Barbed, Bi-Directional Surgical Sutures

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Surgical sutures are the most frequently used biomaterials for wound closure and tissue approximation. However, they rely on the surgeon's ability to tie secured knots, which is a challenging and time consuming process. Improper tying and handling can result in knot breakage or slippage, and potentially wound dehiscence. Further, the knot impedes wound healing, constricts blood flow, distorts tissue, and increases scar formation. To alleviate these problems, attempts have been made to design self-anchoring sutures. Recently, a novel knotless suture has been developed (Figure 1) in which bi-directional barbs are introduced into an absorbable monofilament suture using micro-machining techniques.This paper describes the analytical characterization of the barb geometry, and the biomechanical performance of the suture, including in vitro and in vivo wound closure testing. The former employs specialized microscopy and image analysis techniques. The latter entails tensile strength testing and apposition of tissues with a variety of stitch techniques, in comparison to commercially available sutures. These results will form the basis for further research into barb/tissue interactions and optimization of barb geometry for specific surgical applications.