HELPING YOU FEEL SECUREPolysorb™ Suture

For Nurses

WOUND HEALING: THE FIRST 2 WEEKS AFTER SURGERY ARE CRITICAL

Wound repair following surgery is a long-term process, but the first 2 weeks are particularly crucial — this is the critical wound healing period (CWHP).1,2

During early tissue repair, wound tensile strength is only 7–10% of that of undamaged skin.3 Wound dehiscence most commonly occurs in the CWHP, and may

require repeat surgery, placing a potentially substantial burden on healthcare systems.4

Polysorb™ suture provides strength during the CWHP

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ile s

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642 16

Inflammation

Proliferation

Maturation

Adapted from Townsend CM et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th Edition. 2012, Saunders; Bolognia JL et al. Dermatology. 3rd Edition. 2012, Elsevier Ltd.

POLYSORB™ SUTURES ARE STRONG DURING THE CWHP

The strength of Polysorb™ suture, provided by tighter braided filaments, provides security during the CWHP.4–6

As Polysorb™ suture is designed to provide superior‡ strength when needed during the CWHP, and to then be rapidly absorbed, its tensile strength decreases after 3 weeks of implantation.

A direct comparison between Polysorb™ suture and Vicryl™* using a knot-pull test showed that Polysorb™ suture has7,§:

∙ 37% greater knot pull strength out of the package7

∙ 21% greater knot pull strength after one week7

∙ 8% greater knot pull strength after two weeks7

The greater strength of Polysorb™ suture is complemented by superior knot security, in both wet and dry conditions, compared with Ethicon Vicryl™*.7

†Compared to Vicryl™* suture.

‡Critical wound healing period

§In R&D testing,7 Polysorb™ sutures were statistically significantly comparable or stronger than Vicryl™* sutures during the CWHP: p<0.001 for weeks 0–2 for commonly use size USP 2–0, October 2013.

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5.0

4.0

3.0

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WEEK 0 WEEK 1 WEEK 2 WEEK 3

2/0 BRAIDED SYNTHETIC ABSORBABLE SUTURE

Polysorb™ suture is 37% stronger out-of-package7

Polysorb™ suture provides 21% greater strength during the critical wound-healing period7

Polysorb™ Suture

Vicryl™* Suture

DOES ANTIBACTERIAL SUTURE COATING PROTECT AGAINST SURGICAL SITE INFECTIONS?

Some sutures are coated with an antibacterial agent, such as triclosan, in an effort to reduce the risk of wound infection which can be costly to treat.6

Contrary to findings from single-centre studies, a recently published large, multicentre, randomised clinical trial after colorectal surgery demonstrated that surgical sutures coated with triclosan do not appear to be effective in reducing the rate of surgical site infection.8

This was supported by in vitro data showing no significant difference in Staphylococcus aureus colonisation between Polysorb™ suture and main competitor products, including those coated with triclosan.9

Concerns about the potential environmental impact of triclosan and the possible emergence of antibiotic resistance factored into the decision of the manufacturer of the main triclosan-coated Vicryl™* to phase out triclosan in consumer products by 2015.10

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Overall Superficial Deep

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ns (%

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Triclosan-coatedp=0.64

Conventional

Occurence of surgical site infections8

300 adult patients received triclosan-coated (n=140) or conventional (n=141) sutures

100,000

10,000

1000

100

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0Day 0 Day 1 Day 2 Day 6

Vicryl™ suture

CFU

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Vicryl™ Plus suturePolysorb™ sutureBiosyn™ suture

Bacterial colonization9 (Staphylococcus aureus)

CFUs, colony-forming units

FAVOURABLE HANDLING CHARACTERISTICS OF POLYSORB™ SUTURE MAY FACILITATE WOUND CLOSURE

The favourable handling characteristics of Polysorb™ suture were demonstrated in a study showing that:

Polysorb™ suture was the preferred choice of surgeons,11 in terms of ease of handling, in a test of four absorbable, multifilament sutures (size 2 USP), providing:

The smoothest surface11

The greatest ease of knot positioning11

The best knot tightness11

The best knot security11

POLYSORB™ SUTURE COMBINES STRENGTH AND SECURITY DURING THE CWHP WITH EASE OF HANDLING5–7

The CWHP‡ is well-documented in many studies.

Compared with Vicryl™* products, Polysorb™ suture is uniquely suited to aid wound healing due to:

Greater strength during the CWHP5–7,§

†Compared to Vicryl™* suture.

‡Critical wound healing period

§ In R&D testing,7 Polysorb™ sutures were statistically significantly comparable or stronger than Vicryl™* sutures during the CWHP: p<0.001 for weeks 0–2 for commonly use sizes USP 1 to 3–0, October 2013.

REFERENCES

1. Sabiston DC, Townsend CM, Beauchamp D, Evers M, Mattox K. Sabiston Textbook of Surgery: The biological basis of modern surgical practice. 19th Edition. Saunders; 2012.

2. Weinzweig J. Plastic surgery secrets plus. Second Edition. Mosby, Inc;2010.

3. Bolognia JL, et al. Dermatology. 3rd Edition. Elsevier Ltd; 2012.

4. van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, Lange JF. World J Surg. 2010 Jan;34(1):20-7.

5. Polysorb™ Suture [instructions for use]. Mansfield, MA: Medtronic.

6. Vicryl™* Suture [instructions for use]. Ethicon.

7. Based on internal test report CMP-5347, Comparing the most popular sizes used in the market. 2013.

8. Mattavelli I, Rebora P, Doglietto G, Dionigi P, Dominioni L, Luperto M et al. Multi-center randomized controlled trial on the effect of triclosan-coated sutures on surgical site infection after colorectal surgery. Surgical Infections. 2015 Jun 1;16(3):226-235.

9. Based on internal test report, In vitro evaluation of staphylococcus aureus of commercial braided synthetic absorbable BSA suture materials (some containing triclosan) and monofilament synthetic absorbable (MSA) sutures.

10. www.jnj.com/sites/default/files/pdf/cs/Our%20Position%20on%20Triclosan_July%202014.pdf. Accessed December 2014.

11. Debus ES, Geiger D, Sailer M, Ederer J, Thiede A. Physical, biological and handling characteristics of surgical suture material: a comparison of four different multifilament absorbable sutures. Eur Surg Res. 1997;29(1):52-61.

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