LETTERS TO THE EDITOR
I wanted to reiterate that this has continued to be a good procedure and we have continued to have minimal blood loss. This procedure is one of the major keys to a successful, expedient operation and it minimizes trauma, thereby possibly lessening incontinence. I hope that more will continue to develop their own expertise with this method. RespectfullY,, Richard W. McDuffie Department of Urology Eugene Medical Center Eugene, Oregon 97401 ·"-' 1. McDuffie, R. W., Jr. and Blundon, K. E.: Radical retropubic prostatectomy: 59 cases. J. Urol., 119: 514, 1978. NEW SYNTHETIC ABSORBABLE SUTURE
To the Editor. Urologic surgeons will be interested to know of a new synthetic absorbable monofilament suture material-polydioxanone (PDS).* Absorbable sutures, of course, are highly desirable in operations on the urinary system and for a century catgut has been the standard. Recently, synthetic absorbable suture materials, polyglycolic acid and polyglactin-910, have been introduced and are used extensively in urinary tract procedures. Both of the currently available synthetic absorbable suture materials are offered in braided form, which provides a relatively rough texture. In an effort to overcome this disadvantage and increase ease of handling, a monofilament synthetic material, the polymer polydioxanone,
* Ethicon, Inc., Somerville, New Jersey.
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has been developed. We have had an opportunity to study 20 consecutive patients in whom we used PDS in a variety of urologic operations. In a comparison of PDS to surgical gut the new material has been evaluated relative to visibility, pliability, strength, ease of passage through tissues, ease of time, fraying characteristics, knot security and over-all handling. PDS has been found to be superior or equal to surgical gut in virtually every characteristic. PDS is particularly smooth in its passage through tissues. Its handling characteristics are comparable to fine monofilament nylon suture and it is virtually free of any tendency to fray. In some instances tension on PDS caused slight stretching and a tendency of the material to "corkscrew" as the material is being tied. Furthermore, PDS, like monofilament nylon, requires 3 or more squared throws for knot security. Absorbable suture material is desirable in the bladder 1 and other intraluminal portions of the urinary tract, and the newer synthetic materials produce less tissue reaction than catgut since the synthetics are absorbed by hydrolysis, while catgut is absorbed by phagocytosis.2 PDS appears to offer a number of desirable characteristics for use in urologic operations. Respectfully, Henry C. Hudson, Jr. and James F. Glenn Division of Urology Duke University Medical Center Durham, North Carolina 27710 1. Van Winkle, W. and Hastings, J.C.: Considerations in the choice of suture materials for various tissues. Surg., Gynec. & Obst., 135: 113, 1972. 2. Case, G. D., Glenn, J. F. and Postlethwait, R. W.: Comparison of absorbable sutures in the urinary bladder. Urology, 7: 165, 1976.
I wanted to reiterate that this has continued to be a good procedure and we have continued to have minimal blood loss. This procedure is one of the major keys to a successful, expedient operation and it minimizes trauma, thereby possibly lessening incontinence. I hope that more will continue to develop their own expertise with this method. RespectfullY,, Richard W. McDuffie Department of Urology Eugene Medical Center Eugene, Oregon 97401 ·"-' 1. McDuffie, R. W., Jr. and Blundon, K. E.: Radical retropubic prostatectomy: 59 cases. J. Urol., 119: 514, 1978. NEW SYNTHETIC ABSORBABLE SUTURE
To the Editor. Urologic surgeons will be interested to know of a new synthetic absorbable monofilament suture material-polydioxanone (PDS).* Absorbable sutures, of course, are highly desirable in operations on the urinary system and for a century catgut has been the standard. Recently, synthetic absorbable suture materials, polyglycolic acid and polyglactin-910, have been introduced and are used extensively in urinary tract procedures. Both of the currently available synthetic absorbable suture materials are offered in braided form, which provides a relatively rough texture. In an effort to overcome this disadvantage and increase ease of handling, a monofilament synthetic material, the polymer polydioxanone,
* Ethicon, Inc., Somerville, New Jersey.
429
has been developed. We have had an opportunity to study 20 consecutive patients in whom we used PDS in a variety of urologic operations. In a comparison of PDS to surgical gut the new material has been evaluated relative to visibility, pliability, strength, ease of passage through tissues, ease of time, fraying characteristics, knot security and over-all handling. PDS has been found to be superior or equal to surgical gut in virtually every characteristic. PDS is particularly smooth in its passage through tissues. Its handling characteristics are comparable to fine monofilament nylon suture and it is virtually free of any tendency to fray. In some instances tension on PDS caused slight stretching and a tendency of the material to "corkscrew" as the material is being tied. Furthermore, PDS, like monofilament nylon, requires 3 or more squared throws for knot security. Absorbable suture material is desirable in the bladder 1 and other intraluminal portions of the urinary tract, and the newer synthetic materials produce less tissue reaction than catgut since the synthetics are absorbed by hydrolysis, while catgut is absorbed by phagocytosis.2 PDS appears to offer a number of desirable characteristics for use in urologic operations. Respectfully, Henry C. Hudson, Jr. and James F. Glenn Division of Urology Duke University Medical Center Durham, North Carolina 27710 1. Van Winkle, W. and Hastings, J.C.: Considerations in the choice of suture materials for various tissues. Surg., Gynec. & Obst., 135: 113, 1972. 2. Case, G. D., Glenn, J. F. and Postlethwait, R. W.: Comparison of absorbable sutures in the urinary bladder. Urology, 7: 165, 1976.
![[Synthetic, absorbable suture in eye-muscle surgery (author's transl)].](/assets/img/hold.png)
