Synthetic sutures: clinical evaluation and future developments
Today's sutures are the result of a 4000-year innovation process with regard to their materials and manufacturing techniques, yet little has been done to enhance the therapeutic value of the suture itself. In this review, we explore the historical development, regulatory database and clinical l...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
SAGE Publications
2017
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| _version_ | 1826268300295798784 |
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| author | Abhari, R Martins, J Morris, H Mouthuy, P Carr, A |
| author_facet | Abhari, R Martins, J Morris, H Mouthuy, P Carr, A |
| author_sort | Abhari, R |
| collection | OXFORD |
| description | Today's sutures are the result of a 4000-year innovation process with regard to their materials and manufacturing techniques, yet little has been done to enhance the therapeutic value of the suture itself. In this review, we explore the historical development, regulatory database and clinical literature of sutures to gain a fuller picture of suture advances to date. First, we examine historical shifts in suture manufacturing companies and review suture regulatory databases to understand the forces driving suture development. Second, we gather the existing clinical evidence of suture efficacy from reviewing the clinical literature and the Food and Drug Administration database in order to identify to what extent sutures have been clinically evaluated and the key clinical areas that would benefit from improved suture materials. Finally, we apply tissue engineering and regenerative medicine design hypotheses to suture materials to identify routes by which bioactive sutures can be designed and passed through regulatory hurdles, to improve surgical outcomes. Our review of the clinical literature revealed that many of the sutures currently in use have been available for decades, yet have never been clinically evaluated. Since suture design and development is industry driven, incremental modifications have allowed for a steady outflow of products while maintaining a safe regulatory position and limiting costs. Until recently, there has been little academic interest in suture development, however the rise of regenerative medicine strategies is shifting the suture paradigm from an inert material, which mechanically approximates tissue, to a bioactive material, which also actively promotes cell-directed repair and a positive healing response. These materials hold significant therapeutic potential, but could be associated with an increased regulatory burden, cost, and clinical evaluation compared with current devices. |
| first_indexed | 2024-03-06T21:07:34Z |
| format | Journal article |
| id | oxford-uuid:3cff505a-29db-4c8f-a4fd-5a91fc792c4e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:07:34Z |
| publishDate | 2017 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:3cff505a-29db-4c8f-a4fd-5a91fc792c4e2022-03-26T14:16:55ZSynthetic sutures: clinical evaluation and future developmentsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3cff505a-29db-4c8f-a4fd-5a91fc792c4eEnglishSymplectic Elements at OxfordSAGE Publications2017Abhari, RMartins, JMorris, HMouthuy, PCarr, AToday's sutures are the result of a 4000-year innovation process with regard to their materials and manufacturing techniques, yet little has been done to enhance the therapeutic value of the suture itself. In this review, we explore the historical development, regulatory database and clinical literature of sutures to gain a fuller picture of suture advances to date. First, we examine historical shifts in suture manufacturing companies and review suture regulatory databases to understand the forces driving suture development. Second, we gather the existing clinical evidence of suture efficacy from reviewing the clinical literature and the Food and Drug Administration database in order to identify to what extent sutures have been clinically evaluated and the key clinical areas that would benefit from improved suture materials. Finally, we apply tissue engineering and regenerative medicine design hypotheses to suture materials to identify routes by which bioactive sutures can be designed and passed through regulatory hurdles, to improve surgical outcomes. Our review of the clinical literature revealed that many of the sutures currently in use have been available for decades, yet have never been clinically evaluated. Since suture design and development is industry driven, incremental modifications have allowed for a steady outflow of products while maintaining a safe regulatory position and limiting costs. Until recently, there has been little academic interest in suture development, however the rise of regenerative medicine strategies is shifting the suture paradigm from an inert material, which mechanically approximates tissue, to a bioactive material, which also actively promotes cell-directed repair and a positive healing response. These materials hold significant therapeutic potential, but could be associated with an increased regulatory burden, cost, and clinical evaluation compared with current devices. |
| spellingShingle | Abhari, R Martins, J Morris, H Mouthuy, P Carr, A Synthetic sutures: clinical evaluation and future developments |
| title | Synthetic sutures: clinical evaluation and future developments |
| title_full | Synthetic sutures: clinical evaluation and future developments |
| title_fullStr | Synthetic sutures: clinical evaluation and future developments |
| title_full_unstemmed | Synthetic sutures: clinical evaluation and future developments |
| title_short | Synthetic sutures: clinical evaluation and future developments |
| title_sort | synthetic sutures clinical evaluation and future developments |
| work_keys_str_mv | AT abharir syntheticsuturesclinicalevaluationandfuturedevelopments AT martinsj syntheticsuturesclinicalevaluationandfuturedevelopments AT morrish syntheticsuturesclinicalevaluationandfuturedevelopments AT mouthuyp syntheticsuturesclinicalevaluationandfuturedevelopments AT carra syntheticsuturesclinicalevaluationandfuturedevelopments |