PGA is replacing Catgut Worldwide, we see a general tendency towards moving away from using biological sutures, especially catgut. The reason for this is partly the difficulties in getting serosa of BSE-free proven countries, but more important is the fact that catgut tends to create more substantial tissue reactions than synthetic sutures with more or less identical characteristics when it comes to knot stability and absorption time. In human medicine, catgut has been banned for many years, partly because of the BSE, but mainly because of the more pronounced incidences of inflammation and more severe tissue reactions when using the biological suture of serosa origin. The European Commission, Food and Health Committee conclude and recommend: 1. The Committee considers that there are sufficient alternative products to catgut sutures, i.e. synthetic absorbable sutures made from polymers such as polyglycolic acid, that provide equal, or even better, clinical performance than the catgut. Apart from considerations of TSE, there is no difference between these two types of sutures with respect to matters of safety. 2. On the basis of the considerations in the above clause, generally there are no clinical indications for the preferred use of catgut. Moreover, scientifically there is no further need for catgut sutures. The Committee recognises that there has been a diminishing use of catgut sutures during the last decade and that this decrease is likely to continue. The European Commission, Food and Health Committee quite clearly recommend not to use catgut in surgery at all! Use QR code to read more at The European Commission, Food and Health Committee website http://ec.europa.eu/health/scientific_committees/emerging/opinions/scmpmd/scmp_out05_en.htm Catgut Catgut is manufactured from longitudinally slitting the submucosa of bovine intestine, twisting the ribbons and joining them in wet condition. As the intestines have a certain length, they are subsequently bounded together causing a less uniform appearance of the suture (knots along the suture). Catgut being an absorbable suture is preserved in alcohol to prevent absorption. Both the gut itself and the alcohol cause severe tissue reactions, when used in vivo. PGA PGA is a synthetic and manufactured suture. For this reason, it is easier to produce a completely uniform suture, which is superior to catgut. PGA is a braided suture, appearing soft and flexible when handling it. The suture is coated to achieve easy-knot tying and smooth passage through tissue. PGA gives much less tissue reaction and inflammation in comparison to catgut. Catgut n Excellent knot stability n Less suture consistency n Severe tissue reaction n Tendency to snap/break PGA n Good knot stability n Completely uniform suture appearance n Minimal tissue reaction n Strong and reliable suture kruuse.com
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