Comparison of PDS and Vicryl Longevity
PDS (polydioxanone) is significantly more long-lasting than Vicryl (polyglactin 910), with PDS retaining 25% of its tensile strength at 42 days and taking 130-180 days for complete absorption, while Vicryl has a half-life tensile strength of only 2 weeks. 1, 2
Structural Differences
PDS:
- Monofilament structure
- Lower inflammatory response
- Slower hydrolysis rate
- Complete absorption in 130-180 days
Vicryl:
- Braided multifilament structure
- Higher tissue inflammatory reaction
- Faster hydrolysis rate
- Mostly absorbed after several weeks
Tensile Strength Comparison
Research directly comparing these sutures shows significant differences in their longevity:
- PDS has a half-life tensile strength of 6 weeks 2
- Vicryl has a half-life tensile strength of only 2 weeks 2
- While Vicryl initially has high tensile strength comparable to non-absorbable sutures, it degrades much more rapidly than PDS 3
Clinical Implications
The longer-lasting nature of PDS makes it particularly suitable for:
- Tissues that require extended healing support
- Situations where wound dehiscence is a concern
- Applications where prolonged tensile strength is needed
However, it's important to note that PDS is initially less tractable than Vicryl, though this difference becomes insignificant after approximately 11 days of implantation 4.
Inflammatory Response
PDS and other monofilament sutures elicit a lower degree of chronic inflammation compared to Vicryl and other braided sutures 5. This is particularly important in:
- Sensitive tissues
- Patients prone to excessive inflammatory responses
- Areas where scarring needs to be minimized
Infection Risk
The monofilament structure of PDS causes less bacterial seeding and may be associated with lower infection risk compared to braided sutures like Vicryl 6. This makes PDS potentially advantageous in:
- Contaminated wounds
- Immunocompromised patients
- Areas prone to infection
Practical Considerations
When using PDS:
- Ensure adequate knot security (may require additional knots)
- Avoid excessive tension to prevent tissue necrosis
- Consider the longer absorption time in your follow-up planning
Caveat
While PDS offers longer-lasting support, this isn't always necessary or beneficial for all tissues. For tissues that heal quickly or where prolonged suture presence might cause complications, the shorter-lasting Vicryl might be more appropriate.