Wednesday, November 23, 2011

Chromic Sutures Q & A

How absorbable are chromic sutures and what is their rate of absorption compared to plain gut sutures?
There are different types of chromic gut and different manufacturers have different timelines for rates of absorption and for retention or loss of tensile strength. In most cases chromic sutures can resist absorption for up to two to three months in the body, but there will be a reduction in tensile strength over this time period.  Other factors with regards to the absorption of the sutures include the actual purity of the collagen which has the greatest impact on the in vivo tensile strength and durability.

What is chromic salt and how does it affect the plain gut to increase absorption time in the body?

Chromic salt has a low oxidation state and a low level of reactivity to other types of compounds and elements. It is found in solution and used in a variety of different industrial uses. Plain cut, which is collagen, is submersed in a solution of chromic salt and then spun, allowing a uniform coated strand of chromic gut. This coating of chromic salt acts as a barrier that slows down the enzymatic action of the body to break down the collagen in chromic sutures over plain gut sutures.

What is the most important factor that will impact the absorption rate and tensile strength decrease of chromic sutures?

No one factor is the key in the rate of absorption of chromic sutures and the change in tensile strength exhibited once implanted. Since the chromic salt helps the gut to resist the enzymes of the body one of the key factors is the specific formulation of the chromic salt solution used. The higher the chromic salt solution, designed as extra chromic, the slower the absorption and the greater the resistance to the enzyme action of the human body. Other factors such as blood flow, infections and even the natural healing rate for an individual can also be important considerations. This is why with any absorbable sutures ranges for absorption rates and decreases in tensile strength are provided rather than absolutes.

Other factors that play a role include the diameter of the suture used, any medications that the patient may be on and the individual's reaction to foreign material in the body. Illnesses, infections in other body tissues and general health may also play a role in the rate of absorption of the chromic sutures.

How is chromic gut sterilized?

Chromic sutures are sterilized using a process that exposes the suture material to gamma irradiation. Gamma irradiation is completed by high-energy photons from a specific source, an isotope, which causes electronic disruptions in the collagen. This, in turn, permanently damages the DNA of any cellular organism that is on the material. Viral or bacterial DNA is destroyed, leaving the chromic gut completely free from any type of material. It is important to note that the gamma irradiation does not leave any residual radioactivity. Gamma irradiation is commonly used in single use types of medical equipment, for biological tissue sterilization and for all types of microbial reduction.

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