Application of polydioxanone material in surgical field_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Lin ¹ , LIN Junping ² , DU Hengrui ³ , ZHANG Zhenzhen ¹ , ZHANG Xiangdong ¹ ,  ZHANG Xuanfen ¹

1. Department of Plastic and Aesthetic Surgery, The Second Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
2. Department of Thoracic Surgery, The Second Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
3. The First Department of General Surgery, The Second Hospital of Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding author：

ZHANG Xuanfen, Email: zhxf9304@126.com

Keywords：

polydioxanone; surgical field; application

DOI：

10.7507/1007-9424.201904086

Video：

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Objective To summarize ways and advantages of applying polydioxanone (PDO) material in surgical field.Method The literatures related to the application of PDO materials in the surgery were reviewed and summarized.Results The current researches showed that the PDO material could be used as the stent, carrier, suture, vena cava filters, and hemostatic clips in the surgical field, and its effect was superior to the traditional material products.Conclusions Good biological properties of PDO materials make them suitable for use in surgical field. Despite it has outstanding advantages, its drawbacks cannot be ignored. PDO materials are currently limited in application and further research is needed to assess its true clinical feasibility, safety, and efficacy.

Citation： ZHAO Lin, LIN Junping, DU Hengrui, ZHANG Zhenzhen, ZHANG Xiangdong, ZHANG Xuanfen. Application of polydioxanone material in surgical field. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1265-1268. doi: 10.7507/1007-9424.201904086 Copy

1.	Middleton JC, Tipton AJ. Synthetic biodegradable polymers as orthopedic devices. Biomaterials, 2000, 21(23): 2335-2346.
2.	Jin C, Liang BQ, Li JX, et al. Biodegradation behaviors of poly (p-dioxanone) in different environment media. J Polym Environ, 2013, 21(4): 1088-1099.
3.	Zhao YQ, Ding SD, You Y, et al. Enhanced degradation stability of poly (p‐dioxanone) under different temperature and humidity with bis‐(2,6‐diisopropylphenyl) carbodiimide. J Appl Polym Sci, 2014, 131(6): 596-602.
4.	Siiki A, Rinta-Kiikka I, Sand J, et al. Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: the first report in clinical use in patients. Dig Endosc, 2017, 29(1): 118-121.
5.	Siiki A, Sand J, Laukkarinen J. A systematic review of biodegradable biliary stents: promising biocompatibility without stent removal. Eur J Gastroenterol Hepatol, 2018, 30(8): 813-818.
6.	Jones L, Moir J, Brown C, et al. The novel use of a biodegradable stent placed by percutaneous transhepatic cholangiography for the treatment of a hepaticojejunostomy biliary leak following an extended left hepatectomy and pancreaticoduodenectomy. Ann R Coll Surg Engl, 2014, 96(6): e1-e3.
7.	Mauri G, Michelozzi C, Melchiorre F, et al. Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients. Eur Radiol, 2016, 26(11): 4057-4063.
8.	Grolich T, Crha M, Novotný L, et al. Self-expandable biodegradable biliary stents in porcine model. J Surg Res, 2015, 193(2): 606-612.
9.	Siiki A, Rinta-Kiikka I, Sand J, et al. A pilot study of endoscopically inserted biodegradable biliary stents in the treatment of benign biliary strictures and cystic duct leaks. Gastrointest Endosc, 2018, 87(4): 1132-1137.
10.	Lorenzo-Zúñiga V, Moreno-de-Vega V, Marín I, et al. Biodegradable stents in gastrointestinal endoscopy. World J Gastroenterol, 2014, 20(9): 2212-2217.
11.	ASGE Technology Committee, Tokar JL, Banerjee S, et al. Drug-eluting/biodegradable stents. Gastrointest Endosc, 2011, 74(5): 954-958.
12.	Lassalle V, Ferreira ML. PLA nano- and microparticles for drug delivery: an overview of the methods of preparation. Macromol Biosci, 2007, 7(6): 767-783.
13.	Goonoo N, Jeetah R, Bhaw-Luximon A, et al. Polydioxanone-based bio-materials for tissue engineering and drug/gene delivery applications. Eur J Pharm Biopharm, 2015, 97(Pt B): 371-391.
14.	Yoshida T, Lai TC, Kwon GS, et al. pH- and ion-sensitive polymers for drug delivery. Expert Opin Drug Deliv, 2013, 10(11): 1497-1513.
15.	Sano M, Unno N, Yamamoto N, et al. Frequent fracture of TrapEase inferior vena cava filters: a long-term follow-up assessment. Arch Intern Med, 2012, 172(2): 189-191.
16.	Zhou D, Spain J, Moon E, et al. Retrospective review of 120 celect inferior vena cava filter retrievals: experience at a single institution. J Vasc Interv Radiol, 2012, 23(12): 1557-1563.
17.	US Department of Health and Human Services, US Food and Drug Administration. Removing retrievable inferior vena cava filters: FDA safety communication. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm396377.htm. Accessed Nov 12014.
18.	Morales JP, Li X, Irony TZ, et al. Decision analysis of retrievable inferior vena cava filters in patients without pulmonary embolism. J Vasc Surg Venous Lymphat Disord, 2013, 1(4): 376-384.
19.	Eggers MD, McArthur MJ, Figueira TA, et al. Pilot in vivo study of an absorbable polydioxanone vena cava filter. J Vasc Surg Venous Lymphat Disord, 2015, 3(4): 409-420.
20.	Eggers MD, Reitman CA. In vitro analysis of polymer candidates for the development of absorbable vascular filters. J Vasc Interv Radiol, 2012, 23(8): 1023-1030.
21.	Ko HJ, Choi JY, Moon HJ, et al. Multi-polydioxanone (PDO) scaffold for forehead wrinkle correction: A pilot study. J Cosmet Laser Ther, 2016, 18(7): 405-408.
22.	Kim H, Bae IH, Ko HJ, et al. Novel polydioxanone multifilament scaffold device for tissue regeneration. Dermatol Surg, 2016, 42(1): 63-67.
23.	Zhang GQ, Ren TH, Zeng XQ, et al. Influence of surgical suture properties on the tribological interactions with artificial skin by a capstan experiment approach. Friction, 2017, 5(1): 87-98.
24.	Zhang G, Ren T, Zhang S, et al. Study on the tribological behavior of surgical suture interacting with a skin substitute by using a penetration friction apparatus. Colloids Surf B Biointerfaces, 2018, 162: 228-235.
25.	沈军国, 常秀芬, 吴金芳, 等. 埋线法矫正中下面部皮肤松弛下垂. 中国美容医学, 2018, 27(1): 8-10.
26.	夏阳. PPDO锯齿线结合PPDO螺旋线皮下埋置提升面部皮肤的临床体会. 中国医疗美容, 2017, 7(9): 14-16.
27.	徐亚红, 姜南, 于晓强. PPDO锯齿线结合PPDO螺旋线皮下埋置提升紧致的临床体会. 中国医疗美容, 2017, 7(6): 17-19.
28.	曹道明, 林博杰, 邹方, 等. 改良双向套管针U形埋线悬吊术在面部提升中的应用. 中国美容医学, 2017, 26(8): 42-45.
29.	Kang SH, Byun EJ, Kim HS. Vertical lifting: A new optimal thread lifting technique for Asians. Dermatol Surg, 2017, 43(10): 1263-1270.
30.	徐亚红, 姜南, 于晓强. 玻尿酸注射+PPDO埋线支撑法隆鼻术65例临床观察. 中国医疗美容, 2017, 7(8): 3-6.
31.	李曾显, 姜绍秋, 杨东运. 注射填充+PPDO埋线支撑法鼻整形术32例临床观察. 中国医疗美容, 2016, 6(8): 2-4.
32.	Lee H, Yoon K, Lee M. Outcome of facial rejuvenation with polydioxanone thread for Asians. J Cosmet Laser Ther, 2018, 20(3): 189-192.
33.	Suh DH, Jang HW, Lee SJ, et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatol Surg, 2015, 41(6): 720-725.
34.	Karimi K, Reivitis A. Lifting the lower face with an absorbable polydioxanone (PDO) thread. J Drugs Dermatol, 2017, 16(9): 932-934.
35.	Savoia A, Accardo C, Vannini F, et al. Outcomes in thread lift for facial rejuvenation: a study performed with happy lift^TM revitalizing. Dermatol Ther (Heidelb), 2014, 4(1): 103-114.
36.	Brown JH, Lustrin ES, Lev MH, et al. Reduction of aneurysm clip artifacts on CT angiograms: a technical note. AJNR Am J Neuroradiol, 1999, 20(4): 694-696.
37.	Weishaupt D, Quick HH, Nanz D, et al. Ligating clips for three-dimensional MR angiography at 1.5 T: in vitro evaluation. Radiology, 2000, 214(3): 902-907.
38.	Hsu TC. Comparison of holding power of metal and absorbable hemostatic clips. Am J Surg, 2006, 191(1): 68-71.

1. Middleton JC, Tipton AJ. Synthetic biodegradable polymers as orthopedic devices. Biomaterials, 2000, 21(23): 2335-2346.
2. Jin C, Liang BQ, Li JX, et al. Biodegradation behaviors of poly (p-dioxanone) in different environment media. J Polym Environ, 2013, 21(4): 1088-1099.
3. Zhao YQ, Ding SD, You Y, et al. Enhanced degradation stability of poly (p‐dioxanone) under different temperature and humidity with bis‐(2,6‐diisopropylphenyl) carbodiimide. J Appl Polym Sci, 2014, 131(6): 596-602.
4. Siiki A, Rinta-Kiikka I, Sand J, et al. Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: the first report in clinical use in patients. Dig Endosc, 2017, 29(1): 118-121.
5. Siiki A, Sand J, Laukkarinen J. A systematic review of biodegradable biliary stents: promising biocompatibility without stent removal. Eur J Gastroenterol Hepatol, 2018, 30(8): 813-818.
6. Jones L, Moir J, Brown C, et al. The novel use of a biodegradable stent placed by percutaneous transhepatic cholangiography for the treatment of a hepaticojejunostomy biliary leak following an extended left hepatectomy and pancreaticoduodenectomy. Ann R Coll Surg Engl, 2014, 96(6): e1-e3.
7. Mauri G, Michelozzi C, Melchiorre F, et al. Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients. Eur Radiol, 2016, 26(11): 4057-4063.
8. Grolich T, Crha M, Novotný L, et al. Self-expandable biodegradable biliary stents in porcine model. J Surg Res, 2015, 193(2): 606-612.
9. Siiki A, Rinta-Kiikka I, Sand J, et al. A pilot study of endoscopically inserted biodegradable biliary stents in the treatment of benign biliary strictures and cystic duct leaks. Gastrointest Endosc, 2018, 87(4): 1132-1137.
10. Lorenzo-Zúñiga V, Moreno-de-Vega V, Marín I, et al. Biodegradable stents in gastrointestinal endoscopy. World J Gastroenterol, 2014, 20(9): 2212-2217.
11. ASGE Technology Committee, Tokar JL, Banerjee S, et al. Drug-eluting/biodegradable stents. Gastrointest Endosc, 2011, 74(5): 954-958.
12. Lassalle V, Ferreira ML. PLA nano- and microparticles for drug delivery: an overview of the methods of preparation. Macromol Biosci, 2007, 7(6): 767-783.
13. Goonoo N, Jeetah R, Bhaw-Luximon A, et al. Polydioxanone-based bio-materials for tissue engineering and drug/gene delivery applications. Eur J Pharm Biopharm, 2015, 97(Pt B): 371-391.
14. Yoshida T, Lai TC, Kwon GS, et al. pH- and ion-sensitive polymers for drug delivery. Expert Opin Drug Deliv, 2013, 10(11): 1497-1513.
15. Sano M, Unno N, Yamamoto N, et al. Frequent fracture of TrapEase inferior vena cava filters: a long-term follow-up assessment. Arch Intern Med, 2012, 172(2): 189-191.
16. Zhou D, Spain J, Moon E, et al. Retrospective review of 120 celect inferior vena cava filter retrievals: experience at a single institution. J Vasc Interv Radiol, 2012, 23(12): 1557-1563.
17. US Department of Health and Human Services, US Food and Drug Administration. Removing retrievable inferior vena cava filters: FDA safety communication. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm396377.htm. Accessed Nov 12014.
18. Morales JP, Li X, Irony TZ, et al. Decision analysis of retrievable inferior vena cava filters in patients without pulmonary embolism. J Vasc Surg Venous Lymphat Disord, 2013, 1(4): 376-384.
19. Eggers MD, McArthur MJ, Figueira TA, et al. Pilot in vivo study of an absorbable polydioxanone vena cava filter. J Vasc Surg Venous Lymphat Disord, 2015, 3(4): 409-420.
20. Eggers MD, Reitman CA. In vitro analysis of polymer candidates for the development of absorbable vascular filters. J Vasc Interv Radiol, 2012, 23(8): 1023-1030.
21. Ko HJ, Choi JY, Moon HJ, et al. Multi-polydioxanone (PDO) scaffold for forehead wrinkle correction: A pilot study. J Cosmet Laser Ther, 2016, 18(7): 405-408.
22. Kim H, Bae IH, Ko HJ, et al. Novel polydioxanone multifilament scaffold device for tissue regeneration. Dermatol Surg, 2016, 42(1): 63-67.
23. Zhang GQ, Ren TH, Zeng XQ, et al. Influence of surgical suture properties on the tribological interactions with artificial skin by a capstan experiment approach. Friction, 2017, 5(1): 87-98.
24. Zhang G, Ren T, Zhang S, et al. Study on the tribological behavior of surgical suture interacting with a skin substitute by using a penetration friction apparatus. Colloids Surf B Biointerfaces, 2018, 162: 228-235.
25. 沈军国, 常秀芬, 吴金芳, 等. 埋线法矫正中下面部皮肤松弛下垂. 中国美容医学, 2018, 27(1): 8-10.
26. 夏阳. PPDO锯齿线结合PPDO螺旋线皮下埋置提升面部皮肤的临床体会. 中国医疗美容, 2017, 7(9): 14-16.
27. 徐亚红, 姜南, 于晓强. PPDO锯齿线结合PPDO螺旋线皮下埋置提升紧致的临床体会. 中国医疗美容, 2017, 7(6): 17-19.
28. 曹道明, 林博杰, 邹方, 等. 改良双向套管针U形埋线悬吊术在面部提升中的应用. 中国美容医学, 2017, 26(8): 42-45.
29. Kang SH, Byun EJ, Kim HS. Vertical lifting: A new optimal thread lifting technique for Asians. Dermatol Surg, 2017, 43(10): 1263-1270.
30. 徐亚红, 姜南, 于晓强. 玻尿酸注射+PPDO埋线支撑法隆鼻术65例临床观察. 中国医疗美容, 2017, 7(8): 3-6.
31. 李曾显, 姜绍秋, 杨东运. 注射填充+PPDO埋线支撑法鼻整形术32例临床观察. 中国医疗美容, 2016, 6(8): 2-4.
32. Lee H, Yoon K, Lee M. Outcome of facial rejuvenation with polydioxanone thread for Asians. J Cosmet Laser Ther, 2018, 20(3): 189-192.
33. Suh DH, Jang HW, Lee SJ, et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatol Surg, 2015, 41(6): 720-725.
34. Karimi K, Reivitis A. Lifting the lower face with an absorbable polydioxanone (PDO) thread. J Drugs Dermatol, 2017, 16(9): 932-934.
35. Savoia A, Accardo C, Vannini F, et al. Outcomes in thread lift for facial rejuvenation: a study performed with happy lift^TM revitalizing. Dermatol Ther (Heidelb), 2014, 4(1): 103-114.
36. Brown JH, Lustrin ES, Lev MH, et al. Reduction of aneurysm clip artifacts on CT angiograms: a technical note. AJNR Am J Neuroradiol, 1999, 20(4): 694-696.
37. Weishaupt D, Quick HH, Nanz D, et al. Ligating clips for three-dimensional MR angiography at 1.5 T: in vitro evaluation. Radiology, 2000, 214(3): 902-907.
38. Hsu TC. Comparison of holding power of metal and absorbable hemostatic clips. Am J Surg, 2006, 191(1): 68-71.

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Application of polydioxanone material in surgical field

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