THE INFLUENCE OF VARIOUS MICROENVIRONMENTAL FACTORS ON BIOMECHANICAL FEATURES OF DIFFERENT SUTURE MATERIALS USED IN HEPATO-PANCREATO-BILIARY SURGERY

The key features of any suture material, such as its tensile strength, knot security, resorbability, handling characteristics and biological behavior must be taken into account during the selection process. These biomechanical features may be variable in different microenvironmental conditions in the human body in which the sutures are placed due to the influence of numerous local biohumoral factors. We have reviewed the data on the impact of pancreatic juice and bile, various pH conditions, chemotherapy and heat on different suture materials behavior. It is suggested that in pancreatic and biliary surgery polydioxanone sutures should be used. The review has also demonstrated that absorbable suture materials were more sensitive to pH than non-absorbable sutures. In addition, polyglyconate sutures were the strongest of all absorbable synthetic sutures when exposed to heat and cytotoxic drugs. This review provides a better basis for the selection of suture materials for specific applications.