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Absorbable suture materials are defined as materials that lose their tensile strength within 60 days of implantation (Tan et al. 2003). These sutures are either composed of different synthetic polymers or are of biologic origin. Absorbable sutures that are biologic in origin are broken down by phagocytosis, while synthetic polymers are absorbed by hydrolysis. Hydrolysis involves breaking down polymers into monomers by direct water cleavage, and the monomers are then absorbed and metabolized by the body (Tan et al. 2003). Common absorbable sutures include chromic gut, polydioxanone (PDS™, Ethicon Inc., Cincinnati, OH), poliglecaprone 25 (Monocryl™, Ethicon Inc., Cincinnati, OH), polyglactin 910 (Vicryl™, Ethicon Inc., Cincinnati, OH), polyglyconate (Maxon™, Covidien, Medtronics, Minneapolis, MN), synthetic polyester called Glycomer™ 631 (Covidien, Medtronics, Minneapolis, MN) comprised of glycolide (60%), dioxanone (14%), and trimethyelene carbonate (14%) (Biosyn™, Covidien, Medtronics, Minneapolis, MN), polyglycolic acid (Dexon™, Covidien, Medtronics, Minneapolis, MN), polyglytone 6211 (Caprosyn™, Covidien, Medtronics, Minneapolis, MN), and synthetic polyester called Lactomer™ comprised of a copolymer of glycolide and lactide (Polysorb™, Covidien, Medtronics, Minneapolis, MN).

Figure 2.1 Inflammatory reactions after implantation of different suture materials to demonstrate variation in inflammatory reactions. Samples were chosen as representative examples of zero (a), mild (b), moderate (c), and severe (d) inflammatory responses. Suture material was lost in (a) and (b) during processing, but surrounding inflammatory reaction is intact.

Images are 20× magnification.

Various companies manufacture generic versions of most of these suture materials. In one study comparing the same material made by two different companies (Ethicon, Inc., and Hyaiyin Medical Instruments Co. Ltd.), the materials had significantly different tensile strength and stiffness (De La Puerta et al. 2011). In some comparisons, the generic outperformed the brand name materials. Most studies of suture materials are conducted using brand name materials. Based on this study, direct comparisons between brand names and generic materials cannot be made.