Modern self-fixing surgical suture material and its application in urology

Introduction. Self-fixating barbed sutures are now widely used across surgical specialties, including urology, where they have been shown to reduce operative time and potentially lower complication rates. Despite their growing adoption, there is a paucity of comparative data on the structural characteristics of different barbed suture designs.

Objective. To conduct an experimental comparison of the most commonly used self-fixating suture materials by evaluating their structural features, fixation properties, and tissue interaction using both a polymeric kidney model and ex vivo ovine kidney tissue.

Materials & methods. Three self-fixating sutures with different barb configurations were compared: Stratafix Spiral PDO, V Loc 180, and Alcadinone (USP 2 0). Testing was performed at Linтекs LLC and the St. Petersburg State Institute of Technology. Fixation characteristics were evaluated using an Instron tensile testing machine, and suture tracks were analysed in a polymeric kidney model and in ex vivo sheep kidney specimens.

Results. Experiments conducted on a polymeric kidney model (hardness 38 ± 2.5 Shore units) and on ex vivo ovine kidney tissue evaluated the effect of barb configuration on the performance of self-fixating sutures (Alcadinone, Stratafix Spiral PDO, V Loc 180). Microscopic examination revealed that sutures with a dual-angle cut produced coarser tissue tracks and exerted a more pronounced sawing effect, thereby increasing the risk of tissue trauma; however, these sutures also demonstrated significantly higher fixation strength compared with single-angle barbed designs. Based on these findings, medical and technical specifications for an optimal self-fixating suture for urological applications were established, and potential indications across various urological procedures were proposed.

Conclusion. This experimental study has defined the key medical and technical requirements for an ideal self-fixating suture in urology: biocompatibility and tissue inertness, optimal fixation strength with minimal tissue trauma, availability in both unidirectional and bidirectional barb configurations, in both absorbable and non-absorbable polymers, and inclusion of a terminal loop to facilitate placement of the first stitch. These findings provide a foundation for the development of Russian produced suture materials tailored to the specific needs of urological practice.

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