Absorbable Suture in Vascular Surgery

The choice of suture material in surgery is often individual and a result of personal experience. Cardiovascular surgeons have always been reluctant to use absorbable suture material for direct arterial or venous anastomoses for differ ent reasons, mainly because of suspected anastomotic dilatation or even rupture during or after the absorption phase. More than ten years ago, a new class of synthetic, monofilament, flexible, biodegradable suture material was intro duced for clinical use. Since then, much experimental and clinical work has been carried out to evaluate physical and biological characteristics of this class of suture material (polydioxanone/polydimethylsiloxane = [PDS] and polytri methylene-carbonate = [PTMC]) in many different tissues, including vascular tissue. There is increasing evidence that slow-absorbable sutures will gain clini cal importance for cardiovascular and peripheral vascular surgery in the fu ture, since many experimental and clinical studies during the last forty years have proven histologic superiority over nonabsorbable materials. Descriptions of healing processes in blood vessels after surgical anastomoses lead to the con clusion that persisting f