PGA Replaces Catgut |


PGA Replaces Catgut

Worldwide, we see a general tendency towards moving away from using biological sutures, especially catgut. The reason for this is partly the difficulties in getting serosa of BSE-free proven countries, but more important is the fact that catgut tends to create more substantial tissue reactions than synthetic sutures with more or less identical characteristics when it comes to knot stability and
absorption time.

Some countries, e.g. Australia, have during the last couple of years become stricter in terms of legislation on import and use of bovine serosa (catgut), and the tendency seems to spread worldwide.

In human medicine, catgut has been banned for many years, partly because of the BSE, but mainly because of the more pronounced incidences of inflammation and more severe tissue reactions when using the biological suture of serosa origin.

The European Commission, Food and Health Committee conclude and recommend:

1. The Committee considers that there are sufficient alternative products to catgut sutures, i.e. synthetic absorbable sutures made from polymers such as polyglycolic acid, that provide equal, or even better, clinical performance than the catgut. Apart from considerations of TSE, there is no difference between these two types of sutures with respect to matters of safety.

2. On the basis of the considerations in the above clause, generally there are no clinical indications for the preferred use of catgut. Moreover, scientifically there is no further need for catgut sutures. The Committee recognizes that there has been a diminishing use of catgut sutures during the last decade and that this decrease is likely to continue.

Read more on the European Commission, Food and Health Committee website

About Catgut
Catgut is manufactured from longitudinally slitting the submucosa of bovine intestine, twisting the ribbons and joining them in wet condition. As the intestines have a certain length, they are subsequently bounded together causing a less uniform appearance of the suture (knots along the suture). Catgut being an absorbable suture is preserved in alcohol to prevent absorption. Both the gut itself and the alcohol cause severe tissue reactions, when used in vivo.

About PGA
PGA is a synthetic and manufactured suture. For this reason, it is easier to produce a completely uniform suture, which is superior to catgut. PGA is a braided suture, appearing soft and flexible when handling it. The suture is coated to achieve easy-knot tying and smooth passage through tissue. PGA gives much less tissue reaction and inflammation in comparison to catgut.

Sum up - for and agaist Catgut and PGA

 Catgut   PGA 
 Excellent knot stability   Good knot stability 
 Less suture consistency  Completely uniform suture appearance
 Severe tissue reaction  Minimal tissue reaction
 Tendency to snap/break  Strong and reliable suture