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Use of polyglyconate suture in paediatric gastrointestinal anastomosis
1Department of Surgery, Children's Hospital, Camperdown, New South Wales, Australia.
Insights
Maxon sutures, a polyglyconate copolymer, demonstrate significantly less tissue drag in pediatric gastrointestinal surgery. This absorbable monofilament suture offers a promising alternative for long-term patient outcomes.
Area of Science:
- Surgical Innovation
- Biomaterials Science
- Pediatric Surgery
Background:
- Suture selection in pediatric gastrointestinal surgery requires balancing factors like tissue drag and absorbability due to long patient life expectancies.
- Long-term effects of retained suture materials in pediatric patients are not well-documented, emphasizing the need for absorbable options.
Purpose of the Study:
- To evaluate the efficacy and handling characteristics of a polyglyconate copolymer suture (Maxon) in pediatric gastrointestinal surgery.
- To compare Maxon sutures against other available sutures regarding tissue drag, handling, and patient outcomes.
Main Methods:
- A prospective, randomized trial involving 56 pediatric patients undergoing 65 gastrointestinal anastomoses.
- Sutures were assessed for handling and tissue drag using a visual analogue scale by surgeons.
- Outcomes and complications were monitored across various gastrointestinal join types.
Main Results:
- Maxon sutures exhibited significantly lower tissue drag compared to braided synthetic absorbable sutures.
- No statistically significant differences were observed in overall handling, outcomes, or complication rates.
- Maxon sutures are slowly absorbed, with a half-life of 5 weeks and complete disappearance in 6-7 months.
Conclusions:
- Maxon sutures are a superior option for pediatric gastrointestinal surgery due to their low tissue drag and absorbability.
- The suture's properties address key concerns regarding long-term effects and patient well-being in pediatric surgical procedures.
Abstract:
The perfect suture has been defined, but in certain circumstances some features are more important than others. In paediatric gastrointestinal surgery lack of tissue drag is of great importance. Because the life expectancy of most paediatric patients having gastrointestinal operations is measured in many decades, and the long-term effects of retained suture materials are relatively undocumented, absorbability is also of importance. A polyglyconate copolymer suture (Maxon, Davis & Geck, Gosport, UK) has undergone trial. It is a monofilament absorbable suture. It has a low coefficient of friction, very low tissue drag and is stronger (straight pull and knot strength) than corresponding gauges of braided synthetic absorbable sutures. It is slowly absorbed, its half life (in relation to strength) being 5 weeks and complete disappearance occurring in 6-7 months. The trial was prospective and randomized. All members of the Department of Surgery at the Children's Hospital, Camperdown participated. Sixty-five anastomoses were performed in 56 patients. All varieties of joins were performed (oesophageal, duodenal, small and large bowel, and biliary-enteric). There were no statistically significant differences in the result in terms of outcome and complications. Overall handling and tissue drag were assessed by the surgeon at the end of the operation on a visual analogue scale and analysis of these results showed no significant difference in overall handling, but significantly less tissue drag (unpaired t-test). It is concluded that Maxon is superior to other currently available sutures for paediatric gastrointestinal surgery.