U.S. patent number 3,896,814 [Application Number 05/302,437] was granted by the patent office on 1975-07-29 for collagen based threads.
Invention is credited to Georg Schwartz, Daniel Vivien.
United States Patent |
3,896,814 |
Vivien , et al. |
July 29, 1975 |
**Please see images for:
( Certificate of Correction ) ** |
Collagen based threads
Abstract
A new type of thread comprising collagen or catgut, remaining
supple in dry condition is described. The thread is treated with
water and with one or more products capable of maintaining moisture
on the surface of the thread and/or in the thread. The thread can
be rendered smooth in the same bath or by treatment in a further
bath with a lubricating product, such as a silicone. The treatment
products proper are fatty compounds or derivatives of fatty
compounds, such as glycerine, polyoxyalkylenes such as polyethylene
glycol, or glycol derivatives. The treated threads are useful in
surgery.
Inventors: |
Vivien; Daniel (Nanterre,
FR), Schwartz; Georg (Goussainville, FR) |
Family
ID: |
23167728 |
Appl.
No.: |
05/302,437 |
Filed: |
October 31, 1972 |
Current U.S.
Class: |
606/229; 428/378;
428/473; 977/788; 977/738 |
Current CPC
Class: |
A61L
17/08 (20130101); Y10S 977/788 (20130101); Y10S
977/738 (20130101); Y10T 428/2938 (20150115) |
Current International
Class: |
A61L
17/00 (20060101); A61L 17/08 (20060101); A61l
017/00 () |
Field of
Search: |
;128/335,335.5
;161/175,176,226 ;117/141,139.5F ;57/153 ;106/155,161 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Attorney, Agent or Firm: Burgess, Dinklage & Sprung
Claims
What we claim is:
1. A collagen based suture comprising a collagen surgical thread
containing therewithin from about 10 to 50 percent of water based
on the weight of the thread and about 10 to 70 percent by weight of
at least one hygroscopic agent for retaining the water and selected
from the group consisting of glycerols, glycols and polyalkylene
oxides, said hygroscopic agent having a low volatility and a
molecular weight of up to about 400, and a hydrophobic lubricating
agent on the surface and selected from the group consisting of
lipoids and silicones, whereby said suture retains its suppleness
in dry form.
2. A suture according to claim 1, wherein the hygroscopic agent is
present in about 0.05 percent.
3. A suture according to claim 1, wherein the hygroscopic
lubricating agent is a silicone and is present in about 0.05
percent.
4. A suture according to claim 3 wherein the hygroscopic agent is
present in about 0.05 percent.
Description
BACKGROUND OF THE INVENTION
The invention relates to the field of collagen based threads which
are mainly used in surgery. An object of the invention is a process
for the treatment of such threads in order to make them durably
supple. The invention also relates to threads obtained by the said
process and to applications thereof, notably in the field of
surgery.
The thread known as catgut, which is at present used in surgery, is
a resorbable ligature of animal origin. It is normally prepared
from mammifer collagen. In the present description, the expression
"catgut" designates a collagen based thread of any type and
origin.
PRIOR ART
In the known art, the cords of collagen are immersed in an alcohol,
sterilized and supplied to users, such as surgeons, in tubes or
packets. The alcohol is generally ethanol or isopropanol. The
function of this alcohol is to permit sterilization and
preservation of the ligature. Alcohol, with the small percentage of
water it contains, also confers a certain suppleness on the
ligature as long as it remains in contact with it. This suppleness
disappears rapidly when the alcohol and the small amount of water
evaporate, notably during use of the thread in an operating room
with a high ambient temperature. The catgut then becomes stiff,
which makes it difficult to use. Furthermore, both its diameter and
its resistance decrease and the knots no longer hold in a
satisfactory manner.
Another drawback of the prior art is that catgut, delivered with an
alcohol, must be conditioned in suitable packages which should be
both impervious to alcohol and microbes and easy to open. These
requirements are contradictory, which makes it necessary to resort
to compromise solutions in the conception of conditioning which do
not always give complete satisfaction in practice.
THE PRESENT INVENTION
The aim of the invention is to avoid the inherent drawbacks in the
prior art by doing away with the necessity of conditioning catgut
in the presence of a volatile alcohol. A first object of the
invention is therefore a collagen thread or catgut which can be
supplied and used as such in a lasting manner, after having been
subjected to a treatment to render it supple prior to
sterilization.
Another object of the invention is a collagen based thread for use
in surgery which retains its suppleness under the normal conditions
of temperature and hygroscopy obtaining during preservation and
use. The treated thread according to the invention can be
sterilized and preserved without liquid, then employed by the user
in the state in which it is sold.
Another object of the invention is to provide a process for
treating threads comprising collagen, notably the catgut used in
surgery, in order to make it durably supple prior to and during
use.
The invention therefore provides a collagen thread permanently
containing an amount of residual water at least equal to 10 percent
by weight based on the thread and at least one treatment agent
capable of maintaining the thread moisture by preventing
evaporation of the water contained therein, the said agent being
present in an amount of at least 15 percent by weight based on the
dry thread and having a molecular weight no greater than about
400.
The treatment agents capable of retaining moisture in the collagen
thread can be present on the surface of the thread and/or in the
mass of the thread. They prevent evaporation of the water contained
in the thread, generally owing to their hygroscopicity. The
association of water-treatment agent renders the therad supple. In
certain cases, the surface state of the thread can be still further
improved by the presence of a lubricating product which is well
tolerated by the human or animal organism. It is also obvious that
the treatment agents, which are organic substances, should be well
tolerated by the tissues of human or animal body.
Such treatment agents can be selected singly or in combination from
fatty compounds and the derivatives thereof, higher alcohols having
a low level of volatility at ambient temperature, fatty acids,
esters and ethers of fatty acids and polyalcohols and fatty
alcohols, fatty derivatives in the monomer or polymer form such as
glycerine, glycols and derivatives thereof, and polyoxalkylenes
such as polyoxyethylene glycol.
In combination with the above mentioned treatment agents, various
compounds such as lipoids, silicones and other similar products can
also be present in the thread.
As examples of lubricating products essentially present on the
surface of the thread may be mentioned fatty compounds and
derivatives of the fatty compounds themselves already mentioned as
treatment agents, and, essentially silicones and derivatives
thereof.
The amount of water contained in the thread is at least equal to 10
percent by weight based on the thread, and generally in the range
of 10 percent to 50 percent, for example about 27 percent by
weight. The values corresponding to variations in the diameter of
the thread, which has the form of a swollen thread. The increased
diameter of the thread based on the dry state can range from 5
percent to 50 percent, in the order of 20 percent for instance.
The amount of the treatment agent obviously varies with the nature
thereof. Generally, substantially equal amounts of water and the
treatment agent are used during treatment, but the amount of the
agent remaining in the thread and/or on the surface of the thread
can be smaller than the amount of residual water. One skilled in
the art can easily determine the optimum proportions of water and
the particular treatment agent by carrying out preliminary
trials.
The amount of lubricating agent, such as silicone, which may be
present on the surface of the thread is notably smaller than that
of the treatment agent. For example, the silicone films on the
periphery of the thread can represent about 0.05 percent by weight
of the thread.
It will be noted that the combination water-treatment agent is
indispensable to obtain the results of the invention. Indeed, a
treatment agent of a hygroscopic nature, such as glycerine, is
incapable of penetrating the collagen thread by itself.
Furthermore, water used alone swells the thread but cannot remain
therein in a lasting manner as it evaporates a short while after
being applied. According to the invention, the association of
water-treatment agent permits at the same time the penetration of
water into the thread, with swelling of the latter, and the
retention of moisture in the thread. The combination of means
proposed by the invention is therefore crucial.
The molecular weight of the treatment agent mixed with water
provides a direct influence on the swelling of the thread; the
higher the molecular weight the less the swelling, and swelling is
not permanent if the molecular weight of the treatment agent is
higher than 400.
To obtain supple thread, according to the invention, it is possible
to simply soak the thread in at least one bath consisting of a
solution of distilled water and the treatment agent. The treatment
can also be carried out in a single bath comprising distilled water
and at least one agent capable of maintaining moisture in the
thread and/or on the surface thereof. The treatment agents can be
used in solution, in emulsion or in suspension in the bath of
distilled water or in a third solvent.
The temperature at which the thread is impregnated by the treatment
bath can vary between 10.degree. and 50.degree.C, but it is
possible to diverge from this range without drawbacks arising, so
long as the bath remains liquid. For obvious practical reasons, it
is preferable to carry out impregnation of the thread at a
temperature close to ambient temperature.
The duration of treatment can vary from one second to several days
according to the nature of the treatment agent. Generally speaking,
durations of 10 minutes to 8 hours are suitable. Duration of
treatment obviously depends on factors such as temperature,
diameter of the treated thread and the degree of desired
suppleness. For a given temperature, and the diameter of the thread
being equal, the longer the treatment the greater the degree of
suppleness.
Use of a treatment bath maintained at a higher pressure than normal
atmoshperic pressure does not lie outside the scope of the
invention. Pressurized treatment can facilitate the desired
improvement in suppleness of the thread and decrease the time of
treatment.
It is suitable to maintain the pH of the treatment bath within
certain limits to obtain a thread with a substantially neutral pH
at the end of the treatment. Generally, the pH is included in the
range of 5 to 9. The subsequent sterilization operation somewhat
modifies the pH, resulting in an increase in the pH values. It is
therefore suitable to compensate for this variation by previously
introducing a weak acid, such as acetic acid or citric acid, into
the treatment bath.
In addition to agents to adjust pH, treatment baths can contain
antioxidants or reducing agents with a view to preventing the
formation of rust on the steel needles by means of which the catgut
threads are inserted. An example of such an antioxidant is sodium
nitrite NaNO.sub.2.
It a lubricating product, containing silicone for instance, is to
be used, it can be added to the same single treatment bath in the
form of an emulsion or, when the thread is treated in several
baths, in the form of a solution in an organic solvent.
When the thread, in the form of a skein or loose cell for example,
has been soaked in the treatment bath, the residual amount of the
bath is removed by conventional means, such as draining or rinsing;
the thread is then ready to be sterilized.
The conventional sterilization treatment of catgut consists in
exposing the thread to a sterilizing gas, such as ethylene oxide or
to the action of beta or gamma radiations. It is, moreover, known
that the sterilization of dry catgut with ethylene oxide is always
difficult. According to the present invention, on the other hand,
the presence of residual water in the thread enhances sterilization
in depth through the thin strips of the thread.
In the prior art, it is generally necessary to effect sterilization
in the presence of moisture. In the present invention, this
additional introduction of moisture is avoided since the thread
itself contains a suitable amount of water for sterilization.
The advantages provided by the catgut threads according to the
invention are numerous.
For the manufacture of catgut, conditioning is greatly simplified.
Indeed, as the catgut has undergone treatment prior to
sterilization it can be conditioned as it is, without its being
necessary to immerse it in alcohol. It therefore suffices if the
used packing is sealed against microorganisms. It therefore becomes
possible to use packages made of plastic, treated paper or
cardboard, in the form of a rigid container or a thin envelope.
Another advantage for the manufacturer is that threads are easily
sterilized, the sterilizing gas penetrating deeply into the
thread.
The advantages of the new thread are clearly apparent to the user.
No manipulations are necessary to remove alcohol from the tubes.
The air of the operating room is not tainted by alcohol vapours and
the risk of fire does not exist. As the catgut cannot dry as a
result of the effects of heat and light owing to the evaporation of
the alcohol incorporated to conserve it, it remains permanently
supple and pleasant to use for the surgeon. The catgut remains
supply in a sterile pack for several years. Owing to its slightly
lubricated surface, the thread is easy to use and does not cause
traumatisms to the tissues into which it is inserted.
A variant of the catgut thread used in surgery is chromium plated
catgut, which is resorbed more slowly and which is much stiffer
than normal catgut, and therefore more difficult to use. Chromium
plated catgut can also be rendered supple according to the present
invention. The duration of treatment in the bath is then 2 to 5
times longer than the duration of treatment of normal catgut.
If the swelling and diameter of chromium plated catgut and ordinary
catgut are comparable, their suppleness is substantially identical.
Chromium plated catgut (like ordinary catgut) thus becomes easy and
pleasant to use.
Comparative measurements carried out with the rigidimeter confirm
this fact:
N.degree.4 Dec-catgut thread sterilized and preserved in alcohol,
during use 8' after removal from the tube:
Rigidity in milli Newton/m.sup.2 0.013
N.degree.4 Dec. catgut thread sterilized according to the present
invention, suppled at use:
Rigidity in milli Newton/m.sup.2 0.006
N.degree.4 Dec. chromium plated catgut thread according to the
present invention, suppled, at use:
Rigidity in milli Newton/m.sup.2 0.0063
The invention will not be illustrated, while in no way limited, by
the following examples:
EXAMPLE 1
A single treatment bath having the following composition is
used:
Glycerol 50 parts by weight Distilled water 50 parts by weight
Acetic acid 0.1 part by weight NaNO.sub.2 0.1 part by weight
Silicone emulsion 2.5 parts by weight
A 45/100 th diameter catgut thread comprising collagen, formed into
a skein, is immersed in the above bath at ambient temperature for 1
1/2 hours. After rapid rinsing with ethyl alcohol, or simple
draining, the catgut is rolled or swedged on needles, then
sterilized by being exposed to ethylene oxide.
Finally, a thread containing 27 percent by weight of water is
obtained which represents a swelling, or an increase in diameter,
of 20 percent based on the dry thread. This water is associated in
the thread with 42 percent glycerol and 0.002 percent silicone.
EXAMPLE 2
The operation is carried out as in example 1, with the same
treatment bath, but catgut threads of various diameters and
variable durations of treatment are used.
The results are given in table 1.
TABLE 1 ______________________________________ Conditions of
treatment Properties of the thread
______________________________________ Amount present in the thread
in % by weight based on the dry thread Diameter:45/100 Water
Glycerol Silicone Duration of treatment: 22% 34% 0.002 60 min*
Diameter:60/100 Duration of treatment: 28% 41% 0.003 3 hours
______________________________________
As the duration of treatment in this case was only 60 min., the
thread obtained is a little less supple than the thread of example
1 which was treated for 90 min.
EXAMPLE 3
The operation is carried out with the same treatment agents as in
example 1, but several successive baths are used, that is to say
(A) a bath of distilled water containing glycerol and (B) a
silicone bath for finishing the surface state of the thread. The
respective compositions of the two baths (A) and (B) are as
follows: (A) Glycerol 50 g Distilled water 51 g Lactic acid 0.1 g
(B) Silicone oil 1 g Pure trichlorethylene 100 g
After treatment of the thread for 1 1/2 hours with bath (A) and
draining, then for 1' with bath (B) and draining, the thread is
sterilized as in example 1. A supple catgut thread is obtained
having similar properties to those of example 1, and which is
suitable for use in surgery.
EXAMPLE 4
A catgut thread is treated by soaking in a bath composed of:
Ethylene glycol 50 parts by weight Distilled water 50 parts by
weight
After draining, a durably supple thread is obtained.
In the following examples, other compositions of treatment baths
suitable to the requirements of the invention are given.
EXAMPLE 5
Diethylene glycol 70 parts by weight Distilled water 30 parts by
weight Citric acid 0.1 part by weight
EXAMPLE 6
Trimethylolpropane 50 parts by weight Distilled water 50 parts by
weight pH adjusted to 6 with HCl
EXAMPLE 7
Glycolic acid 40 parts by weight Distilled water 60 parts by weight
pH adjusted to 5.5
The catguts rendered supple and swollen by the baths defined in
examples 3(A) and 4 to 7 can then be treated in a second bath to
lubricate their surface, as defined in example 3(B). Examples of
the second bath are given hereinbelow.
EXAMPLE 8
Vaseline oil 2g Xylene 100g
EXAMPLE 9
Castor oil 2g Chloroform 100g
After application of the baths mentioned in examples 5 to 11,
cargut threads having durable suppleness are obtained.
* * * * *