Introduction
Like other antibacterial sutures polyglycolic acid suture also available with coating of antibacterial agents like chlorhexidine or triclosan. Antibacterial coating of PGA suture helps in reducing chances of surgical site infection.
A. Polyglycolic acid suture with chlorhexidine
Composition
Polyglycolic acid suture with chlorhexidine (eg. Megasorb plus) is braided PGA suture which is further coated with chlorhexidine which is an antibacterial agent (first coating is done with a mixture of polycaprolactone and calcium stearate).
Absorption & Tensile Strength
It is degraded by hydrolysis like normal PGA suture. Available in both dyed and undyed forms.
Complete absorption takes place between 60 to 90 days. Retention of 70-80 % knot tensile strength up to 14 days.
Fig: Megasorb Plus-Chlorhexidine coated antibacterial PGA suture
Tissue Reaction
It has minimum inflammatory reaction and ideal for antibacterial wound closure.
B. Polyglycolic acid suture with Triclosan
Composition
Polyglycolic acid suture with Triclosan (e.g. Petcryl Plus, MITSU AB Suture) is polyglactin 910 sutures further coated (also coated with equal parts of copolymer of glycolide and Lactide (Polyglactin 370) and Calcium Stearate) with the triclosan to fight surgical site infections or SSIs. Antibacterial sutures are also used for minimising the risk of suture induced SSIs.
Tissue Reaction
These coated sutures are slightly reactive and may incite grade 1 tissue reaction. It is non-antigenic and non-pyrogenic braided polyfilament suture.
Absorption & Tensile Strength
Absorption takes place by simple hydrolysis.
It loses 25% tensile strength after 14 days of implantation. 50 % tensile strength is lost within 21 days and completely absorbed within 56-70 days.
Sizes
These sutures are available form 6-0 to 4 USP size with different types of swaged needles attached with them.
Indications
Petcryl plus / Mitsu Ab suture or triclosan coated polyglycolic acid sutures are indicated in general soft tissue approximation/closure, gastrointestinal tract surgeries, ophthalmic surgery, peripheral nerve anastomosis, microsurgery and obstetrics/ gynaecological procedures.
Fig: Petcryl Plus Triclosan coated polyglycolic acid Antibacterial suture
Contraindications
Polyglactin coated with triclosan / Petcryl plus has not been tested for safety and effectiveness in cardiovascular tissues. Should not be used in the patients having a known history of hypersensitivity towards triclosan or other ingredients of the polyglactin 910.
Normal suture handling guidelines must be followed.
FAQs
Yes. Dexon sutures are absorbable in nature.
Yes. PGA sutures are absorbable in nature and do not need to be removed.
Dexon suture is green in color.
PGA sutures are homopolymer made up of 100% polyglycolic acid while vicryl is a copolymer made up of 90% polyglycolic acid and 10% lactic acid.
No, Dexon suture is synthetic in nature.
Following sutures can be used as substitute of dexon – Petcryl, Kruuse PGA, Truglyde etc. They are made up of 100% polyglycolic acid.
Quite descriptive and nice information about suture material, plz describe about suture techniques.
We are trying our best and will update it soon with good illustrations.
Thank you for your feedback and vital time.