Polypropylene is a compound that has an isostatic crystalline stereoisomer form. It is a hydrocarbon polymer that allows very less saturation. This is manufactured by a patented process which enhances pliability and handling. Thus, polypropylene monofilament sutures cannot be degraded or weakened by the action of tissue enzymes. They cause a negligible amount of tissue reaction and hold knots better than most other synthetic monofilament materials. One suture that is made of such a compound is Prolene suture. It is made by Ethicon Inc., which is part of the Johnson and Johnson Company.
Prolene sutures are widely used in general, cardiovascular, plastic, and orthopedic surgery. Prolene sutures do not stick on to tissue and are therefore effective as a pullout suture. Prolene sutures are relatively biologically inert in comparison to other sutures, and offer strength, reliability and versatility that have been proven time and time again during surgeries. Prolene sutures are recommended for use where minimal suture reaction is desired. This can be in cases such as contaminated and infected wounds to minimize the sinus that can form later. Prolene sutures are also recommended for suture extrusion, i.e. forced out or squeezed through small openings. However, the few disadvantages include fragility, high plasticity, high expense, and difficulty of use compared to standard nylon sutures.
Certain patients may be sensitive to the compound that PROLENE suture is made up of, and might exhibit an immunological reaction resulting in inflammation, tissue granulation or fibrosis, wound suppuration and bleeding, as well as sinus formation.
The surgeon's or friction knot is recommended for tying Prolene polypropylene suture. The surgeon’s knot also may be performed using a one hand technique. The surgeon should avoid unnecessary tension when running down knots, to reduce the occurrence of surface fraying and weakening of the strand. Prolene sutures are available in the market in two forms. The undyed version is available in clear, and the dyed one comes in blue for better visibility.
Prolene has also become the mainstay of vascular anastomosis and had facilitated significant advances in cardiac and vascular surgery. It is used on both small vessels such as coronary artery bypasses and large vessels such as the aorta. It is used in obstetrical practice, during cesarean sections to suture the rectus sheath of the abdominal wall because it is non absorbable in nature and provides the sheath the due strength it deserves (rectus sheath is made up of various tendon extensions and muscle fibers and keeps up the strength of the abdominal wall, if it becomes weak the abdominal contents start producing symptoms of hernia) it stays there forever and is also often seen during repeat cesarean section as that of the previous section.
Polypropylene suture is also made by many different manufacturers as Look and Sharpoint, which have a much better overall cost than the brand name. Although Prolene suture is made by Ethicon, there are other suture makers that also manufacture it. In the case of Syneture (Covidien) their polypropylene suture product is called Surgipro.
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