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ON INVESTIGATION OF TENSILE STRENGTH OF COMMERCIAL SYNTHETIC NON-ABSORBABLE SUTURE MADE FROM OF BLUE POLYPROPYLENE MONOFILAMENT

Objective: The purpose of this research is to investigate the tensile strength of commercial synthetic non-absorbable suture made from blue polypropylene monofilament that commonly used in surgery.Methods: The commercial synthetic non-absorbable made from blue polypropylene monofilament was prepared for this purpose. The ASTM C1557-03 was used as a standard the method for analysis. For accuracy of the measurement, the diameter of the sutures was measured using optical microscope. The tensile strength, strain at failure, and modulus elasticity of the sutures were measured following instruction from the standard test method. The graph strain versus stress was provided.Results: Results show that that the average tensile strength of five valid tested samples is about 875.812 MPa. The average strain is found about 0.282. The average of modulus of elasticity is 4026.069 MPa.Conclusion: It is concluded that the sutures of commercial synthetic non-absorbable suture made from blue polypropylene monofilament having linier elastic as well as plastic properties. The average tensile strength of five valid tested samples is about 875.812 MPa. The average strain at failure is found about 0.282. The average of modulus of elasticity is 4026.069 MPa.


INTRODUCTION
Suture material is classified either as non-absorbable or absorbable. A non-absorbable suture material is much more slowly broken down over many months, and modern synthetics are much more inert. Nonabsorbable sutures have high tensile strength, but lose between 10% and 15% of the tensile strength every year. It is a relatively elastic material and causes minimal tissue inflammation. And similarly nonabsorbable sutures do not cause much tissue reaction. Absorbable suture is defined as suture that loses most of its tensile strength. The time it takes to be degraded in tissue varies by type of material. It has a high tensile strength, but the tensile strength decreases as the suture mass is absorbed. The absorbable sutures are available in monofilament or braided varieties [1].
The application of suture in surgery is very important, ranging from fascia, repair of tension band of fractures, joint capsules, and closure of surgical wounds, muscles, tendon, or ligaments. The quality of repair depends on variables such as the surgical technique, material properties suture, and tissue characteristics. The types of material that is used for suture have important implications in tissue repair. Adverse surgical outcomes can be avoided by selecting suitable suture materials [11]. Table 1 is a list of material for sutures obtained from previous publication.
Evaluations of suture are conducted continuously by group of purchasing organizations. The purchasing commission conducts research to survey materials managers, surgeons, and operating room supervisors, at member hospitals regarding their rating of product's clinical acceptability and their vendor preference [12]. These data will assist the surgeon in selection and application of appropriate suture materials to specific tasks [11].
The important properties of sutures are provided adequate tension for wound closure and non-reactivity for the least inflammatory response [13]. The purpose of this work is to provide the tensile strength data of commercial synthetic non-absorbable sutures made from blue polypropylene monofilament. The data of failure strain and modulus elasticity are also provided for consideration of the user.

METHODS
Commercial synthetic non-absorbable suture made from blue polypropylene monofilament was prepared in this research for tensile strength investigation. The suture was under trademark Corleone from the company of Peter Surgical, France.
The tested material was extracted from sterile packaging and referred from instruction from previous publication [13]; the samples then were immersed in alcohol for 1 day.
The average of the diameter sample measurements represented the mean diameter value for each material investigated as explained in previous publication [13]. The diameter measurements were performed on each sample of material at three different equidistant points of the sutures. The diameter of the sutures was measured using optical microscope (Olympus SZH 10).
Tensile testing has been performed to evaluate the tensile strength of sutures. The modulus elasticity (E) and strain (ε) are also presented. Five times repetition of valid tensile tests were conducted and average value of tensile test will be provided. The tensile strength test analysis has been carried out following standard test method for tensile strength and modulus elasticity of fiber [14]. The load was measured by digital balance (Sartorius).

Full Proceeding Paper
The mounting tab was utilized for specimen mounting. Schematic of the mounting tab for tensile test of the single fiber is presented in Fig. 1. Small amount glue is placed on the mounting tab. The fiber is bond to the mounting tab. The gauge length in this research was 50 mm and was defined as gauge length.
The tensile strength (σ) was calculated using Equation 1. Where A is across sectional area fracture plane normal to fiber axis (mm 2 ) and F is force to failure (N) [14].
The tensile strain, ε (dimension less) was measured using Equation 2.
Where L 0 (mm) was the gauge length and ΔL (mm) was elongation of the gauge length [14].
The modulus elasticity E of the suture (MPa) was calculated using Equation 3 [14].

RESULTS AND DISCUSSION
The result of tensile strength of commercial synthetic non-absorbable suture made from blue polypropylene monofilament is presented in The graph of strain versus stress from the tensile test of commercial synthetic non-absorbable suture made from blue polypropylene   of the different vendor's products. It is importance of conducting comparisons of multiple vendors [12].
Tensile strength data assist the surgeon in selection and application of appropriate suture materials to specific tasks [11]. Table 3 is comparison of tensile properties to absorbable sutures obtained from previous investigation [9]. The non-absorbable suture in this research is found superior above tensile strength of natural absorbable sutures (chromic catgut monofilament). Chromic gut was problems with suture security overtime [15]. However, if compare to synthetic absorbable suture (braided violet coated polyglycolide), the tensile strength of synthetic non-absorbable suture in this research is found a bit lower (Fig. 3). It should take into consideration also that braided sutures have greater strength and pliability making a knot less likely to slip, meaning fewer throws could result in a secure knot [16].
Instead braided violet coated polyglycolide having better tensile strength, previous publication also informed that polyglactin would be the best suture material with regard to tissue security and reaction scores [16].
Previous publication reports that non-absorbable surgical sutures, due to their antigenicity and/or the presence of bacterial infection, can cause granuloma formation after surgery [4]. Therefore, application of absorbable sutures is promoted due to this reason.
The strain failure of synthetic non-absorbable suture also is found lower comparing synthetic absorbable sutures (Fig. 3), this is due polyglycolide exhibits stress relaxation [3]. The highest modulus elasticity is found also in the synthetic absorbable suture (Fig. 4), which means that suture made from synthetic braided violet coated polyglycolide is more stiffness than synthetic non-absorbable in this research.
The difficulty was faced during conducting this research. The material that was tested in this research was in micron size. Therefore the tensile test of the sutures should be done by experienced technician. monofilament can be analyzed from Fig. 2. The graph indicates that the suture having linier elastic region as well as plastic region.
It is important to compare the tensile strengthσ of commercial synthetic non-absorbable suture made from blue polypropylene monofilament as was conducted in this research to other type of sutures. This information will be importance information for the surgeon for decision during choosing type of sutures. Suture from other vendor than in this research may have different result because does not have equivalent performance profiles. Specific brand seems to be the most important determinant of physician evaluations , synthetic absorbable (braided violet coated polyglycolide) [9], and synthetic non-absorbable (blue, polypropylene, monofilament) that is investigated in this work