, macroscopic examination showed that the adhesion formation was quantitatively reduced in the PDS-treated horns, and most of those adhesions were avascular. The high inertness and absorbability suggest a practical application of PDS in infertility surgery.