wound closure products - medtronic.com · in general soft tissue approximation and/ or ligation,...

WOUND CLOSURE PRODUCTS

Desktop Reference Guide

PRODUCTS

Absorbable SuturesBraided Synthetic Absorbable Sutures

8 Polysorb™ Suture 10 Velosorb™ Fast Suture

Monofilament Synthetic Absorbable Sutures

12 Caprosyn™ Suture 14 Biosyn™ Suture 16 Maxon™ Suture

Non-Absorbable Sutures

20 Surgipro™/Surgipro™ II Suture

22 Ti-Cron™ Suture 24 Vascufil™ Suture 26 Steel Suture 28 Flexon™ Suture 30 Novafil™ Suture 32 Monosof™/Dermalon™ Suture 34 Surgidac™ Suture 36 Surgilon™ Suture 38 Sofsilk™ Suture

V-Loc™ Suturing Devices

44 V-Loc™ 90 Device 46 V-Loc™ 180 Device 50 V-Loc™ PBT Device

PROCEDURES

CV Procedures

54 Coronary Artery Bypass Graft 58 Valve Replacement

PV Procedures

62 Abdominal Aortic Aneurism (AAA) Procedure 64 Femoral-Popliteal Bypass

OB/GYN

68 Episiorrhaphy 69 C-Section

Plastics

70 Breast Reconstruction 71 Abdominoplasty 72 Sleeve Gastrectomy 73 Laparoscopic Hysterectomy

Ortho

74 Total Knee 75 Total Hip 76 Common V-Loc™ Device Usage

NEEDLES

82 Needle Charts

FREQUENTLY ASKED QUESTIONS

96 FAQ/Objection Handling

KEY PRODUCTS

ABSORBABLE SUTURES

8 9

Polysorb™ Fast Suture Polysorb™ Fast Suture

Frequent Uses

∙ Soft tissue approximation

∙ Ligation

∙ Ophthalmic

Polysorb™ Suture Top Codes

Polysorb™ suture has been your trusted brand for more than 20 years — with a history of improvements and performance.

Features and Benefits

∙ Stronger than Vicryl™* during the critical wound healing period

GL69MG Polysorb™ suture 3-0 18” UD V-20 DT

CL13MG Polysorb™ suture 2-0 18” UD GS-21DT

CL14MG Polysorb™ suture 0 18” UNDYED GS-21 DT

SL5627 Polysorb™ suture 4-0 18” UNDYED P-12

GLS322 Polysorb™ suture 3-0 30” UNDYED V-20

Average Knot Pull Strength (size 1 to 3-0)27

Out of Package Polysorb™ suture is from 27 to 58% stronger than Vicryl™*

After 1 week of implantation

Polysorb™ suture is 15 to 35% stronger than Vicryl™*

After 2 week of implantation

Polysorb™ suture is comparable to 32% stronger than Vicryl™*

∙ Polysorb™ is triclosan free.

Product Polysorb™ Suture28 Vicryl™*/Vicryl™* PLUS29

Structure Braided Braided

Suture Type Mid-Term Absorbable Mid-Term Absorbable

Composition 93% Polyglicolic acid and 7% Polylactic acid

90% Polyglicolic acid 10% Polylactic acid

Coating Glycolide, Caprolactone

and Calcium Stearoyl

Lactylate

Vicryl™*: Caprolactone; Vicryl™* PLUS: Caprolactone and Triclosan

Color Violet, Undyed Violet, Undyed

Tensile Strength 80%: 2 weeks; 30% 3 weeks. % of USP

75%: 2 weeks; 50%: 3 weeks; 25%: 4 weeks

% of initial strength

Absorption Profile 56-70 days 56-70 days

Sizes 8-0 to 2 8-0 to 3

Indications Polysorb™ sutures are indicated for use in soft tissue approximation or ligation and ophthalmic surgery, but not in cardiovascular or neural tissue.

Coated Vicryl™* suture is indicated for use in general soft tissue approximation and/or ligation, including use in ophthalmic procedures, but not for use in cardiovascular and neurological tissues.

Contraindications Polysorb™ sutures, being absorbable, should not be used where extended approximation of tissue is required.

This suture, being absorbable, should not be used where extended approximation of tissue is required.

Coated Vicryl™* Plus antibacterial suture should not be used in patients with known allergic reactions to Igracare™* MP (triclosan)

Box Quantities 1, 2 or 3 dozen 1, 2 or 3 dozen

Note: N=30 per material, size (USP) and data point.

8

10 11

Velosorb™ Fast Suture

Velosorb™ Fast braided absorbable suture for use in soft tissue approximation of the skin and mucosa, when only 7 to10 days of wound support is required.

CV917 Velosorb™ suture 2-0 UD 36” KV-34

SV425 Velosorb™ suture 3-0 UD 30” P-12


SV2298 Velosorb™ suture 3-0 UD 30” C-13



∙ Pliable handling and easy knot tying during closure2

∙ Strong when 7 to 10 days of wound support is needed

∙ A fast absorption profile with no need for suture removal

∙ Original strength essentially gone by day 14

∙ A variety of needles to meet surgeons’ needs

∙ Convenient because patients won’t have to get sutures removed

∙ Ease of use ensured

∙ Strength throughout critical wound healing period

∙ Material is not present long term

Frequent Uses


∙ OB/GYN

∙ Dental/oral

Velosorb™ Fast SutureTop Codes

Product Velosorb™ Fast Suture30 Vicryl™* Rapide31


Suture Type Short-Term Absorbable Absorbable

Composition 90% Glycolide and 10% Lactide (derived from glycolic and lactic acids)

90% Polyglicolic acid and 10% Polylactic acid

Coating Glycolide, Lactide

Copolymer and Calcium

Stearate

Caprolactone

Color Violet, Undyed Violet, Undyed

Tensile Strength 45%: 5 days; All of the

original tensile strength is

gone by 14 days.

50%: 5 days; 0%: 14 days

Absorption Profile 40-50 days 42 days

Sizes 6-0 to 1 8-0 to 1

Indications Velosorb™ suture is indicated for use in soft tissue approximation of the skin and mucosa, where only 7 to 10 days of wound support is required. Not for use in ligation, ophthalmic, cardiovascular or neurological procedures.

Vicryl™* Rapide is intended for use in soft tissue approximation where only short-term wound support is required and where the rapid absorption of the suture would be beneficial. Due to its absorption profile, Vicryl™* Rapide is useful for skin closure, particularly in pediatric surgery, episiotomies, circumcision and closure of oral mucosa. Vicryl™* Rapide is also successfully used in ophthalmic surgery for conjunctiva sutures.

Contraindications Velosorb™ sutures, being absorbable, should not be used where extended approximation of tissue beyond 7 days is required.

Due to the rapid loss of tensile strength, Vicryl™* Rapide should not be used where extended approximation of tissue under stress is required or where wound support or ligation beyond 7 days is required. Vicryl™* Rapide is not for use in cardiovascular and neurological tissues.

Box Quantities 1 or 3 dozen —

Velosorb™ Fast Suture

10

12 13

Caprosyn™ SutureCaprosyn™ Suture

SC5617G Caprosyn™ suture UD 4-0 18” P-12




GC122 Caprosyn™ suture UD 3-0 30” V-20

Caprosyn™ suture has been your trusted brand for more than 10 years — with a proven history of performance.


∙ Short-term tensile strength is accompanied by rapid absorption.

Frequent Uses


∙ Ligation

∙ Most plastic, gynecology and urology procedures

Caprosyn™ Suture Top Codes

Product Caprosyn™ Suture32

Structure Monofilament

Suture Type Short-Term Absorbable

Composition POLYGLYTONE™ 6211 Glycolide, Caprolactone, Trimethylene Carbonate, and Lactide

Coating Uncoated

Color Violet, Undyed

Tensile Strength 5 days: 50%-60% USP; 10 days: 20%-30% USP;

21 days: All strength lost

Absorption Profile 56 days

Sizes 6-0 to 1

Indications Caprosyn™ synthetic absorbable suture is indicated for use in general soft tissue approximation and/or ligation, but not for use in cardiovascular or neurological surgery, microsurgery, or ophthalmic surgery.

Contraindications This suture, being absorbable, should not be used where extended approximation of tissue is required.

Box Quantities 1, 2 or 3 dozen

14 15

Biosyn™ SutureBiosyn™ Suture

Biosyn™ suture has been your trusted brand for more than 15 years — with a proven history of performance.


∙ Provides mid-term tensile strength with the benefit of 1 additional week of wound support

∙ Ideal for most plastic surgery procedures when 3 weeks of tensile strength and good cosmesis are desirable

Frequent Uses


∙ Ligation

∙ Plastic

∙ GI anastomosis

∙ General closure

∙ Gynecology

Biosyn™ Suture Top Codes

SM5627 Biosyn™ UD 4-0 18” P-12

SM5637 Biosyn™ UD 4-0 30” P-12

SM5638 Biosyn™ UD 3-0 30” P-12

SM5628 Biosyn™ UD 3-0 18” P-12

SM5687 Biosyn™ UD 5-0 18” P-13

Product Biosyn™ Suture33 Monocryl™* and Monocryl™* Plus34

Structure Monofilament Monofilament

Suture Type Mid-Term Absorbable Synthetic Absorbable

Composition Synthetic polyester composed of Glycolide, Trimethylene Carbonate and Dioxanone

Poliglecaprone

Coating Uncoated Uncoated

Color Violet, Undyed —

Tensile Strength 2 weeks: 75% USP;

3 weeks: 40% USP

1 week: 50%-60% USP;

2 weeks: 20%-30% USP

Absorption Profile 90-110 days 91-119 days

Sizes 6-0 to 1 6-0 to 1

Indications Biosyn™ synthetic absorbable suture is indicated for use in general soft tissue approximation and/ or ligation including use in ophthalmic surgery, but not for use in cardiovascular or neurological surgery.

Monocryl™* and Monocryl™* Plus suture is indicated for use in general soft tissue approximation and/or ligation, but not for use in cardiovalcular or neurological tissues, microsurgery or ophthalmic surgery.

Contraindications This suture, being absorbable, should not be used where extended approximation of tissue is required.

This suture, being absorbable, should not be used where extended approximation of tissue under stress is required. Monocryl™* Plus antibacterial suture should not be used in patients with known allergic reactions to Igracare™*

MP (triclosan).

Box Quantities 1, 2 or 3 dozen 1 or 3 dozen

16 17

Maxon™ SutureMaxon™ Suture

Maxon™ suture has been your trusted brand for more than 25 years — with a history of improvements and performance.

Features and Benefits35

∙ Offers superior tensile strength out of package and throughout the critical stages of healing, when strength is most important

∙ Ideal for fascial closure when 6 weeks of tensile strength is desirable

Frequent Uses


∙ Ligation

∙ Fascial closure

∙ GI anastomosis

∙ General closure

∙ Plastic

∙ Orthopedics

∙ General surgery

Maxon™ Suture Top Codes

8886664141 Maxon™ suture GRN 3-0 1X30” CE-6/C-14

8886623341 Maxon™ suture GRN 3-0 1X30” T-5/V-20

GMM344L Maxon™ suture GRN 240CM 1X12” LP GS26

8886664151 Maxon™ suture GRN 2-0 1X30” CE-6/C-14

8886623351 Maxon™ suture GREEN 2-0 1X30” T-5/V-20

Product Maxon™ Suture 36 PDS™* and PDS™* II Plus37


Suture Type Long-Term Absorbable Synthetic Absorbable

Composition PolyglyconateCopolymer of GlycolicAcid and TrimethyleneCarbonate

Polydioxanone


Color Green, Clear Violet, Clear

Tensile Strength 2 weeks: 70%USP; 4 weeks: 50%USP; 6 weeks: 25%USP

2 weeks: 70% USP; 4 weeks: 50% USP; 6 weeks: 25% USP

Absorption Profile 180 days 180 days

Sizes 7-0 to 1 9-0 to 2

Indications Maxon™ and Maxon™ CV suture is indicated for use as absorbable suture in general soft tissue approximation and/or ligation, including use in pediatric cardiovascular tissue, where growth is expected to occur, and in peripheral vascular tissue. Maxon™ and Maxon™ CV suture is not indicated for use in adult cardiovascular tissue, ophthalmic surgery, microsurgery and neural tissue.

PDS™* and PDS™* II Plus suture is indicated for soft tissue approximation, including use in pediatric cardiovascular tissue where growth is expected to occur and ophthalmic surgery. PDS™* II Plus is not indicated in adult cardiovascular tissue, microsurgery and neural tissue. This suture is particularly useful where the combination of an absorbable sutureand extended wound support (up to 6 weeks) is desirable.

Contraindications The use of this suture is contraindicated in patients with known sensitivities or allergies to its components. This suture, being absorbable, should not be used where extended approximation of tissue is required or for fixation of permanent cardiovascular prostheses or synthetic grafts.

PDS™* II suture, being absorbable, is not to be used where prolonged (beyond 6 weeks) approximation of tissue under stress is required and is not to be used in conjunction with prosthetic devices (i.e., heart valves or synthetic grafts).

PDS™* Plus advanced antibacterial suture should not be used in patients with known allergic reactions to Igracare™* MP (triclosan).

Box Quantities 1, 2 or 3 dozen 1,2 or 3 dozen

16

NON- ABSORBABLE SUTURES

20 21

Surgipro™ Suture Surgipro™ II Suture

Surgipro™ Suture Surgipro™ II Suture

Surgipro™/ Surgipro™ II suture is a brand you have trusted for many years with several product innovations.

Timeline

∙ 1991 Surgipro™ suture launched

∙ 1994 Surgalloy™ premium needle alloy introduced

∙ 1996 Lubricant added to help minimize suture breakage

∙ 2001 1. Surgipro™ II suture launched with improved handling characteristics

2. NuCoat™ coating added to improve needle with multipass penetration

∙ 2007 1. Surgipro™ II suture resin enhanced to improve knot run down characteristics

2. NuPack™ designed to reduce memory in suture

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular

∙ Neural tissue

ProductSurgipro™ Suture 2

Surgipro™ II Suture2 Prolene™* Suture3


Suture Type Non-Absorbable Non-Absorbable

Composition Polypropylene Polypropylene


Color Blue, Clear Blue, Clear

Tensile Strength Permanent Permanent

Absorption Profile Permanent Permanent

Sizes Sizes 10-0, 6-0, 2-0 through 2 (Surgipro™ suture) and sizes 8-0 to 3-0 (Surgipro™ II suture)

10-0 through 2

Indications Surgipro™ and Surgipro™ II polypropylene suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neural tissue.

Prolene™ polypropylene suture

is indicated for use in general

soft tissue approximating and/or ligation, including use in cardiovascular, ophthalmic and neurological procedures.

Contraindications None known None known


Surgipro™ II Suture Top Codes

VP709X Surgipro™ II suture 6-0 30” BL CV-1D/A

VP557X Surgipro™ II suture 4-0 36” BL CV-23 DA


SP5698G Surgipro™ II suture BL 5-0 18” P-13


20

22 23

Ti-Cron™ SutureTi-Cron™ Suture

Ti-Cron™ suture has been your trusted brand for more than 20 years — with a proven history of performance


∙ Soft and supple

∙ Silicone (impregnated) coating designed for handling and pliability

∙ Knot security

Pledgets

Available as firm and soft pledgets rectangular and oval in different sizes:

Rectangular Oval

3 mm by 3 mm3 mm by 5 mm3 mm by 7 mm4.8 mm by 9.5 mm

3 mm by 6 mm4.5 mm by 6 mm

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular

∙ Neurological surgery

Product Ti-Cron™ Suture5 Ethibond™* Excel6



Composition Polyester Polyester

Coating Silicone Polybutylate

Color Blue, White Green, Undyed (white)



Sizes 7-0 through 5 6-0 through 2, 5

Indications Ti-Cron™ polyester suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological surgery.

Ethibond™* Excel suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological procedures.

Contraindications None known.

Box Quantities 1/2, 1, 2 or 3 dozen

Ti-Cron™ Suture Top Codes

8886332356 Ti-Cron™ suture W-B 10X30” CV-316 2-0 DA 7F

8886321956 Ti-Cron™ suture WB 8X30” Y-31 2-0 DA 7F

8886302779 Ti-Cron™ suture 5 BLUE 30” C-20-HOS-14

8886338556 Ti-Cron™ suture W-B 10X30” CV-316 2-0D/A

8886321856 Ti-Cron™ suture W-B 8X30” Y-31 2-0 DA 3F

24 25

Vascufil™ SutureVascufil™ Suture

Suture selection can be critical for a CABG procedure. Vascufil™ suture is made of polybutester designed to minimize premature suture breakage. The cross-linking molecular structure of polybutester helps maintain structural integrity of the suture — designed for less fraying and breaking of the strand. Polybutester is a fray-resistant material with a unique feel and performance that meets the demands of CV and PV surgery.7-9,58

Features and Benefits10,11

∙ Polybutester provides a 20% larger luminal opening.

∙ The unique handling characteristics of polybutester include less memory, softness, suppleness and elasticity.

∙ The elastic properties of polybutester are designed to provide greater knot security and tighter and smaller knots.

∙ The unique handling characteristics of polytribolate coating are designed to provide smooth knot run down, facilitate parachute technique and reduce tissue drag.

Frequent Uses


∙ Cardiovascular

∙ Ophthalmic

Product Vascufil™ Suture9 Pronova™*12



Composition Polybutester Hexafluoropropylene-VDF

Coating Polytribolate —

Color Blue Blue



Sizes 7-0 to 2-0 8-0 through 2-0

Indications Vascufil™ polybutester suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular and ophthalmic surgery, but not in microsurgery and neural tissue.

Pronova™* suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological procedures.

Contraindications The use of this suture is contraindicated in patients with known sensitivities or allergies to its components.

—

Box Quantities 1 or 3 dozen —

Vascufil™ Suture Top Codes

8886479505V Vascufil™ suture 7-0 2X24” BL MV-175-8 DA

8886470411V Vascufil™ suture 6-0 30” BL D/A CV-1

8886478805V Vascufil™ suture 7-0 4X24” BL MV-175-8 DA



26 27

Steel SutureSteel Suture

Steel sutures are composed of 316L stainless steel conforming to ASTM Standard F138 Grade 2 stainless steel bar and wire for surgical implants.Steel sutures meet all requirements established by the United States Pharmacopeia (USP) and for non-absorbable surgical sutures. Steel sutures are for use in abdominal wound closure, intestinal anastomosis, hernia repair and sternal closure.


∙ Roto-Grip™ Needles (available on some monofilament steel) are designed to reduce kinking.

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular


Product Steel Suture25


Suture Type Non-Absorbable

Composition Stainless Steel

Coating Uncoated

Color Steel

Tensile Strength Permanent

Absorption Profile Permanent

Sizes 2-0 to 7

Indications Steel sutures are indicated for use in abdominal wound closure, intestinal anastomosis, hernia repair and sternal closure.

Contraindications The use of this suture is contraindicated in patients with known sensitivities or allergies to steel and/or its principal metallic components, chromium and nickel. Additionally, the presence of steel may interfere with certain radiodiagnostics and its use is contraindicated where radiotransparency of suture material is required.

Box Quantities 1 or 3 dozen

Competitive product is Stainless Steel™*

8886222469 S-Steel suture Mono 6 4X18” CV320 SCC


8886239369 Steel suture 6 18” KV-40


8886249589 Steel suture 5 18” BGS-29

Steel Suture Top Codes

28 29

Flexon™Flexon™

Flexon™ suture is a temporary cardiac pacing lead with a stainless steel twisted, multistrand wire coated with orange or white PTFE poly (tetrafluoroproethylene) or clear FEP poly (tetrafluoroethylene-co-hexafluoropropylene).


∙ PTFE poly or FEP poly coating on the wire provides insulation and ease of removal

∙ Breakaway cutting needles (after chest wall penetration) eliminates requirement to cut needle.

Frequent Uses

∙ Temporary atrial and ventricular pacing and sensing during and after cardiac surgery

8886262353 Flexon™ suture 2-0 24” OR-WH SC-6V-20 D/A

8886261753 Flexon™ suture 2-0 24” OR SC-6 V-20 D/A

8886259763 Flexon™ suture 0 24” CL SC-2 V-20 D/A

8886261553 Flexon™ suture 2-0 24” WH SC-6 V-20 D/A

8886258963 Flexon™ suture 0 24” CL SC-6 V-20 D/A

Flexon™ Suture Top Codes

Product Flexon™ Suture26

Structure Multifilament


Composition Stainless Steel

Coating FEP Polymer, or PTFE Polymer

Color Clear, Orange, White



Sizes 3-0 to 0

Indications Flexon™ suture temporary cardiac pacing lead is indicated for use in temporary atrial and ventricular pacing and sensing during and after cardiac surgery.

Contraindications 1. When permanent pacing or monitoring is required, the use of Flexon™ suture temporary cardiac pacing lead is contraindicated.

2. The use of this product is contraindicated in patients with known sensitivities or allergies to its components.

3. The particular medical condition and anatomy of the patient may dictate the lead system and implantation procedure to be used.

Box Quantities 1, 2 or 3 dozen

30 31

Novafil™ SutureNovafil™ Suture

Novafil™ suture has been your trusted brand for more than 30 years — with a proven history of performance.


∙ Minimal memory

∙ Pliability (easy to handle, easy to tie)

∙ Elastic (stretchy suture)

∙ Hydrophobic suture

∙ Accommodates for edema

∙ Creep resistant

Frequent Uses


∙ Ophthalmic

SPB5633G Novafil™ suture BL 4-0 18” P-12



8886445951 Novafil™ suture BL 1X30” 2-0 T19-GS-22


Novafil™ Suture Top Codes

Product Novafil™ Suture14



Composition Polybutester

Coating Uncoated

Color Blue and clear



Sizes 7-0 to 2

Indications Novafil™ polybutester sutures are indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular and ophthalmic surgery, but not in microsurgery and neural tissue.

Contraindications The use of this suture is contraindicated in patients with known sensitivities or allergies to its components.

Box Quantities 1 or 3 dozen

32 33

Monosof ™/Dermalon™

SutureMonosof ™/Dermalon™

Suture

Monosof™/Dermalon™ suture has been your trusted brand for more than 50 years — with a proven history of performance.


∙ Pliability (easy to handle and tie)

∙ Strength

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular


Monosof™ Suture Top Codes

SN5667 Monosof™ suture 4-0 BLACK 18” P-12

SN5698G Monosof™ suture 5-0 BLACK 18” P-13



SN5667G Monosof™ suture 4-0 BLACK 18” P-12

Dermalon™ Suture Top Codes

8886179941 Dermalon™ suture 3-0 30” BL CE-6 - C-14

8886175631 Dermalon™ suture 4-0 18” BL C13

8886175641 Dermalon™ suture 3-0 18” BL C13

8886174441 Dermalon™ suture 3-0 18” BL CE-6 - C-14

8886174924 Dermalon™ suture 5-0 18” BL P-13

Product Monosof™/Dermalon™ Suture15

Ethilon™* Suture16



Composition Nylon Nylon

Coating Uncoated

Color Black, Clear (Monosof™ suture)Blue (Dermalon™ suture)

Black, Green, Clear

Tensile Strength Gradual loss over time Gradual loss over time


Sizes 2 through 11-0 (Monosof™ suture)1 through 6-0 (Dermalon™ suture)

11-0 through 2-0

Indications Monosof™ and dermalon™ monofilament nylon suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic, and neurological surgery.

Ethilon™* suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic, and neurological procedures.

Contraindications Due to the gradual loss of tensile strength which may occur over prolonged periods in vivo, nylon sutures should not be used where permanent retention of tensile strength is required.

Due to the gradual loss of tensile strength which may occur over prolonged periods in vivo, nylon suture should not be used where permanent retention of tensile strength is required.


32

34 35

Surgidac™ SutureSurgidac™ Suture

Surgidac™ suture has been your trusted brand for more than 20 years — with a proven history of performance.


∙ Uniform braided structure is designed to provide resistance to breaking.

∙ Cutting-edge spatula needles are designed for anterior segment surgery in ophthalmology.

∙ Spatula needles separate or split through the thin lamellar plane of corneal and scleral tissue.

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular


Surgidac™ Suture Top Codes

D1764K Surgidac™ suture 5-0 18” WH SS-24 D/AUNC

D1683K Surgidac™ suture 6-0 18” WH SS-28 SS-28


D1760K Surgidac™ suture 5-0 18” WH SS-14 D/A


Product Surgidac™ Suture17 Mersilene™* Suture18

Structure Braided Braided and Monofilament


Composition Polyester Polyester

Coating Uncoated —

Color White, Green Green, Clear (undyed)

Tensile Strength Permanent Implantation studies in animals show no meaningful decline in polyester suture strength over time.

Absorption Profile Permanent —

Sizes 6-0 to 2 11-0 and 10-0, 6-0 through 5

Indications Surgidac™ polyester suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological surgery.

Mersilene™* polyester fiber suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological procedures.

Contraindications None known None known


36 37

Surgilon™ SutureSurgilon™ Suture

Surgilon™ braided suture is inert, non-absorbable, sterile suture composed of the long-chain aliphatic polymers Nylon 6 and Nylon 6.6. The braided sutures are coated uniformly with silicone to enhance handling characteristics. Surgilon™ sutures are also non-absorbable nylon surgical sutures available dyed black or undyed (white).


∙ Uniform braided structure is designed to provide resistance to breaking

∙ Easy to handle

∙ Knot security

Frequent Uses


∙ Ophthalmic


Surgilon™ Suture Top Codes

8886195732 Surgilon™ suture 4-0 BK 5X18” CV-22 DT

8886196262 Surgilon™ suture 0 BLK 5X18” T-12GS-21 DT

8886196962 Surgilon™ suture 0 BLK 5X18” T-19GS-22 DT

8886192732 Surgilon™ suture 4-0 BLK 5X18” CV-23 DT

8886196752 Surgilon™ suture 2-0 BLK 5X30” T-5-V-20

Product Surgilon™ Suture 21 Nurolon™* Suture 22



Composition Nylon Nylon

Coating Silicone —

Color Black, White Black


Absorption Profile Permanent —

Sizes 6-0 to 3 6-0 through 1

Indications Surgilon™ braided nylon suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic, and neurological surgery.

Nurolon™* suture is indicated for use in general soft tissue approximating and/or ligation, including use in cardiovascular, ophthalmic procedures, and neurological procedures.

Contraindications Due to the gradual loss of tensile strength which may occur over prolonged periods in vivo, nylon sutures should not be used where permanent retention of tensile strength is required.



38 39

Sofsilk™ SutureSofsilk™ Suture

Sofsilk™ silk suture is non absorbable,sterile, non-mutagenic surgical suture composed of natural proteinaceous silk fibers called fibroin. This protein is derived from the domesticated silkworm species Bombyx mori of the family bombycidae. The silk fibers are treated to remove the naturally occurring sericin gum and braided to produce Sofsilk™ silk sutures. The braided sutures are available coated uniformly with either silicone or a special wax mixture.

Frequent Uses


∙ Ophthalmic

∙ Cardiovascular


Product Sofsilk™ Suture23 Perma-Hand Silk™*24



Composition Silk Silk

Color Black, White Black, Undyed



Sizes 8-0 to 5 7-0 through 2, 5

Indications Sofsilk™ suture is indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic, microsurgery, and neurological surgery.

Perma-Hand™* Silk suture is indicated for use in general soft tissue approximating and/or ligation, including use in cardiovascular, ophthalmic, and neurological procedures.

Contraindications The use of this suture is contraindicated in patients with known sensitivities or allergies to silk. Due to the gradual loss of tensile strength which may occur over prolonged periods in vivo, Sofsilk™ sutures should not be used where permanent retention of tensile strength is required.



Sofsilk™ Suture Top Codes

GS63M Sofsilk™ suture 3-0 18” BLACK V-20 DT

GS62M Sofsilk™ suture 2-0 5X18” BLACK V-20 DT

GS833 Sofsilk™ suture 2-0 30” BLACK V-20108Q

SS685 Sofsilk™ suture 2-0 18” BLACK C-15 02E

GS66M Sofsilk™ suture 2-0 30” BLACK V-20 DT

38

V-LOC™ WOUND CLOSUREDEVICES

42 43

V-Loc™

Wound Closure Device

The V-Loc™ wound closure device is a revolutionary product that lets surgeons close wounds without tying knots. The V-Loc™ device is backed by over 7 years of clinical experience and is supported by Oxford Level 1 evidence.38 It is sold in over 40 countries, with over 10 million strands put into the hands of surgeons.


∙ Closes dermal incisions up to 50% faster without compromising strength or security.39,40

∙ Has 20 unidirectional barbs per centimeter that precisely grasp the tissue at numerous points, providing even distribution of tension both along and across the wound.41

∙ Each strand has circumferential barbs to anchor tissue at numerous points.

∙ Potentially reduces knot-related complications by limiting the knot mass in the wound.

Frequent Uses

∙ Plastic: abdominoplasty, breast reconstruction, breast augmentation

∙ Gynecology

∙ Urology

∙ Mohs: skin cancer removal

∙ General/bariatric

CompositionTensile Strength

Absorption Profile

Color

V-Loc™ 9042

Glycolide, dioxanone and trimethylene carbonate

7 days, 90%14 days, 75%

7 days, 90%14 days, 75%

Clear Violet

V-Loc™ 18043

Copolymer of glycolic acid and trimethylene carbonate

7 days, 80% 14 days, 75% 21 days, 65%

180 days Clear Green

V-Loc™ PBT44

Polybutester Permanent Permanent Blue

44 45

V-Loc™

Wound Closure DeviceV-Loc™

Wound Closure Device

V-Loc™ 90 wound closure device is a unidirectional short-term, absorbable, knotless barbed suture.

V-Loc™ 90 Device Top Codes

Product V-Loc™ 90 Device42 Stratafix™* Spiral PGA-PCL45

Structure Unidirectional barbed monofilament

Unidirectional or bi-directional barbed monofilament

Suture Type Short-Term Absorbable Short-Term Absorbable

Composition Synthetic polyester composed of glycolide, dioxanone andtrimethylene carbonate

Copolymer of glycolide and e-caprolactone

Color Violet, Clear Clear

Tensile Strength 7 days, 90% 14 days, 75%

7 days, 62%; 14 days, 27%

Absorption Profile

90 – 110 days 90 – 120 days

Sizes 4-0, 3-0, 2-0 4-0, 3-0, 2-0

VLOCM0345 V-Loc™ 90 device 2-0 VL 9 GS-21

VLOCM0024 V-Loc™ 90 device 3-0 CL 18 P-12

VLOCM0023 V-Loc™ 90 device 4-0 CL 18 P-12

VLOCM0804 V-Loc™ 90 device 3-0 VL 6 CV-23

VLOCM2145 V-Loc™ 90 device 2-0 VL 9 GS-22

Product V-Loc™ 90 Device42 Stratafix™* Spiral PGA-PCL45

Indications V-Loc™ 90 absorbable wound closure devices are indicated for soft tissue approximation where use of an absorbable suture is appropriate.

Stratafix™* Spiral PGA-PCL is indicated for use in soft tissue approximation where the use of absorbable sutures are appropriate.

Contraindications The use of the V-Loc™ 90 absorbable wound closure device is contraindicated in patients with known sensitivities or allergies to its components. The V-Loc™ 90 absorbable wound closure device is not for use where prolonged (beyond 2 weeks) approximation of tissues under stress is required or for fixation of permanent cardiovascular prostheses or synthetic grafts. V-Loc™ 90 absorbable wound closure device should not be used for interrupted suture patterns. V-Loc™ 90 absorbable wound closure device is not intended to be used by tying surgical knots. V-Loc™ 90 absorbable wound closure device should not be used for ligating vessels or luminal structures.

Stratafix™* Spiral PGA-PCL device is not to be used where extended approximation of tissue under stress is required and is not to be used in conjunction with or for fixation of prosthetic devices (e.g. heart valves or synthetic grafts) that are non-absorbable in nature.

Box Quantities 1 dozen 1 dozen

46 47

V-Loc™ 180 Wound Closure Device


V-Loc™ 180 wound closure device is a unidirectional long-term, absorbable, knotless barbed suture.

V-Loc™ 180 Device Top Codes

Product V-Loc™ 180 Device43 Stratafix™* Spiral PDO46

Structure Unidirectional barbedmonofilament

Unidirectional or bidirectional barbed monofilament

Suture Type Long-Term Absorbable Long-Term Absorbable

Composition PolyglyconateCopolymer of glycolicacid and trimethylenecarbonate

Dyed (violet) polyester, poly(p-dioxanone)

Color Green, Clear Violet

Tensile Strength 7 days, 80%14 days, 75%21 days, 65%

3-0 and larger 14-28 days, 80%; 42 days, 40-70% 4-0 14 days, 67%; 28 days, 50% 42 days, 37%

Absorption Profile

180 days 120-180 days

Sizes 4-0, 3-0, 2-0, 0 5-0, 4-0, 3-0, 2-0, 0, 1

VLOCL0316 V-Loc™ 180 device 0 GR 12 GS-21

VLOCL0804 V-Loc™ 180 device 3-0 GR 6 CV-23

VLOCL0315 V-Loc™ 180 device 2-0 GR 12 GS-21

VLOCL0024 V-Loc™ 180 device 3-0 CL 18 P-12

VLOCL0124 V-Loc™ 180 device 3-0 CL 18 P-14

Product V-Loc™ 180 Device43 Stratafix™* Spiral PDO46

Indications V-Loc™ 180 absorbable wound closure devices are indicated for soft tissue approximation where use of an absorbable suture is appropriate.

Stratafix™* Spiral PDO device is indicated for use in soft tissue approximation where use of absorbable sutures is appropriate.

Contraindications The use of the V-Loc™ 180 absorbable wound closure device is contraindicated in patients with known sensitivities or allergies to its components. The V-Loc™ 180 absorbable wound closure device is not for use where prolonged (beyond 3 weeks) approximation of tissues under stress is required or for fixation of permanent cardiovascular prostheses or synthetic grafts. V-Loc™ 180 absorbable wound closure device should not be used for interrupted suture patterns. V-Loc™ 180 absorbable wound closure device is not intended to be used by tying surgical knots. V-Loc™ 180 absorbable wound closure device should not be used for ligating vessels or luminal structures.

Stratafix™* Spiral PDO device is not to be used where prolonged (beyond 6 weeks) approximation of tissue under stress is required and is not to be used in conjunction with or for fixation of prosthetic devices (e.g. heart valves or synthetic grafts) that are non-absorbable in nature.


48 49



Product V-Loc™ 180 Device43 Stratafix™* Symmetric PDS™* Plus47

Structure Unidirectional barbed monofilament

Unidirectional barbed

Suture Type Long-Term Absorbable Long-Term Absorbablewith anti-bacterial barrier

Composition PolyglyconateCopolymer of glycolicacid and trimethylenecarbonate

Dyed (violet) polyester, poly(p-dioxanone)

Color Green, Clear Violet

Tensile Strength 7 days, 80%;14 days, 75%;21 days, 65%

14 days, 75%;28 days, 65%;42 days, 55%

Absorption Profile 180 days 120-180 days

Sizes 4-0, 3-0, 2-0, 0 3-0, 2-0, 0, 1

Product V-Loc™ 180 Device43 Stratafix™* Symmetric PDS™* Plus47

Indications V-Loc™ 180 absorbable wound closure devices are indicated for soft tissue approximation where use of an absorbable suture isappropriate.

Stratafix™* Symmetric PDO Plus devices are indicated for generalsoft tissue approximation whereuse of absorbable sutures is appropriate.

Contraindications The use of the V-Loc™ 180absorbable wound closure device is contraindicated in patients with known sensitivities or allergies toits components. The V-Loc™ 180 absorbable wound closure deviceis not for use where prolonged (beyond 3 weeks) approximationof tissues under stress is required or for fixation of permanent cardiovascular prostheses or synthetic grafts. V-Loc™ 180absorbable wound closure device should not be used for interruptedsuture patterns. V-Loc™ 180 absorbable wound closure device is not intended to be used bytying surgical knots. V-Loc™ 180 absorbable wound closure deviceshould not be used for ligating vessels or luminal structures.

Stratafix™* Symmetric PDS™* Plus device, being absorbable, is not to be used where prolonged (beyond 6 weeks) approximation of tissue under stress is required and is not to be used in conjunction with prosthetic devices (i.e., heart valves or synthetic grafts). Stratafix™* Symmetric PDS™* Plus device should not be used in patients with known allergic reactions to Irgacare™* MP (triclosan).


50 51

V-Loc™ PBT Wound Closure Device

V-Loc™ PBT Wound Closure Device

V-Loc™ PBT wound closure device is a unidirectional permanent knotless barbed suture.

V-Loc™ PBT Device Top Codes

Product V-Loc™ PBT Device43 Stratafix™* Spiral Polypropylene48

Structure Unidirectional barbedmonofilament

Unidirectional or bidirectionalbarbed monofilament

Suture Type Permanent Permanent

Composition Copolymer of butyleneterephthalate andpolytetramethylene ether glycol

Polypropylene

Color Blue Blue, Clear



Sizes 3-0, 2-0, 0, 1 0,1

VLOCN0644 V-Loc™ device NON ABS 3-0 BL 9 V-20

VLOCN0327 V-Loc™ device NON ABS 1 BL 18 GS-21


VLOCN0326 V-Loc™ device NON ABS 0 BL 18 GS-21


Product V-Loc™ PBT Device44 Stratafix™* Spiral48

Indications V-Loc™ PBT non-absorbable wound closure devices are indicated for soft tissue approximation.

Stratafix™* Spiral polypropylene device is indicated for use in soft tissue approximation, excluding closure of the epidermis.

Contraindications The use of the V-Loc™ PBT nonabsorbable wound closure deviceis contraindicated in patients with known sensitivities or allergies toits components. V-Loc™ PBT nonabsorbable wound closure deviceshould not be used for interrupted suture patterns. V-Loc™ PBT nonabsorbable wound closure device is not intended to be used by tying surgical knots. V-Loc™ PBT nonabsorbable wound closure device should not be used for ligating vessels or luminal structures.

Stratafix™* Spiralpolypropylene device isnot indicated for surfaceclosures through theepidermis, as the smallopposing facing barbsmake Stratafix™* Spiralpolypropylene deviceremoval unfeasible.


KEY PROCEDURES

54 55

Coronary Artery Bypass Graft Procedure


Step One: Harvesting Graft

The Saphenous Vein, Internal Mammary Artery are the two most common bypass grafts used for the CABG procedure. The Saphenous Vein is harvested from the leg and LIMA is diverted from the chest wall to the coronary artery beyond the blockage.INDICATIONS: Polysorb™ sutures are indicated for use in soft tissue approximation or ligation and ophthalmic surgery, but not in cardiovascular or neural tissue. Suture Brand: SofSilk™ | Suture Size: 4-0

Saphenectomy Suture Brand

Suture Size

Needle Type

Needle Tip

Needle Curvature

Transfix Ligature

Polysorb™

Ti-Cron™

Sofsilk™

3-0, 4-0 Pre-cuts or reel

— —

Skin Closure Deep Dermal Layer

Polysorb™ 2-0 V-20 Taper Point 1/2 circle

Skin Closure Subcuticular/Epidermis

Caprosyn™

Biosyn™

V-Loc™ 90

Novafil™

3-0, 4-0

P-12 P-14

Premium Reverse Cutting

3/8 circle

Step Two: Median Sternotomy

Surgeons make 8-10 inch incision and retractor is used to hold the chest open.


Suture Size

Needle Type

Needle Tip

Needle Curvature

Transfix Ligature

Polysorb™

Ti-Cron™

Sofsilk™

3-0, 4-0 Pre-cuts or reel

— —

Skin Closure Deep Dermal Layer

Polysorb™ 2-0 V-20 Taper Point 1/2 circle

Sternotomy: Bone Hemostasis Accessory: Bone Wax (BW-25G)

Step Three: Cardio-Pulmonary Bypass

Pericardium is retracted, heart is cannulated and patient is placed on a heart-lung bypass machine. Cardioplegia is introduced so that the heart can be safely stopped.


Suture Size

Needle Type

Needle Tip

Needle Curvature

Pericardium Retraction

Sofsilk™ 2-0 V-20 Taper Point 1/2 circle

Bypass Cannulation

Ti-Cron™ 2-0 CV-305

CV-331

Y-5

Y-31

Taper Point

Taper Point

Penetrating Taper

Penetrating Taper

1/2 circle

1/2 circle

1/2 circle

1/2 circle

Cardioplegia Cannulation

Surgipro™ II

Vascufil™

4-0 CV-15 (d/a) Taper point 3/8 circle

Coronary Artery Exposure

Surgipro™ II

Vascufil™

5-0 CV-11

KV-11 (d/a)

Taper Point

Penetrating Taper

3/8 circle

3/8 circle

Closure of Right Atrium and Aortotomy

Surgipro™ II

Vascufil™

3-0, 4-0

V-20 (d/a) Taper Point 1/2 circle

Saphenous vein is harvested

56 57



Step Four: Graft Anastomosis

Grafts are sewn into the coronary arteries to bypass the blockage. Proximal and distal anastomoses are made with the graft material.

Graft Anastomosis

Suture Brand

Suture Size

Needle Type

Needle Tip

Needle Curvature

Proximal Anastomosis

Surgipro™ II

Vascufil™

5-0, 6-0

CV-11

CV-22

CV-23

CV-20

CVL-11

CV-15 (d/a)

Taper Point

Taper Point

Taper Point

Taper Point

Taper Point

Taper Point

3/8 circle

1/2 circle

1/2 circle

1/2 circle

CardioCurve

3/8 circle

Distal Anastomosis (Saphenous Vein)

Surgipro™ II

Vascufil™

6-0, 7-0

CV-1

CV-351

MV-175-8/MVF-175-8

MV-175-9

MV-135-5 (d/a)

Taper Point

Taper Point

Taper Point

Taper Point Taper Point

3/8 circle

3/8 circle

3/8 circle

3/8 circle 3/8 circle

Distal Anastomosis (Internal Mammary Artery)

Surgipro™ II

Vascufil™

7-0, 8-0

MV-135-5 (d/a)

MV-175-8 (d/a)

MV-175-9

CV-1 (d/a)

Taper Point

Taper Point

Taper Point

Taper Point

3/8 circle

3/8 circle

3/8 circle

3/8 circle

In the CABG procedure, proximal and distal anastomoses of the graft material typically takes 10-12 minutes per anastomosis.

Step Five: Chest Closure

Clamps on the aorta are removed, tubes are disconnected and blood flow to heart is restored. Chest tubes are inserted to drain fluid and temporary pacing wires are placed. The skin layers are closed.

Chest Closure Suture Brand

Suture Size

Needle Type

Needle Tip

Needle Curvature

Temporary Pacing Leads

Flexon™ 0, 2-0, 3-0

V-20/SC-6

SC-2/V-20

Taper Point/Cutting

Cutting/Taper

Point

1/2 circle/ straight

Straight/ 1/2 circle

Pericardial Closure (Optional)

Surgipro™ II 2-0, 3-0 V-20

VF-20

Taper Point

Taper Point

1/2 circle

1/2 circle

Sternum Closure

Steel 5, 6, 7 SCC

SCC-1

KV-40

Conventional Cutting

Conventional

Cutting

Penetrating Taper

1/2 circle

1/2 circle

1/2 circle

Skin Closure Fascia

Polysorb™ 2-0 V-20 GS-21

Taper Point Taper Point


Skin Closure Subcuticular/ Epidermis

Caprosyn™

Biosyn™

V-Loc™ 90

Novafil™

3-0, 4-0 P-12

P-14

Premium Reverse Cutting

3/8 circle

Drain Fixation Sofsilk™ 2-0 GS-11 Reverse Cutting 1/2 circle

Temporary pacing wires Flexon™ 0, 2-0, 3-0

Temporary Pacing Wires

Sternum - Steel 5, 6, 7Fascia Polysorb™ 2-0

V-Loc™ (Subcuticular Closure)

Topical Skin Adhesive (sterile barrier)

Chest Closure

58 59

Valve Replacement Procedure


Step One: Median Sternotomy

Surgeons make 8-10 inch incision and retractor is used to hold the chest open.

Top Bone Hemostasis Code: Bone Wax (BW-25G)

Step Two: Valve Replacement

Pericardium is retracted, heart is cannulated and patient is placed on a heart-lung bypass machine. Cardioplegia is introduced so that the heart can be safely stopped.

Valve Replacement

Suture Brand

Suture Size

Needle Type

Needle Tip

Needle Curvature

Pericardium Retraction

Sofsilk™ 2-0 V-20 Taper Point 1/2 circle

Bypass Cannulation

Ti-Cron™ 2-0 CV-305 CV-331 Y-5 Y-31

Taper Point Taper Point Penetrating

Taper Penetrating

Taper

1/2 circle 1/2 circle 1/2 circle

1/2 circle

Cardioplegia

Cannulation

Surgipro™ II 4-0 CV-15 (d/a) Taper Point 3/8 circle

Step Three: Aortic Valve Replacement

An opening is made and traction sutures are placed. The aortic valve leaflets are then excised. A mechanical or biological valve is placed, using 12-18 sutures (alternate colors – Blue and White Ti-Cron™ 2-0). The alternating combination of blue and white sutures helps in keeping the order correct. The mechanical or biological valve is glided down and secured with sutures. Once the new valve is placed, the opening in the aorta is closed.

Aortic Valve Replacement

Suture Brand

Suture Size

Needle Type

Needle Tip

Needle Curvature

Traction Sutures on Aortotomy

Surgipro™ II 5-0, 4-0 V-20 Taper Point 1/2 circle

Aortic Valve Ti-Cron™ with or without soft/firm pledgets

2-0 CV-331 Y-31 CV-23 CV-24

KV-5

Taper Point Penetrating Taper Taper Point Taper Point Penetrating Taper

1/2 circle


1/2 circle

Closure of Aortotomy

Surgipro™ II 5-0, 4-0 CV-15 CV-23

KV-15

Taper Point Taper Point Penetrating Taper


3/8 circle

Closure of Right Atrium and Aortotomy (Cannulation)

Surgipro™ II 3-0, 4-0 V-20 Taper Point 1/2 circle

Pericardium

Median Sternotomy

SofSilk™ 2-0

SofSilk™

Surgipro™ II 3-0, 4-0

Surgipro™ II 3-0, 4-0

TiCron™ 2-0

Cardioplegia

Cardio-Pulminary BypassRetracted Pericardium

Aortic Valve Replaced with Mechanical Valve

Mitral valve

Mechanical or biological valve

Pulmonary valve

Tricuspid valve

Aortic Valve Replacement

Mitral valve

Aortic valvePulmonary

valve

Tricuspid valve

60 61



Step Four: Mitral Valve Replacement

An opening is made and traction sutures are placed. The aortic valve leaflets are then excised. A mechanical or biological valve is placed, using 16-18 sutures (alternate colors – Blue and White Ti-Cron™ 2-0). The alternate combination of blue and white sutures helps in keeping the order correct. The mechanical or biological valve is glided down and secured with sutures. Once the new valve is placed, the opening in the aorta is closed.

Mitral Valve Replacement

Suture Brand Suture Size

Needle Type

Needle Tip

Needle Curvature

Mitral Valve Ti-Cron™ suture with or without soft/firm pledgets

0, 2-0, 3-0

CV-305 Y-5 KV-7 KV-26 V-20

Taper point Penetrating taper Penetrating taper Penetrating taper Taper point

1/2 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle

Closure of Left Atrium

Surgipro™ II suture 4-0 V-20 d/a Taper point 1/2 circle

Closure of Right Atrium and Aortotomy (Cannulation)

Surgipro™ II suture 3-0, 4-0

V-20 d/a Taper point 1/2 circle

Mitral valve replacement

Mitral valve replaced with mechanical valve


Tricuspid valve

Tricuspid valve

Aortic valve

Aortic valve

Pulmonary valve

Pulmonary valve

Step Five: Chest Closure

Clamps on the aorta are removed, tubes are disconnected and blood flow to heart is restored. Chest tubes are inserted to drain fluid and temporary pacing wires are placed. The skin layers are closed.

Chest Closure


Needle Type

Needle Tip

Needle Curvature

Temporary Pacing Leads

Flexon™ suture 0, 2-0, 3-0

V-20/SC-6

SC-2/V-20

Taper point/cutting Cutting/taper point

1/2 circle/ straight Straight/1/2 circle

Pericardial Closure (Optional)

Surgipro™ II suture 2-0, 3-0

V-20 VF-20

Taper point Taper point


Sternum Closure

Steel suture 5, 6, 7 SCC SCC-1 KV-40

Conventional cutting Conventional cutting Penetrating taper


Skin Closure Fascia

Polysorb™ suture 2-0 V-20 GS-21




Caprosyn™ suture Biosyn™ suture V-Loc™ 90 device Novafil™ suture

3-0, 4-0

P-12 P-14

Premium reverse cutting

3/8 circle

Drain Fixation

Sofsilk™ suture 2-0 GS-11 Reverse cutting 1/2 circle

Temporary pacing wires

Temporary pacing wires Flexon™ suture 0, 2-0, 3-0

Chest closure

Topical Skin Adhesive (sterile barrier)

V-Loc™ device (Subcuticular Closure)

Fascia Polysorb™ suture 2-0

Sternum - Steel 5, 6, 7


62 63

Abdominal AorticAneurysm Procedure

Abdominal AorticAneurysm Procedure

Step One

A midline vertical incision is made in the abdomen. The intestines are pulled out to expose the aneurysm site. Arteries above and below are clamped to stop blood flow.

Graft Anastomosis


Needle Type

Needle Tip

Needle Curvature


Surgipro™ II suture Ti-Cron™ suture

2-0, 3-0

CV-25 CV-13 KV-7 V-20/ VF-20 V-26 V-30 CV-331 Y-31 KV-5 YE-7 CV-316 Y-16 CV-305 V-20 Y-5 KV-7 KV-26 CV-300

Taper point Taper point Penetrating taper Taper point Taper point Taper point Taper point Penetrating taper Penetrating taper Penetrating taper Taper point Penetrating taper Taper point Taper point Penetrating taper Penetrating taper Penetrating taper Taper point

1/2 circle 3/8 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle

Step Two

Next, the surgeon makes a series of incisions on the artery wall to access the damaged area and may choose to remove clots and suture damaged blood vessels. A graft tube is inserted into the aorta to provide support.


Surgipro™ II suture Ti-Cron™ suture

4-0 CV-23/ CVF-23 CV-15/ CVF-15 KV-5 KV-15 CV-24 CV-25 CV-13 KV-7 V-20 CV-331 Y-31 YE-7 CV-316 CV-305

Taper point Taper point Penetrating taper Penetrating taper Taper point Taper point Taper point Penetrating taper Taper point Taper point Penetrating taper Penetrating taper Taper point Taper point

1/2 circle 3/8 circle 1/2 circle 3/8 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle 1/2 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle 1/2 circle

Step Three

Graft anastomoses are performed at both ends and the aorta is closed on top of the graft. Then, the clamps are removed, and blood flow is restored and monitored. The surgeon checks for blood leaks around the aorta, and uses sutures and topical skin adhesive to close the skin, respectively.

Closure Suture Brand Suture Size

Needle Type

Needle Tip

Needle Curvature

Posterior Fascia

Polysorb™ suture Surgipro™ II suture Maxon™ (looped) suture

1 GS-25 GS-24



Anterior Fascia


0 GS-25 GS-24



Skin Closure Deep Dermal Layers

Polysorb™ suture 2-0 V-20 Taper point 1/2 circle



3-0, 4-0

P-12 P-14


3/8 circle

Opened aorta Removal of blood clot Graft tube inserted

64 65

Femoral-PoplitealBypass Procedure


Step One

First, the femoral and popliteal arteries are exposed by making an incisionthrough the skin, subcuticular and fascia layers. The saphenous vein is then harvested.

Ligation Suture Brand Suture Size

Needle Type

Needle Tip

Needle Curvature

Transfix Ligature

Polysorb™ suture Ti-Cron™ suture Softsilk™ suture

3-0 4-0

CV-23 CV-25 (d/a)

Taper point 1/2 circle

Ligation Softsilk™ 4-0 V-20 d/a Taper point 1/2 circle

Popliteal artery exposed Femoral artery exposed

Saphenous vein harvested

Step Two

Tubing or silk sutures are passed around the femoral and popliteal arteries for proper exposure. When a good lumen has been demonstrated, the graft is sewn into place to bypass the diseased section of the artery. Proximal and distal anastomoses are then performed.

Graft Anastomosis


Needle Type

Needle Tip

Needle Curvature


Surgipro™ II suture 4-0 5-0

CV-23 CV-15 KV-15 KV-5 CV-24 CV-25 CV-13 KV-7 V-20 (d/a)

Taper point Taper point Penetrating taper Penetrating taper Taper point Taper point Taper point Penetrating taper Taper point

1/2 circle 3/8 circle 3/8 circle 1/2 circle 1/2 circle 1/2 circle 3/8 circle 1/2 circle 1/2 circle


Surgipro™ II suture 5-0 6-0

CV-11 CV-22 CV-23 CV-20 CV-15 KV-1 KV-5 KV-15 CV-1 KV-1 CV-337 (d/a)

Taper point Taper point Taper point Taper point Taper point Penetrating taper Penetrating taper Penetrating taper Taper point Penetrating taper Taper point

3/8 circle 1/2 circle 1/2 circle 1/2 circle 3/8 circle 3/8 circle 1/2 circle 3/8 circle 3/8 circle 3/8 circle 1/2 circle

Tubing around femoral artery Tubing around popliteal artery

Proximal and distal anastomosis

66 67


Step Three

After good blood flow and pulse have been reestablished, the surgeon uses sutures and topical skin adhesive to close the skin, respectively.

Closure Suture Brand Suture Size

Needle Type

Needle Tip

Needle Curvature

Posterior Fascia


0 GS-25 GS-24



Anterior Fascia


2-0 GS-25 GS-24



Skin Closure Deep Dermal Layers

Polysorb™ suture 2-0 V-20 Taper point 1/2 circle



3-0, 4-0

P-12 P-14


3/8 circle

Posterior Fascia Polysorb™

Anterior Fascia Polysorb™

Deep Dermal Polysorb™

Muscle

EpidermisTopical Skin Adhesive (sterile barrier)

Subcuticular Layer V-Loc™ 90

OBSTETRICS/GYNECOLOGY

68 69

Episiorrhaphy C-Section

Surgical repair (suturing) of a lacerated vulva or of an episiotomy

Technique — Traditional Method

Suturing in different layers

∙ Vaginal wall

∙ Perineal muscles

∙ Skin

Tissue Layer

Technique Suture Material

USP Size

Needle Type

Muscles Interrupted Polysorb™ or Biosyn™ suture

0 2-0 3-0

Taper point/taper-cutting

Mucosa Continuous Velosorb™ Fast suture 0 2-0 3-0

Taper point/taper-cutting

Skin Continuous subcuticular

Velosorb™ Fast or Caprosyn™ suture

3-0 4-0

Reverse cutting (P)

∙ Delivery of the fetus through an abdominal incision and hysterotomy

∙ A surgical incision through the abdominal wall and the uterus, performed to deliver a fetus

∙ Two classifications — classical or low cervical

∙ Classical refers to delivery of an infant through a vertical incision in the corpus of the uterus (greater blood loss/increased risk of uterine rupture with subsequent pregnancy)

∙ Low cervical-transverse incision in the lower, noncontractile portion of the uterus

Tissue Layer

Technique Suture Material

USP Size

Needle Type

Uterus Continuous/interrupted

Maxon™ suture Polysorb™ suture

2-0 0

Taper point

Fascia Continuous Maxon™ suture Novafil™ suture

2-0 3-0

Taper point

Subcuticular and Dermal

Continuous Biosyn™ suture Caprosyn™ suture Velosorb™ suture

3-0 4-0

Reverse cutting (P)

70 71

AbdominoplastyBreast Reconstruction

Step One

Place deep adaption sutures to approximate the subcutaneous breast tissue; multiple interrupted 2-0 Maxon™ suture stitches. Then use the V-Loc™ device for the subcutaneous and subcuticular closures. The starting point of the V-Loc™ device subcutaneous layer is the outer angle of the submammary incision.

Step Two

Complete the subcutaneous wound closure the length of the horizontal incision. From the opposite incision angle, begin the subcuticular closure with the V-Loc™ device. Once the horizontal incision is completed, begin closing the vertical incision running the V-Loc™ device toward the areola.

Step One

Rectus plication: Take 1 bite with the V-Loc™ device on either side of the wound and advance needle through the anchor loop. Begin to run the suture the length of the incision as for a traditional suture. Once at the end of the incision, take 1 to 2 backbites toward the beginning of the incision and then advance the needle under the suture line perpendicular to the incision.

Step Two

Deep dermal closure: Interrupted stitches could be used to approximate the incision; these stitches can remain or be removed after using the V-Loc™ device as desired by the surgeon. Begin the closure by taking a backward, split-thickness bite through the deep dermal layer. Exit the needle directly opposite the looped end. Pull so that the looped end is drawn into the dermal layer. Take a single, forward split-thickness bite away from the vertex on the contralateral edge of the skin incision. The arc of the bite should be such that the needle exits the skin directly opposite the looped end. Pass the needle through the looped end, applying gentle traction to carefully appose the skin edges.

Step Three

After the subcutaneous and subcuticular layers of the vertical incision are closed, begin the refixation of the areola at the 6 o’clock position. Complete the circumferential closure with V-Loc™ 90 device.

Step Four

Complete the areola closure by exiting the needle lateral to the initial starting point. Be sure to cut flush with the tissue. Use SwiftSet™ topical skin adhesive as a final layer of closure to provide an antimicrobial barrier.

Step Three

Beginning with a sinusoidal bite on the same side as the looped end, close the skin incision in standard fashion with a continuous subcuticular pattern. Take care not to pull too tightly, as this will cause the incision to pucker and inhibit the release of tension.

Step Four

Once at the end of the incision, take 1 to 2 backbites toward the beginning of the incision. Then take a bite perpendicular to the incision and exit the skin, making sure to cut the suture flush with the tissue. Use SwiftSet™ topical skin adhesive as a final layer of closure to provide an antimicrobial barrier.

72 73

Laparoscopic HysterectomySleeve Gastrectomy

Step One

In a sleeve gastrectomy, after creating the gastric sleeve, oversew the staple line. The V-Loc™ device can be started at the proximal or distal end of the sleeve. Take 2 bites on either side of the sleeve, pass the needle through the loop, and cinch down.

Step Two

Continue to run the V-Loc™ device the length of the sleeve, being sure to imbricate the staple line.

Step Three

Once the staple line is oversewn, take 1 to 2 backbites with the V-Loc™ device toward the beginning of the incision. To securely complete the knotless closure, pass the needle under the suture line and exit perpendicular to the staple line. Cut flush with the tissue to ensure that no tail is remaining.

Step One

Start the V-Loc™ device at the apex of the cuff, on either side of the opening, and try to incorporate the lateral ligaments. Take 2 healthy bites of the vaginal epithelium, at least 1 to 2 cm in depth, and thread the V-Loc™ device through the loop.

Step Two

Continue to run the V-Loc™ device using a baseball stitch for the length of the cuff. Recommend that surgeons use the needle driver to apply counter-traction to the vagina when cinching down the V-Loc™ device. This can be done by opening the jaws of the needle driver in a V shape and pushing against the tissue while pulling back the V-Loc ™ device.

Step Three

To complete the cuff closure, take 2 bites right before closing the distal end of the cuff. Do not have surgeons pull the suture tight, as this will allow them to evert the cuff to take bites of mucosa. Then take 2 to 3 bites toward the middle of the cuff and advance the needle under the suture line to come out perpendicular to the suture line. Ensure that the V-Loc™ device is cut flush with tissue. To avoid complications, do not leave a tail.

74 75

Total Hip ReplacementTotal Knee Replacement

Step One

After the knee implant is placed and the joint capsule is ready to be closed, approximate the tissue over the implant.

Step Two

To close the joint capsule, 12 to 15 interrupted Ti-Cron™ sutures are placed to ensure a secure closure.

Step Three

Use the V-Loc™ device to close the deep dermal layer. Take 1 bite with the V-Loc™ device on either side of the wound and advance the needle through the anchor loop. Begin to run the suture the length of the incision as for a traditional suture. Once at end of the incision, take 1 to 2 backbites toward the beginning of the incision. Then advance the needle under the suture line, coming out perpendicular to the incision, and cut flush.

Step Four

For the subcuticular closure, complete the same actions of Step Three. Use SwiftSet™ topical skin adhesive as a final layer of closure to provide an antimicrobial barrier.

Step One

After the hip implant is placed and the joint capsule is ready to be closed, approximate the tissue over the implant.

Step Two

To close the joint capsule, 12 to 15 interrupted Ti-Cron™ sutures are placed to ensure a secure closure.

Step Three

Use the V-Loc™ device to close the deep dermal layer. Take 1 bite with the V-Loc™ device on either side of the wound and advance the needle through the anchor loop. Begin to run the suture the length of the incision as for a traditional suture. Once at end of the incision, take 1 to 2 backbites toward the beginning of the incision. Then advance the needle under the suture line, coming out perpendicular to the incision, and cut flush.

Step Four

For the subcuticular closure, complete the same actions of Step Three. Use SwiftSet™ topical skin adhesive as a final layer of closure to provide an antimicrobial barrier.

76 77

Common V-Loc™

Device UsageCommon V-Loc™

Device Usage

Orthopedic

Procedure Joint (knee or hip)

V-Loc™ device 180, 90, PBT

Size 0, 2-0, 3-0

# of Strands 3-6

Average Length 18", 24"

Preferred Needle GS-21 GS-22 GS-25 GS-11

Layers Closed Deep Dermal, Subcuticular

Plastic

Procedure Abdominoplasty

V-Loc™ device 180, 90, PBT

Size 0, 2-0, 3-0

# of Strands 2-5


Preferred Needle P-12

Layers Closed Muscle Plication, Deep Dermal, Subcuticular

Plastic

Procedure Joint (knee or hip)

V-Loc™ device 180, 90

Size 2-0, 3-0, 4-0

# of Strands 2-5


Preferred Needle P-14


Plastic

Procedure Breast Augmentation

V-Loc™ device 90

Size 2-0, 3-0, 4-0

# of Strands 2

Average Length 6"

Preferred Needle V-20


Gynecology

Procedure Hysterectomy


Size 0, 2-0

# of Strands 1-2


Preferred Needle GS-21

Layers Closed Vaginal Cuff

Gynecology

Procedure Myomectomy


Size 2-0, 3-0

# of Strands 2-3


Preferred Needle GS-21

Layers Closed Uterus

78 79

Common V-Loc™

Device UsageCommon V-Loc™

Device Usage

Electrophysiologists

Procedure Pacemaker/Defibrillator

V-Loc™ device 90

Size 3-0, 4-0

# of Strands 2-3


Preferred Needle V-20, P-12

Layers Closed Deep Dermal Subcuticular

Dermatology: Mohs

Procedure Skin Cancer Removal


Size 2-0, 3-0, 4-0

# of Strands 2-3

Average Length 9", 12", 18"

Preferred Needle P-12, P-14

Layers Closed Deep Dermal Subcuticular

Urology

Procedure Robotic/Lap Prostatectomies


Size 3-0

# of Strands 2-3


Preferred Needle CV-23

Layers Closed Bladder-Urethra Anastomosis Rocco Stitch

GEN/Bariatric

Procedure Sleeve Gastrectomy Gastric Bypass

V-Loc™ device 180, PBT

Size 2-0, 3-0

# of Strands 2-3


Preferred Needle GS-22, V-20

Layers Closed Staple Line Oversewing Enterotomy Closure Peterson’s Defect

NEEDLES

82 83

NeedlesNeedles

We provide a full line of suture needles. Our portfolio offers both choice to accommodate clinical preference and high performance to meet clinical needs.All of our needles are treated with our proprietary NuCoat™ coating that reduces needle dulling.We use only high grade stainless steel that is heat treated to optimize strength.We use laser and mechanical drilling technology and a proprietary annealing process to limit inadvertent suture detachment. Every suture strand is 100% pull tested.

Cutting Needles (Primarily for Skin Closure)

Premium Line — For sharpness and a thinner cross section

∙ Premium reverse cutting P-needles

∙ Premium conventional cutting PC-needles

∙ DermaX™ needles – a unique cross-cutting tip

∙ Slim Blade SBE needles – slim needles for cosmetic surgery

Commodity Line — For value pricing and when strength and a stiff, robust feel are preferred

∙ Cuticular C-needles

Cardiovascular Needles

∙ For all Cardiovascular, Peripheral Vascular and some general closure applications

∙ We offer a wide array of CV needle options to provide a best fit for surgeon technique and patient needs

∙ All SurgiPro™ suture and Vascufil™ suture needles are made with our proprietary Surgalloy™ stainless steel and heat treated for optimized strength

Common CABG Distal Anastomosis Needle Options

∙ CV-1: Comparable to the BV-1

∙ CVF-1: Flat pressed for the enhanced stability in the needle driver

∙ MV-175-8: A shorter 8 mm needle with a smaller wire diameter than the CV-1 for less tissue damage and easier penetration

∙ MVF-175-8: Flat pressed for the enhanced stability |in the needle driver

∙ MV-175-9: Thinner wire diameter for less tissue damage and easier penetration

∙ CVL: A unique geometry designed for speed

∙ KV-1: A sharper tip for difficult tissue

Length Slim Taper Point (CV)

Taper Point Heavy Taper Point

Taper-Cutting/ Diamond Point

26 mm V-20/ VF-20 GS-22 HGS-22 KV-30

37 mm V-26 GS-21 HGS-21 KV-34

40 mm GS-24 HGS-24 KV-37

48 mm GS-25 KV-40

When to Use:

Thinner needle to minimize defect size

For majority of applications

Thicker needle for added strength

Taper-cutting tip for better penetration

Length Reverse Cutting

Heavy Reverse Cutting

Blunt Taper Point

5/8 Circle Taper Point

Heavy 5/8 Circle Taper Point

26 mm GS-10 HOS-10 BTV-20 GU-46 HGU-46

37 mm GS-11 HOS-11 BGS-21/ HBGS-21/ BTP-1

GU-45

40 mm GS-12 HOS-12 BGS-24 GU-44

48 mm GS-13 BGS-25

When to Use:

Cutting tip for best penetration on difficult tissue

Thicker cutting needle for best penetration and better strength on toughest tissue

Blunt tip for vascular tissue (i.e., liver, pancreas) or to reduce risk of needle stick in a high-risk patient (i.e., HIV, HEP)

For application with little space to maneuver (i.e. port site closure or urology)

Thicker needle for applications with little space to maneuver

∙ KVF-1: Flat pressed for the enhanced stability in the needle driver

∙ CV-310: 300 series steel for a different feel

Common CABG Proximal Anastomosis Options

∙ CV-11: Comparable to the C-1

∙ CVF-11: Flat pressed for the enhanced stability in the needle driver

∙ CV-301: 300 Series steel for a different feel

∙ KV-11: A sharper tip for a difficult tissue

∙ KVF-11: Flat pressed for the enhanced stability in the needle driver

General Surgery Needles

For a given needle length, we offer a broad range of needle thicknesses and tip geometries to accommodate different clinical applications and surgeon preferences.

84 85

CardiovascularCardiovascular

*Suggested

CODE COMP LENGTH

taper point - ⅜ circle

CV-1/CVF-1 BV-1 9mmCV-310 BV 10mmCV/CVF BV 11mmCV-11/CVF-11 C-1 13mmCV-301 C-1* 13mmCV-307 BB* 16mmCV-15/CVF-15 BB 17mmCV-327 BB* 18mmCV-16 20mmCV-13 BB-1 22mmCV-18 TE-2 26mmCV-17 TE-2 32mmCV-19 50mm

taper point - ½ circle

CV-20 RB-3 10mmCV-337 RB-3 10mmCVF-21 TF 12mmCV-22/CVF-22 RB-2 13mmCV-330 RB-2 13mmCV-26 RB-1* 15mmCV-331 RB-1* 16mmCV-23/CVF-23 RB-1 17mmCV-316 SH-2 20mmCV-24 SH-2 20mmCV-25 SH-1 22mmCV-305 SH* 25mmV-20/VF-20 SH 26mmV-30 30mmCV-300 MH* 35mmV-26 MH* 37mm

CODE COMP LENGTHCODE COMP LENGTH

taper point - CardioCurveTM

CVL 11mmCVL-11 13mm

penetrating taper - ⅜ circle

YE-1 CC-1 13mmYE-7 V-4 18mm

penetrating taper - ½ circle

Y-31 V-5 16mmY-16 V-6* 20mmY-5 V-7 26mm

tapercutting - ⅜ circle

KV-1/KVF-1 CC 9mmKV-11/KVF-11 CC-1 13mmKV-15 V-4 17mmKV-26 V-26 26mm

tapercutting - ½ circle

KV-5/KVF-5 V-5 17mmKV-7 V-7 26mm

conventional cutting - ½ circle

SCC CCS 48mmSCC-1 CCS-1 60mm

conventional cutting - ⅜ circle

GCC-90 90mm

CODE COMP LENGTH

taper point - CardioCurve™

CODE COMP LENGTH

*Suggested

86 87

CuticularPlastic/Cosmetic

CODE COMP LENGTH conventional cutting - 3/8 circlePC-13 P-1 11 mm PC-10 PC-1 13 mmPC-11 PC-3 16 mmPC-12 PC-5 19 mm

premium reverse cutting - ⅜ circle

P-16 P-6 7mmP-10 P-1 11mmP-13 P-3 13 mmP-15 15 mmP-11 PS-3 16 mmP-12 PS-2 19 mmP-14 PS-1 24mmP-17 PSL 30mmP-18 PSLX 39mm

premium reverse cutting - ½ circle

P-21 P-2 9mmP-22 PS-5 13mmP-24 PS-4* 16mm

DermaX™ premium X cutting - ⅜ circle

DX-11 P-1 11mmDX-13 PC-1 13mmDX-16 PC-3 16mmDX-19 PC-5 19mm

DermaX™ premium X cutting - ½ circle

DXH-16 PC-12 16mm

CODE COMP LENGTH

conventional cutting - ⅜ circle

CODE COMP LENGTH

*Suggested

CODE COMP LENGTH reverse cutting - 3/8 circleC-1 C-2* 12mmC-12 FS-3 16mmC-13 FS-2 19mmC-14 FS-1 24mmC-15 FS 26mmC-16 FSL 30mmC-18 35mmC-17 FSLX* 39mmC-50 LS-1* 50mmGS-18 LS-1* 77mm

reverse cutting - ½ circle

C-21 M-1* 13mmC-26 J-1* 15mmC-22 J-1 18mmC-27 20mmC-23 X-1* 24mmC-25 CP-2* 30mm

cutting - straight

SC-11 SC-1* 11mmSC-4 24mmSC 44mmSC-1 TS* 51mmSC-2 KS 60mmSC-250 254mm

CODE COMP LENGTH

reverse cutting - ⅜ circle

CODE COMP LENGTH

*Suggested

88 89

General SurgeryGeneral Surgery

CODE COMP LENGTH

taper point - 1/2 circle

GS-23 CT-3 22mmHGS-23 MO-7 22mmGS-22 CT-2 27mmHGS-22 MO-6 27mmGS-20 CT-1* 34mmHGS-20 MO-5* 34mmGS-21 CT-1 37mmHGS-21 MO-4 37mmGS-24 CT 40mmHGS-24 MO-2 40mmGS-25 CTX 48mmGS-26 TP-1 65mmGS-27 XLH 76mm

taper point - straight

ST-4 ST-4 19mmTS-3 38mmST-2 44mmST-1 ST 51mmST 60mm

taper point - ski

SK 23mm

blunt taper point - Protect•Point™ - ½ circle

BTV-20 SHB 26mmBGS-21 CTB-1 37mmHBGS-21 MOB-4 37mmBTP-1 CTB-1 37mm

CODE COMP LENGTH

taper point - ½ circle

CODE COMP LENGTH

BGS-24 40mmBGS-25 CTX-B 48mmBTP-X CTX-B 48mmBGS-29 BP-1 65mmBGST-29 BP-1 65mmBGS-28 BP* 85mm

blunt point - Protect•Point™ ½ circle

BP-27 64mm

diamond point - ⅜ circle

KV-20 20mm

diamond point - ½ circle

KV-25 22mmKV-30 27mmKV-8 30mmKV-9 35mm

tapercutting - ½ circle

KV-34 V-34 37mmKV-37 V-37 40mmKV-40 V-40 48mmKV-56 V-56 60mm

CODE COMP LENGTH

*Suggested

90 91

OrthopedicMicrosurgery

taper point - ⅜ circle

MV-100-3 BV-100-3 4mmMV-50-3 BV-50-3 4mmMV-70-3 BV-75-3 4mmMV-135-3 BV-130-3* 4mmMV-70-4 BV-75-4 5mmMV-135-4 BV-130-4* 5mmMV-100-4 BV-100-4 5mmCV-345 BV-130-5 6mmMVF-135-5 BV-130-5 6mmMV-135-5 BV-130-5 6mmCV-351 BV-175-6 8mmMV-175-8 BV-175-6 8mmMVF-175-8 BV-175-6 8mmMV-175-9 BV-175-8 10mm

tapercutting - ⅜ circle

MVK-70-3 BV-75-3 4mmMVK-100-4 BV-100-4 5mm

UROLOGY

taper point - ⅝ circle

GU-46 UR-6 27mmHGU-46 UR-6 27mmGU-45 UR-5 37mmGU-44 UR-4 40mm

CODE COMP LENGTH


GS-18 77mm

reverse cutting -½ circle

GS-10 CP-2 26mmHOS-10 OS-4* 26mmGS-11 CP-1 37mmHOS-11 OS-6 37mmGS-12 CP 40mmHOS-12 OS-8 40mmGS-13 CPX 48mmHOS-14 55mm

tapercutting - straight

KS 24mm

CODE COMP LENGTH

*Suggested

92 93

OphthalmicOphthalmic


HE-10 5.6mm 130˚ G-6* 110˚ HE-6 7.4mm 110˚ G-6 110˚ HE-7 7.4mm 145˚ G-7 165˚ HE-5 8.6mm 135˚ HE-1 11.0mm 135˚ G-1 135˚ HE-3 13.0mm 155˚ G-3 155˚

reverse cutting - ½ circle

HE-2 8.6mm 205˚ G-2 180˚

inverted premium spatula - ¼ circle

SS-29 7.4mm 110˚ S-29 110˚

inverted premium spatula - ⅜ circle

SS-28 7.4mm 145˚ S-28 163˚

premium spatula - ⅙ circle

SS-1 5.6mm 60˚ SM-1 60˚

premium spatula - ¼ circle

SE-100-8 6.3mm 100˚ TG-100-8 97˚SD-1 8.1mm 90˚ RD-1 90˚SS-24 8.6mm 95˚ S-24 90˚SS-14 8.6mm 115˚ S-14 112˚

premium spatula - 5/16 circle

SE-110-11 8.0mm 110˚ S-29 110˚(previously SLO-110-11)

premium spatula - ⅜ circle

SE-140-6 6.3mm 140˚ TG-140-6/CS-140-6 140˚SE-140-8 6.3mm 140˚ TG-140-8/CS-140-8 140˚SE-140-9 6.5mm 140˚ TG-140-8 137˚

07/17/99 Converted from D&G format.10/12 Added DA Needle07/07/05 Updated per Tim Kosa

Curvature = 130˚Radius = .102”Length = .220”Wire Diameter = .012”

3/8 CIRCLE6 mm

HE-10

3/8 6 mm

HE-10CUTTING

130∫Wire Dia.

.012"

.102"

3/8 6 mm

HE-10CUTTING


07/08/05 Updated per Tim Kosa

1/2 CIRCLE7 mm

HE-7

HE-7CUTTING

1/2 7 mm

HE-7CUTTING

1/2 7 mm

165?

Wire Dia..012"

.116"

1/2 CIRCLE9 mm

HE-2

Curvature = 216˚ (180˚ + Straigh Barrel)Radius = .095”Length = .340”Wire Diameter = .017”

07/08/05 Update per Tim Kosa

HE-2CUTTING

1/2 9 mm

HE-2CUTTING

1/2 9 mm

180∫

Wire Dia..017"

.095"

Curvature = 135˚Radius = .184”Length = .433”Wire Radius = .017”

07/08/05 Update per Tim Kosa

3/8 CIRCLE11 mm

HE-1

HE-1.NONE HE-1.HE-1

HE-1CUTTING

3/8 11 mm

HE-1CUTTING

3/8 11 mm

135∫

Wire Dia..017"

.184"

3/8 CIRCLE13 mm

HE-3


Curvature = 155°Centerline Radius = .189”Inside Radius = .177”Length = .512Wire Diameter = .021

HE-3CUTTING

3/8 13 mm

HE-3CUTTING

3/8 13 mm

155∫

Wire Dia..021"

.189"

1/4 CIRCLE8 mm SD-1

08/03/05 Updated per Tim Kosa08/23/05 Updated per Tim Kosa


SD-1PREMIUM SPATULA

SD-1PREMIUM SPATULA

1/4 8 mm 1/4 8 mm

90?Wire Dia.

.012"

.203"

1/4 CIRCLE9 mm SS-24

4/18/01 Needle symbol changed per Mrkg04/13/95 Updated to Fungible format07/08/05 Updated per Tim Kosa

Curvature = 90˚Radius = .216”Length = .340”Wire = .017”

SS-24PREMIUM SPATULA

1/4 9 mm


1/4 9 mm

90∫Wire Dia..017"

.216"






1/4 9 mm 1/4 9 mm

115∫Wire Dia.

.017"

.170"

1/6 CIRCLE6 mm SS-1



SS-1PREMIUM SPATULA

SS-1PREMIUM SPATULA

1/6 6 mm 1/6 6 mm

60∫Wire Dia.

.012"

.210"

HE-6CUTTING

3/8 7 mm

HE-6CUTTING

3/8 7 mm

3/8 CIRCLE45 mm

HE-6



110∫Wire Dia.

.012"

.162"

CODE LENGTH CURVATURE COMP

1/2 CIRCLE8 mm SS-2

12/19/01 Needle redrawn to Eng. specs.4/18/01 Needle symbol changed per Mrkg04/13/95 Updated to Fungible format07/08/05 Updated per Tim Kosa


SS-2PREMIUM SPATULA

1/2 9 mm

SS-2PREMIUM SPATULA

200∫

Wire Dia..017"

.098"

1/2 9 mm



Curvature = 170˚Radius = .094”Length = .290”Wire = .012”


1/2 7 mm


1/2 7 mm

170∫

Wire Dia..012"

.094"

premium spatula - ½ circle

SE-160-4 5.5mm 160˚ TG-160-4/CS-160-4 160˚SE-160-6 5.5mm 160˚ TG-160-6/CS-160-6 160˚SE-160-8 5.5mm 160˚ TG-160-8/CS-160-8 160˚SE-160-9 5.5mm 160˚ TG-160-8/CS-160-8 160˚SE-175-6 7.0mm 175˚ TG-175-6/CS-175-6 175˚SE-175-8 6.9mm 175˚ TG-175-8/CS-175-8 175˚SS-22 7.4mm 170˚ S-22 170˚SS-2 8.6mm 200˚ S-2 180˚

premium spatula - compound curve

SE-CC-6 4.8mm 130˚ TG6-S

CODE LENGTH CURVATURE COMP

FREQUENTLY ASKED QUESTIONS

(Handling Objections)

96 97

FAQ/Handling ObjectionsFAQ/Handling Objections

Polysorb™ Suture BSA

Q: Polysorb™ suture doesn’t have four weeks of tensile strength and is weaker than Vicryl™*.

A: Polysorb™ suture is stronger when you need it during the critical wound healing period.27 Use tensilometer to demonstrate out-of-package strength of Polysorb™ suture.

Q: Polysorb™ suture feels “slick.”

A: Surgeon notices the tighter braiding. Explain the smaller interstices and how it means that there are fewer chances of an infection.

Q: Polysorb™ suture ties differently.

A: With Polysorb™ suture made of more filaments woven tighter, it will hold its rounded body design. Refer to the Polysorb™ suture brochure to note the design differences, strength, absorption profile, chemical make-up of the two sutures.27,56 Neutralize differences and speak to similarities. Polysorb™ suture is designed with specific performance measures in mind: strength advantage, smooth run down and tissue passage along with smallest interstices.

Q: Polysorb™ suture tangles in the packaging.

A: Because of the figure eight design, you can pull a Polysorb™ suture strand into the corner of a package and cause tangling. Do an in-service to remove strand at a 45 degree angle and explain how the strand is placed in the package. Scrub techs do understand and will replicate your demonstration.

Velosorb™ Suture

Q: Velosorb™ suture’s absorption profile is different than Vicryl™* Rapide.

A: Velosorb™ suture absorbs in 40 to 50 days and Vicryl™* Rapide absorbs in 42 days. The key to absorption profile is both sutures lose all strength by 14 days.

Caprosyn™ Suture

Q: The Caprosyn™ suture product unravels.

A: Set expectations — Must throw an extra throw with Caprosyn™ suture. Don’t cut at the knot and use surgeon’s throw on first throw.

Biosyn™ Suture MSA

Q: Biosyn™ suture splits more than Monocryl.™*

A: Monocryl™* is fully absorbed in 91 to 119 days, whereas Biosyn™ suture is fully absorbed in 90 to 110 days.

Q: Monocryl™* is stronger than Biosyn™ suture.

A: Biosyn™ suture is stronger during the critical wound healing period and has one extra week of strength.33,34

Q: Biosyn™ suture breaks when repositioned.

A: With Biosyn™ suture, there’s no need to reposition the throw. Just run down the knot and the step is finished.

Q: Biosyn™ suture feels “rougher” or “stiffer” than Monocryl.™*

A: Due to an additional week of strength, Biosyn™ suture has a more robust feel than Monocryl™*. Biosyn™ suture also provides excellent first throw knot security, whereas Monocryl™* knots may need to be repositioned.33,34

Q: Biosyn™ suture breaks.

A: Strength test on tensilometer. Strand may pop on instrument tie. Monocryl™* performs similar. Many times Biosyn™ is already being used by the surgeon, rebranded as V-Loc™ 90 knotless wound closure device.

Maxon™ Suture

Q: PDS™* II is stronger than Maxon™ suture.

A: Maxon™ suture is stronger than PDS™* II during the critical wound healing period.

Q: PDS™* II absorbs differently than Maxon™ suture.

A: PDS™* II takes between 182 and 238 days to absorb, while Maxon™ suture only takes 180 days. Sell benefits.35,36

Q: Maxon™ suture seems to have more memory than PDS™* II.

A: This can be minimized by recommending the scrub tech run the suture through their fingers prior to handing the suture to the surgeon.

Q: Medtronic does not offer antimicrobial suture.

A: We made a conscientious decision not to offer triclosan-impregnated sutures in our line. There is little evidence that this coating is effective and there is mixed information in the public domain concerning this.

Q: Medtronic has a multipack of 5 versus the Ethicon pack of 8.

A: This keeps counts consistent with everything else in the OR, which are in packs of 5. We are also sticking to AORN guidelines and keeping all counts the same. If cost comes into the conversation, let them know that Medtronic suture is measured as cost per strand.

98 99

Surgipro™ Suture & Surgipro™ II Suture

Q: Surgipro™ suture frays and breaks more than Prolene.™*

A: Over time, improvements were made to the Surgipro™ II suture to reduce fracturing and fraying.

Q: Why is Surgipro™ II suture more slippery than Prolene™*?

A: Although Surgipro™ II suture is more slippery than Prolene™*, both sutures accommodate for same number of throws (5 to 8 throws) to secure a knot.

Q: Too much memory (Biosyn™ suture, Maxon™ suture, Surgipro™ suture, etc.) in suture strands.

A: In many cases, the “racetrack” or “flat pack” packaging will eliminate this. In 2007 NuPack was designed to reduce the amount of suture memory. Across all suture lines, it is a matter of communicating to the scrub tech that memory needs to be removed from the suture prior to use. It is not an issue with the suture; it is merely a result from packaging and can easily be avoided by preparing the suture on the mayo stand.

Q: Surgipro™ suture feels different/slippery/delicate.

A: Most of the time, in blind studies, an individual cannot tell the difference between Surgipro™ suture and Prolene™*. Over time, improvements were made to the product line. For example, the PEG additive allows for better handling characteristics to the suture.

Ti-Cron™ Suture

Q: Ti-Cron™ suture is weaker than Ethibond™* Excel.

A: Several Ethibond™* Excel sizes do not meet USP standard for diameter. It is oversized for several sizes or lots of suture. The difference is noticeable. Ti-Cron™ suture has been used for both valve and orthopedic specialties for decades. Follow up with this set of questions: “Can you break it by hand?” (This reinforces its strength.) “Will there be greater forces on the valve than that?” (Probably not.)

Q: Ti-Cron™ suture feels different than Ethibond™* Excel.

A: Ti-Cron™ suture is made of silicone-impregnated coating designed for excellent handling and pliability. Ethibond™* Excel is made of PBA coating.

Q: Ti-Cron™ suture feels smaller in USP (or thinner) than Surgidac™

A: Explain USP sizing and how Ti-Cron™ suture is true to the USP scale.

Q: Ti-Cron™ suture 2-0 V-20 doesn’t match SH needle.

A: Suggest they switch to the CV305 needle. The surgeon will love it.

Q: Ti-Cron™ suture is not as long as Ethibond™*

A: Ethicon’s package and label information does not match the actual length of the strands. Do a side-by-side comparison of the strands. Ask why Ethicon labels read 18 inches when the strands are 20 to 21 inches. Ask, “I do not understand. Do you?”

Silk Suture

Q: Silk suture breaks too easily.

A: Silk suture is of an organic makeup and inherently a weak fiber. We recommend Surgilon™ suture if a stronger suture is desired.

Novafil™ Suture/Vascufil™ Suture

Q: Q: Are Novafil™ and Vascufil™ sutures stretchy?

A: The elasticity is an inherent property of polybutester suture (Novafil™ suture/Vascufil™ suture). This feature allows for improved handling characteristics, such as tighter and smaller knots that can have less chance of bacterial infection. It is a soft and supple suture that is pliable. The inert aspect of the suture avoids tissue reactivity, and its hydrophobic nature prevents the suture from swelling in conditions like edema. As a result, the suture is creep resistant and can likely be a better pull-out suture.

Steel Suture

Q: How does the USP size of Steel suture correspond to the gauge of Steel?

A: When a customer refers to a “gauge” they are referring to the Brown and Sharpe (BS) gauge of Steel. The following BS gauge correlates to USP size: BS 18 = USP 7; BS 19 = USP 6; BS 20 = USP 5; BS 22 = USP 4; BS 23 = USP 3; BS 24 = USP 2; BS 25 = USP 1; BS 26 = USP 0; BS 28 = USP 2-0; BS 30 = USP 3-0; BS 32 & 34 = USP 4-0; and BS 35 = USP 5-0.

Q: If Steel suture was used on a patient, can the patient be given a MRI?

A: Stainless steel sutures are compatible with MRI/NMR procedures having static magnetic fields of 3.0 Tesla or less. However, there may be some slight image distortion.

Q: What is the percentage of nickel found in Steel sutures?

A: There is 10% to 14% nickel in 316L stainless steel sutures.


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Monofilament Sutures

Q: There’s a lot of memory in the monofilaments.

A: Review taking out memory by pulling on the strand. Have each person do it. Speak to the difference in package designs. We put NuPack™ where needed and have flat packs for CV. Nylon is the cheapest material and will not add cost to the packaging when simple pulls of the strand while loading the needles eliminate most of the issue. Pass an accordion shaped strand as a demonstration. “Would you hand a suture to a surgeon to tie in a drain like this?” Just take the two seconds to pull on the strand with the needlesuture junction protected.

Differences in Brand Names Among Sutures and Needles

Q: Brand names of needles and suture materials for Medtronic are different.

A: Good conversion charts have been made, displayed and reduced in the form of pocket guides. The staff can make or break an evaluation and can easily influence a surgeon. So please start developing the relationship. Talk to the similarity of colors for products. Help team learn about our suture and needles (how long did it take you to learn the Medtronic suture and needle names – remember our CBTs and Exams during sales training?).

Needles

Q: The CV needles roll in needle holders.

A: We have both CV and CVF needle options. The CVF (flat pressed) needles are designed to give better stability in the needle driver.

Q: CV needles are not sharp enough.

A: We receive a wide variety of feedback on our CV needles. The great thing is that we provide numerous options depending on preference and/or patient situation. Moving to our MV needle allows a finer needle with sharper penetration (if taper needle is preferred) and our KV series is great for calcified tissue or when a penetrating taper is needed.

Q. The CV-1 is too thick.

A. Please let the surgeon try the MV-175-8 or MV-175-9.

Q: The GS series needles are bulkier than CT.

A: Have the customer try the V series needles. They have the same dimensions, just finer needles. This could be a common solution for the V-Loc™ device users that communicate this.

Q: P series needles are weaker.

A: Have the surgeon use C needles.

Q: P series needles are not sharp enough.

A: Have the surgeon try DermaX™ or SBE needles if available.

Q: The P-needle is too “flimsy” (or delicate) versus the C-needle is too bulky.

A: The C series needle is more of a “work horse” needle, and the P series is for more delicate handling and finer suturing with less tissue trauma. Please try to keep GS, ortho, and residents to the C series and plastics to the P series if possible (sometimes the customer just needs to try both).

Q: The V-20 bends or is not sharp enough.

A: Have the surgeon try a Surgalloy™version if available. Other alternatives are the GS-22, HGS-22, KV-30, GS-10 or HOS-10.

V-Loc™ Device

Q: The V-Loc™ device is not bidirectional.

A: The unidirectional design of the V-Loc™ device is intuitive, and surgeons do not have to change technique to use it.

Q: The V-Loc™ device is too expensive.

A: The V-Loc™ device has been proven to reduce dermal closure time as well as reduce number of sutures used when compared with traditional suture.1-3

Q: Ethicon is coming with their unidirectional barbed suture.

A. Ethicon’s Stratafix™* Spiral is the same as Quill™* with Ethicon needles. The V-Loc™ device has 2.5 times more barbs, is proven to be stronger, and is the reliable and consistent market-leading barbed suture.4-6


102 103

Notes Notes

1. Surgipro™ II Brochure - P120069.

2. Surgipro™ II Instructions for Use.

3. Prolene™* Instructions for Use.

4. Ti-Cron™ Brochure - P120070.

5. Ti-Cron™ Instructions for Use.

6. Ethibond™* Excel Instructions for Use.

7. Fray Memo, internal Research and Development.

8. Surgipro™ II Instructions for Use (for chemical composition).

9. Vascufil™ Instructions for Use (for chemical composition).

10. Vascufil™ Brochure - P120059.

11. Baumgartner N, Dobrin P, Morasch M, Dong QS, Mrkvicka R. Influence of suture technique and suture material selection on the mechanics of end-to-end and end-to-side anastomoses. J Thorac Cardiovasc Surg. 1996;111:1063-1072.

12. Pronova™* Instructions for Use.

13. Pinheiro ALB, Lisboa de Castro JF, Thiers FA, et al. Using Novafil™: would it make suturing easier? Braz Dent J. 1997;8(1):21-25.

14. Novafil™ Instructions for Use.

15. Monosof™/Dermalon™ Instructions for Use.

16. Ethilon™* Instructions for Use.

17. Surgicdac™/Dermalon™ Instructions for Use.

18. Mersilene™* Instructions for Use.

19. Chromic Gut/Plain Gut Instructions for Use.

20. Surgical Chromic Gut/Surgical Gut Plain Instructions for Use.

21. Surgilon™Instructions for Use.

22. Nurolon™* Instructions for Use.

23. Sofsilk™ Instructions for Use.

24. Perma-Hand Silk™* Instructions for Use.

25. Steel™ Instructions for Use.

26. Flexon™ Instructions for Use.

27. Internal R&D Testing Service Report CMP-5347, 2013.

28. Polysorb™ Instructions for Use.

29. Vicryl™*/Vicryl PLUS™* Instructions for Use.

30. Velosorb™ Fast Instructions for Use.

31. Vicryl™* Rapide Instructions for Use.

32. Caprosyn™ Instructions for Use.

33. Biosyn™ Instructions for Use.

34. Monocryl™*Instructions for Use.

35. Maxon™ Instructions for Use.

36. PDS™* and PDSM™* II Instructions for Use.

References37. Internal R&D Testing Service Report CMP-

3257, 2011.

38. Capla JM, Rubin JP, Dunn R, et al. A prospective, randomized study to evaluate dermal closure with an absorbable barbed suture (V-Loc™ 90 device or V-Loc™ 180 device) as compared to a conventional absorbable suture 10.2011.

39. Brown S. Utilization of a porcine model to demonstrate the efficacy of an absorbable barbed suture for dermal closure. UTSW, 06.2009.39.

40. Based on Medtronic V-Loc 180™ Absorbable Wound Closure Device Time Study. Single layer closure with V-Loc™ 180 device compared to double layer closure using standard suture methods. Grant R. Argent Global Services, Data on File.

41. Zaruby J, Gingras K, Taylor J, et al. An in vivo comparison of barbed suture devices and conventional monofilament suture for cosmetic skin closure: biomechanical wound strength and histology. Aesth Surg J. 2011;31:232-240.

42. V-Loc™ 90 Instructions for Use.

43. V-Loc™ 180 Instructions for Use.

44. V-Loc™ PBT Instructions for Use.

45. Stratafix™* Spiral PGA-PCL Instructions for Use.

46. Stratafix™* Spiral PDO Instructions for Use.

47. Stratafix™* Symmetric PDS™* Plus Instructions for Use.

48. Stratafix™* Spiral polypropylene Instructions for Use.

49. SwiftSet™ Instructions for Use.

50. Dermabond™ Advanced Instructions for Use.

51. Dermabond™ Mini Instructions for Use.

52. Coronary Artery Bypass Graft Procedural Brochure - P130033.

53. Valve Replacement Procedural Brochure - P130036.

54. Abdominal Aortic Aneurysm Procedural Brochure - P130034.

55. Femoral-Popliteal Bypass Procedure Brochure - P130035.

56. Internal R&D Testing Service Report CMP-3257, 2013.

57. Polysorb™ Brochure 11.10 - P100198.

58. Rodeheaver, G., Ph. D., et al. An Innovative Absorbable Coating for the Polybutester Suture. 2005. Pg 6-11

IMPORTANT: Please refer to the package insert for complete instructions, contraindications, warnings and precautions.

© 2018 Medtronic. All rights reserved. Medtronic, Medtronic logo and Further, Together are trademarks of Medtronic. ™* Third party brands are trademarks of their respective owners. All other brands are trademarks of a Medtronic company.18-weu-wc-reference-guide-2276926

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