CN101296661B - 带倒刺的编织缝合线 - Google Patents

带倒刺的编织缝合线 Download PDF

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CN101296661B
CN101296661B CN2006800234436A CN200680023443A CN101296661B CN 101296661 B CN101296661 B CN 101296661B CN 2006800234436 A CN2006800234436 A CN 2006800234436A CN 200680023443 A CN200680023443 A CN 200680023443A CN 101296661 B CN101296661 B CN 101296661B
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wire
band
suture assemblies
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CN101296661A (zh
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J·P·科利尔
D·老林德
J·G·纳夫罗茨基
K·赫里斯托夫
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Johnson and Johnson Medical SAS
Ethicon Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166Sutures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2409Support rings therefor, e.g. for connecting valves to tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0404Buttons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472Multiple-needled, e.g. double-needled, instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B2017/06057Double-armed sutures, i.e. sutures having a needle attached to each end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166Sutures
    • A61B2017/06176Sutures with protrusions, e.g. barbs

Abstract

本发明提供了一种缝合线组件及其制造方法。该缝合线组件包括多个互相缠绕的不带倒刺的丝状元件,以及至少一个带倒刺的丝状元件,该带倒刺的丝状元件具有纵向轴以及多个以相对于该纵向轴小于90度的第一方向向外伸出的倒刺。依照示例性实施方案,该至少一个带倒刺的丝状元件可以沿着其长度与该多个不带倒刺的丝状元件缠绕,并且该多个倒刺向外伸出超过了该不带倒刺的丝状元件,或者该至少一个带倒刺的丝状元件的主要外部外围可以包含在缠绕着的不带倒刺的丝状元件中,而该多个倒刺延伸穿过该多个不带倒刺的丝状元件并且从该多个不带倒刺的丝状元件向外伸出。

Description

带倒刺的编织缝合线
发明领域
本发明一般地涉及外科缝合线领域,并且更具体地涉及一种具有带倒刺编织构造的外科缝合线组件。
发明背景
众所周知许多伤口和外科切口用某种外科缝合线来闭合。缝合线通常也运用于许多其它的外科应用中,比如修补损坏或切断的肌肉、血管、组织等等。典型地是将缝合线一端系于针上,然后拉着针穿过组织以形成一个或多个圈使组织固定在一起,而随后将缝合线打结以便保持组织结合在一起。已知的外科缝合线包括单丝缝合线以及编织缝合线。同样已知的是在单丝缝合线上制造倒刺以起到防止缝合线在组织中的滑动的作用,其中的一个例子在美国专利No.5,931,855中有描述。这些带倒刺的单丝缝合线已经运用于包括额头及面部整容在内的多种整容手术中。
然而,带倒刺的单丝缝合线却随着特殊手术所需固定强度的增加而变得逐渐倾向于失灵。由于带倒刺的缝合线典型地通过使用某种刀刃在缝合线上制造切口或槽而形成,该槽作用为压力集中点。在巨大负荷作用在缝合线上的应用中,即,在心脏瓣膜修补或置换术以及整容应用中,所给的倒刺可能失灵或开始从缝合线轴体上剥离。一旦这种情况发生,由于缝合线材料的纤维特性,倒刺可能沿着缝合线上的有效长度从缝合线轴体剥离开从而引发灾难性事故。
单丝缝合线都需要打一个或多个结来将该缝合线固定在适当位置。打结是一项劳动密集型的工作,并且对外科手术的总时间有重大影响。此外,在一些手术中,存在这种结本身就是不利的。例如,在二尖瓣置换术中,缝纫环围绕着新的瓣膜,并且用来将该瓣膜缝纫在瓣膜环面的适当位置。典型的手术可能用到20条缝合线,并且这将导致大约160个投结(knot throw)。除了耗时之外,该数量的结能对该环的轮廓起妨碍瓣膜功能的反作用。
因而,需要提供一种具有增强的固定强度和/或减少或消除打结需要的缝合线。
发明概述
本发明提供了一种缝合线组件,其具有多个互相缠绕的不带倒刺的丝状元件,以及至少一个带倒刺的丝状元件,该带倒刺的丝状元件具有纵向轴以及多个以相对于该纵向轴小于90度的第一方向向外伸出的倒刺。该至少一个带倒刺的丝状元件沿着其长度与该多个不带倒刺的丝状元件缠绕,并且该多个倒刺向外伸出超过了该不带倒刺的丝状元件。
本发明还提供了一种缝合线组件,其具有多个互相缠绕并具有纵向轴的不带倒刺的丝状元件,以及至少一个带倒刺的丝状元件,该带倒刺的丝状元件具有纵向轴、主要外部外围以及多个以相对于该纵向轴小于90度的第一方向向外伸出超过该主要外部外围的倒刺。该至少一个带倒刺的丝状元件的主要外部外围被包含在缠绕着的不带倒刺的丝状元件中,其中该多个倒刺延伸穿过该多个不带倒刺的丝状元件并且从该多个不带倒刺的丝状元件向外伸出。
本发明还提供了另一种缝合线组件,其具有多个互相缠绕的不带倒刺的丝状元件,以及至少一个带倒刺的丝状元件,该带倒刺的丝状元件具有纵向轴和主要外部外围,并且具有以相对于该纵向轴小于90度的第一方向向外伸出超过该主要外部外围的第一组多个倒刺。该不带倒刺的丝状元件基本上围绕着该至少一个丝状元件的主要外部外围,并且其中该多个倒刺向外伸出超过了所述不带倒刺的丝状元件。
本发明还提供了一种制造缝合线组件的方法,所述方法包括在丝状元件上形成多个倒刺,使多个不带倒刺的丝状元件缠绕以形成具有纵向轴的不带倒刺的组件,以及将该带刺的丝状元件插入到该不带倒刺的组件中以形成缝合线组件,其中该多个倒刺从该不带倒刺的组件向外伸出。
本发明还提供了另一种制造缝合线元件的方法,所述方法包括在丝状元件上形成多个倒刺,以及将该带倒刺的丝状元件与多个不带倒刺的丝状元件缠绕以形成缝合线组件,其中该多个倒刺从该不带倒刺的组件向外伸出。
通过以下对具体实施例详细的描述并在阅读中结合附图,本发明的这些以及其他的目的、特征和优点将变得明显。
附图简述
图1是根据本公开内容的缝合线组件的一个实施方案的透视图;
图2a是具有交错倒刺的一个实施方案的侧视图;
图2b是具有对齐倒刺的另一实施方案的侧视图;
图2c是具有两组相对的倒刺的另一实施方案的侧视图;
图3示出了用来制造示例倒刺的切削尺度;
图4-8示出了用来制造本公开内容的缝合线组件的方法的各个步骤;
图9a-9d示出了用本公开缝合线组件在示例心瓣膜置换术中的各个步骤;以及
图10和11示出了根据本发明公开内容的缝合线组件的各种实施方案。
发明详述
现在参考图1,缝合线组件1的优选实施方案包括将在下面更进一步描述的至少一个带倒刺的丝状元件2和多个编织或缠绕的不带倒刺的丝3。这里采用的术语“编织的”意思为以任意方式缠绕。该带倒刺的丝状元件可以由任意适合的不可吸收的材料例如聚丙烯,或可吸收材料例如聚(乙交酯-丙交酯)或聚(乙交酯-ε-己内酯)来制造。可选地,该带倒刺的丝状元件能够由形状记忆聚合物形成,如基于聚氨酯的聚合物,使得暴露在形状记忆聚合物的转变温度之后促进倒刺的展开。在示出的实施例中,该带倒刺的丝状元件具有基本上比不带倒刺的丝更大的横截面,并且在优选的实施方案中,该带倒刺的丝状元件由0号的缝合线形成,而与之结合的不带倒刺的丝状元件是2/0号的缝合线。尽管该带倒刺的丝状元件示为具有基本上为圆形的横截面,但是也可以采用其它横截面,诸如三角形、矩形等等。这里用到的术语“主要外部外围”p指的是不存在倒刺的缝合线组件的横截面的外围,例如沿着图1中的线A-A。如图2a中更详细所示,该带倒刺的丝状元件2基本上沿着纵向轴x-x设置,并且具有多个倒刺4以相对于该纵向轴成小于90度的角度α为第一方向向外伸出。
如图2a中所示,该倒刺4可以存在于沿着该丝状元件2基本上整个长度L上,或者是只存在于沿着该长度上的一部分。此外,倒刺相对于丝状元件2的任何合适的构造也能够运用于本发明的缝合线组件上。例如,倒刺4可以以任何方式交错在丝状元件的周围(图2a)或如图2b所示沿着丝状元件对齐。如图2c所示,丝状元件长度的一部分上也可以包括以朝向相对于丝的纵向轴大于90度的第二方向的第二组倒刺4a。下面将更详细地描述图2c中的构造为有利的用途。
倒刺可以依照任何需要的构造被排列在单丝上,并且能够采用任意合适的方法来形成,包括那些本领域众所周知的方法。这些方法可以包括喷射造型、冲压、用刀具或激光切削、压制成形等等。依照优选的方法,倒刺通过用任意适合的切削刀刃或刀具切削单丝缝合线而形成。所需数量的锐角切口被直接构造进缝合线的体内。图3示出了示例切口,其中切削刀刃30首先相对于纵向轴x-x以大约30度角的角度β切入到单丝32中,深度大约0.08英寸,随后以大约0度角的角度在单丝内进一步切削大约0.024英寸的距离。为了完成这次切削,该单丝通常以本领域中已知的方式放置并保持在切削钳等上。模板也可以用来帮助引导该切削刀刃。
在制造了带倒刺的单丝和缠绕的不带倒刺的丝之后,缝合线组件1由结合该带倒刺的和不带倒刺的丝来形成。如图4所示,依照用于实现其的一个示例方法,带倒刺的单丝的一端40被插入针的远端44(相对于尖端44)的中空凹进42中。缝合线的端部40可以用任意适合的方法来保持在针的中空凹进中的合适位置,例如通过在缝合线周围卷曲针的末端或采用粘合剂等等。此外,作为选择,该缝合线的末端可以插入到套管、护套或其它任意适合的装置中,以此将其拉过在下面描述的编织缝合线。后者的装置可以额外作用以在倒刺被拉过编织丝时保护这些倒刺。
然后如图5所示,针50被用来拉着带倒刺的单丝52穿过不带倒刺的缠绕单丝54的中心。然后如图6所示,移除该针(或套管),留下组件1。倒刺4将趋向于从带倒刺的单丝向外伸出,其中一些倒刺向外伸出超过了不带倒刺的缠绕单丝的主要外部外围p。然而为了进一步加强倒刺的凸出,如图7所示需要将该组件缠绕于心轴60上。然后如图7中箭头所示施加牵力,这使得倒刺如图8所示的那样完全凸出。为了将带倒刺单丝的末端稳固地固定在不带倒刺的缠绕丝中,随后可以施加热、压力以及/或粘合剂使得它们之间连接。
在另一个的实施方案中,该不带倒刺的单丝可以通过直接与带倒刺的丝编织或是直接与多个带倒刺的丝编织与该带刺的丝结合。为了帮助防止组件松开和/或促进缝合线组件通过组织等等,一个或多个单丝能够被涂布或被加热以将该组件固定一起。例如,采用已加热的印模(die)等可以在缝合线组件的每个末端加热。示范性的涂层可以包括聚酯树脂或聚醋酸乙烯酯。
上面描述的缝合线组件适合运用于多种外科手术中,包括运其中将假体组织固定到组织的外科手术。示例手术为心瓣膜置换术,现在将详细地描述其中之一。当前的二尖瓣置换术中,通常通过完全的正中胸骨切开术,在病人的胸部形成一条外科切口。然后通过将套管插入到上下腔静脉来静脉引流以及插入到上行主动脉来动脉灌注,其中将套管与心肺机相连,以建立心肺旁路。一旦已经实现了心肺旁路和心脏停顿,通过用缝合线或回收设备来进入左心房并收回心房组织使二尖瓣暴露出来。尽管也可以采用其他的方法,但通常在左心房的右侧、右肺静脉的前面进行心房切开术(切口进入)。
一旦获得通路以及所评估的状态,采用几种不同的将假体固定到环面上的公知技术的一种进行瓣膜置换,所述技术包括断续褥式缝合术、连续行进缝合术、断续简单(非褥式)缝合术、或专用夹或钉。最普通的技术就是断续缝合术,其中一种这样的技术示出在图9a-9d中。依照本发明的多个双针缝合线组件900用来进行修补。如图9b中最优所示,该缝合线组件包括第一部分910,以及第二部分914,其中沿着第一部分910形成面向一个方向的第一组倒刺912,而沿着第二部分914形成面向优选朝向第一组倒刺的第二方向的第二组倒刺916。
在假体接近瓣膜环面908之前,设置所有的针脚904为穿过人工瓣膜906。使用了采用了本发明的缝合线组件的断续的褥式针脚,并优选采用交替的颜色。Compressed Teflon(压缩的特富龙)毡纱布902可以用来加强修补。该褥式针脚设置为穿过假体的缝纫环,然后在后部穿过该二尖瓣环面,与腱索(chordaetendineae)联合。然后分别穿过该Teflon
Figure S2006800234436D00053
(特富龙
Figure S2006800234436D00054
)纱布。最初的针脚优选设置在环面的上部,以所示的逆时针方式向下操作。
在完成在二尖瓣环面后半部上的缝合之后,瓣膜假体被拉动到右侧,并且如图9b所示,针脚设置为穿过环面的前面部分,开始向上并且以顺时针的方式向下操作。针脚从心房表面开始穿过二尖瓣环面,然后穿过假体的缝纫环。牵引缝合线暴露其后的针脚,并且将Teflon(特富龙
Figure S2006800234436D00056
)纱布预置在双针缝合线中央。在布置了所有的缝合线后,如图9c所示随着瓣膜假体滑过这些缝合线进入到二尖瓣环面中,对缝合线施加了强牵力。
在用现有技术缝合线的传统置换术中,当时每条缝合线都以与设置它们相同的顺序系上,从后开始并以逆时针方式操作。前面的缝合线然后以顺时针方式打结完成修补。因而,典型的二尖瓣置换术包括多个缝合结,数量大约为12-16(假定每个结大约5-7个投则大约要60到112个投结(knot throw)),其中每个结要花费大约20-30秒来完成。此外,每个结必须将环稳固并紧密地固定在环面组织上以防止渗漏。然而,利用所描述和示出的带倒刺的缝合线以及带倒刺的缝合线组件,由于打结所需的时间和难度减少了,该瓣膜置换术大大地简化。如图所示,该缝合线组件的不带倒刺的部分保证了人工瓣膜能够轻易地落入相对于瓣膜环面的位置。然而,紧接着最终定位该环,随着人工瓣膜滑动通过缝合线组件的带倒刺区域,其变得固定了。如果需要,接受额外穿刺通过缝纫环以进一步固定该环。
图10更详细地示出了在图9a-9d所阐明的瓣膜置换术中可以采用的本发明的缝合线组件。在图10中,缝合线组件102伸展在两根缝合针104之间。第一部分长度106包括以第一方向向外伸出的第一组倒刺108,第二长度110包括以所示的朝向第一组倒刺的第二方向向外伸出的第二组倒刺112。该编织的缝合线组件可以以如上所述的各种方式形成。图11示出了缝合线组件150,其只有一端系在单根针152,而第二端是不带倒刺的长度。在二尖瓣置换术中,这样的设计要求外科医生在将针刺穿环面周围的组织之前穿过缝纫环,随后在将该环固定紧靠在该组织之前将针回穿过该环。
测试结果已经表明采用本发明的缝合线组件对比于带倒刺的单丝在固定强度方面有显著改进。下面列出的图表显示出了这些结果。左边的第一柱条代表0号的双臂式带倒刺的PROLENE缝合线(美国新泽西州Somerville市的Ethicon有限公司制造的聚丙烯缝合线)在拉直穿过(垂直的)DACRON
Figure S2006800234436D00061
缝纫环直到倒刺与缝纫环啮合时的固定强度。一旦啮合,需要2.5Ibs.(+/0.6)的力才能取出该缝合线。下一柱条代表了缝合线组件的固定强度(4.9Ibs.+/-1.0),该缝合线组件在同样由Ethicon有限公司制造的2/0号ETHIBOND缝合线,其是编织的聚(对苯二甲酸乙二醇酯)缝合线,中具有上文同样的带倒刺缝合线。第三个柱条代表了当用所描述的缝合线组件额外咬合(bite)缝纫环时所达到的增加的固定强度(14.1+/-0.2)。最后,右边最后的柱条代表了具有8个投结的2/0号的ETHIBOND缝合线的固定强度(12.5+/-2.1)。可以看出,该带倒刺的编织缝合线组件的固定强度比带倒刺的单丝的固定强度大96%,当接受额外的咬合时固定强度增加了188%。此外,就一个咬合而言,其固定强度大于具有8个投结的编织的缝合线。因此,可以实现较高的固定强度而不具有系多个结所涉及的时间和难度。
Figure S2006800234436D00071
尽管在此参照附图已经描述了本发明的示意性实施例,应当理解本发明不局限于这些精确的实施例,而本领域技术人员可以在此对其所进行改变和修正,而不脱离本发明的范围和精神。

Claims (32)

1. 一种缝合线组件,其包括:
多个互相缠绕的不带倒刺的丝状元件;
至少一个带倒刺的丝状元件,其具有纵向轴以及多个以相对于该纵向轴小于90度的第一方向向外伸出的倒刺;
其中该至少一个带倒刺的丝状元件沿着其长度上与多个该不带倒刺的丝状元件缠绕,并且其中该多个倒刺向外伸出超过该不带倒刺的丝状元件。
2. 如权利要求1所述的缝合线组件,其中该不带倒刺的丝状元件和/或该带倒刺的丝状元件由可吸收的材料组成。
3. 如权利要求1所述的缝合线组件,其中该不带倒刺的丝状元件和/或该带倒刺的丝状元件由不可吸收的材料组成。
4. 如权利要求1所述的缝合线组件,其中该多个倒刺沿着在该带倒刺丝状元件长度上的预定部分布置。
5. 如权利要求4所述的缝合线组件,其中该带倒刺的丝状元件进一步包括第二组多个倒刺,其以相对于该纵向轴大于90度且小于180度的第二方向向外伸出。
6. 如权利要求5所述的缝合线组件,其中该第二组多个倒刺沿着在该带倒刺丝状元件长度上的预定部分布置。
7. 如权利要求6所述的缝合线组件,其中该第一组和第二组多个倒刺是彼此相对的。
8. 如权利要求1所述的缝合线组件,其中该多个倒刺交错在该带倒刺的丝状元件的周围。
9. 如权利要求1所述的缝合线组件,其中该多个倒刺当中的选择的多个倒刺绕着该带倒刺的丝状元件的周围彼此对齐。
10. 如权利要求1所述的缝合线组件,其中该至少一个带倒刺的丝状元件进一步通过热固着该至少一个带倒刺的丝状元件的至少第一和第二末端而与多个不带倒刺的丝状元件结合。
11. 如权利要求1所述的缝合线组件,其中至少一个带倒刺的丝状元件和/或不带倒刺的丝状元件涂布有材料,该材料选自:聚烯烃、聚酯、聚酰亚胺、聚酰胺、聚苯乙烯、硅氧烷、氟聚合物、聚氨酯、polybutilate、环氧树脂、聚乙烯吡咯烷酮、羧甲基纤维素、乙基纤维素、甲基纤维素、聚乙二醇、聚乙烯醇、聚醋酸乙烯酯、聚对苯二甲酸丁二醇酯、丙烯腈丁二烯苯乙烯、苯乙烯丙烯腈共聚物、苯乙烯丁二烯共聚物以及其共聚物和组合。
12. 如权利要求1所述的缝合线组件,其中该至少一个带倒刺的丝带元件由形状记忆聚合物组成。
13. 一种缝合线组件,其包括:
多个互相缠绕并且具有纵向轴的不带倒刺的丝状元件;
至少一个带倒刺的丝状元件,其具有纵向轴、主要外部外围以及多个以相对于该纵向轴小于90度的第一方向向外伸出超过该主要外部外围的倒刺;
其中该至少一个带倒刺的丝状元件的主要外部外围被包含在缠绕着的不带倒刺的丝状元件中,其中该多个倒刺延伸穿过该多个不带倒刺的丝状元件并且从该多个不带倒刺的丝状元件向外伸出。
14. 如权利要求13所述的缝合线组件,其中该不带倒刺的丝状元件和/或该带倒刺的丝状元件由可吸收的材料组成。
15. 如权利要求13所述的缝合线组件,其中该不带倒刺的丝状元件和/或该带倒刺的丝状元件由不可吸收的材料组成。
16. 如权利要求13所述的缝合线组件,其中该多个倒刺沿着在该带倒刺丝状元件长度上的预定部分布置。
17. 如权利要求16所述的缝合线组件,其中该带倒刺的丝状元件进一步包括第二组多个倒刺,其以相对于该纵向轴大于90度且小于180度的第二方向向外伸出。
18. 如权利要求17所述的缝合线组件,其中该第二组多个倒刺沿着在该带倒刺丝状元件长度上的第二预定部分布置,并且该第一组和第二组多个倒刺是彼此相对的。
19. 如权利要求13所述的缝合线组件,其中该多个倒刺交错在该带倒刺的丝状元件的周围。
20. 如权利要求13所述的缝合线组件,其中该多个倒刺当中的选择的多个倒刺绕着该带倒刺的丝状元件的周围彼此对齐。
21. 如权利要求13所述的缝合线组件,其中该至少一个带倒刺的丝状元件进一步通过热固着该至少一个带倒刺的丝状元件的至少第一和第二末端而与多个不带倒刺的丝状元件结合。
22. 如权利要求13所述的缝合线组件,其中至少一个带倒刺的丝状元件和不带倒刺的丝状元件涂布有材料,该材料选自:聚烯烃、聚酯、聚酰亚胺、聚酰胺、聚苯乙烯、硅氧烷、氟聚合物、聚氨酯、polybutilate、环氧树脂、聚乙烯吡咯烷酮、羧甲基纤维素、乙基纤维素、甲基纤维素、聚乙二醇、聚乙烯醇、聚醋酸乙烯酯、聚对苯二甲酸丁二醇酯、丙烯腈丁二烯苯乙烯、苯乙烯丙烯腈共聚物、苯乙烯丁二烯共聚物以及其共聚物和组合。
23. 如权利要求13所述的缝合线组件,其中该至少一个带倒刺的丝带元件由形状记忆聚合物组成。
24. 一种缝合线组件,其包括:
多个互相缠绕的不带倒刺的丝状元件;
至少一个带倒刺的丝状元件,其具有纵向轴和主要外部外围以及以相对于该纵向轴小于90度的第一方向向外伸出超过该主要外部外围的第一组多个倒刺;
其中该不带倒刺的丝状元件基本上围绕着该至少一个丝状元件的主要外部外围,并且其中该多个倒刺向外伸出超过了该不带倒刺的丝状元件。
25. 如权利要求24所述的缝合线组件,其中该多个倒刺沿着在该带倒刺丝状元件长度上的预定部分布置。
26. 如权利要求25所述的缝合线组件,其中该带倒刺的丝状元件进一步包括第二组多个倒刺,其以相对于该纵向轴大于90度且小于180度的第二方向向外伸出。
27. 如权利要求26所述的缝合线组件,其中该第二组多个倒刺沿着在该带倒刺丝状元件长度上的第二预定部分布置,并且该第一组和第二组多个倒刺是彼此相对的。
28. 如权利要求27所述的缝合线组件,其中该带倒刺的丝状元件上的第一和第二预定部分被该带倒刺的丝状元件长度上的不具有向外凸出倒刺的第三预定部分隔开。
29. 一种制造缝合线组件的方法,所述方法包括:
在丝状元件上形成多个倒刺;
将多个不带倒刺的丝状元件缠绕以形成具有纵向轴的不带倒刺的组件;以及
将该带刺的丝状元件插入到该不带倒刺的组件中以形成缝合线组件,其中该多个倒刺从该不带倒刺的组件向外伸出。
30. 一种制造缝合线组件的方法,所述方法包括:
在丝状元件上形成多个倒刺;
将该带倒刺的丝状元件与多个不带倒刺的丝状元件缠绕以形成缝合线组件,其中该多个倒刺从该不带倒刺的组件向外伸出。
31. 如权利要求30所述的方法,其中该缠绕步骤包括用该多个不带倒刺的丝状元件编织该带倒刺的丝状元件。
32. 如权利要求30所述的方法,其中该带倒刺的丝状元件具有主要外部外围,该倒刺向外伸出超过了该主要外部外围,并且其中该缠绕步骤包括将该多个不带倒刺的丝状元件围着该带倒刺的丝状元件缠绕以便基本上围绕该带倒刺的丝状元件的主要外部外围,但是其中该多个倒刺延伸穿过该不带倒刺的丝状元件并向外伸出。
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US20130066369A1 (en) 2013-03-14
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CA2613839A1 (en) 2007-01-11
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US20070005110A1 (en) 2007-01-04
ATE482654T1 (de) 2010-10-15
JP2009500074A (ja) 2009-01-08
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US8715320B2 (en) 2014-05-06
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AU2006266242B2 (en) 2013-01-31
CA2613839C (en) 2014-04-01
ES2351356T3 (es) 2011-02-03
PT1895913E (pt) 2010-11-02
DE602006017213D1 (de) 2010-11-11
JP5090343B2 (ja) 2012-12-05
WO2007005296A1 (en) 2007-01-11
CN101296661A (zh) 2008-10-29
DK1895913T3 (da) 2011-01-31
EP1895913A1 (en) 2008-03-12

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