PGA Sutures - Absorbable Wound Closure Workhorses

PGA sutures refer to a class of absorbable stitches made of synthetic polyglycolic acid used to close incisions. They serve as a temporary means to accurately oppose tissue post-surgery and support initial healing until the body’s own collagen matrix closes the gap.

In simpler terms, PGA sutures provide tension to bring wound edges together, reinforce as healing starts, and then gradually transfer load-bearing responsibility to new endogenous fibers formed within the closure line. As natural strength returns, the PGA stitches steadily mass-absorb such that nothing foreign remains within the site long term. This avoids the need for removal down the road.

The polyglycolic acid polymer chains that comprise PGA sutures were designed to perform similarly to the body’s native proteins. They elicit only minimal inflammation and foreign body response yet provide sufficient initial tensile strength for surgical closure and healing. The material’s hydrolytic instability, however, allows steady dissolution such that absorption and mass loss are essentially complete by 90-120 days post-implantation. 

PGA sutures have been used successfully across many specialties, including general surgery, orthopedics, gynecology, ophthalmology, and oral and maxillofacial surgery. In dentistry, common applications include extraction site closures, periodontal flaps, implant incisions, and other oral wound repairs. PGA’s smooth passage through tissue and excellent knotting ability lend efficiency to its use. The material comes factory-dyed violet for high visibility, then fades during absorption.

Compared to non-resorbable options like silk or nylon, the benefit of PGA sutures lies in their transitional strength profile coupled with reliable self-elimination. This means no suture removal visit nor potential reactive granulomas, which can bother some patients if permanent threads remain. PGA’s controlled degradation, however, avoids premature loss of closure integrity.

While valued for their transitional properties, PGA sutures also have limitations. Their rapid loss of tensile strength may mandate earlier removal to avoid wound gapping in slower-healing tissues. Rare hypersensitive reactions also occur. Costs are higher than natural options as well. However, new variants like polyglytone 6211 now afford suture diameter reductions for minimally invasive procedures. Additionally, knot security and smooth passage actually exceed other common absorbables like gut or polydioxanone. So PGA sutures remain widely used, especially where follow-up would pose difficulty. With innovations ensuring reliable performance, their application continues expanding across specialties needing temporary, self-eliminating wound support until native collagen regeneration occurs.

In summary, PGA sutures offer a temporary means to accurately stabilize and strengthen post-surgical wound closure lines during the critical healing phase until endogenous collagen regeneration provides natural, lasting integrity. Their gradual absorption and tissue compatibility make them an excellent choice across many surgical disciplines. Both practitioners and patients can benefit from PGA sutures’ ease of use, avoidance of removal needs, and support of optimal healing outcomes.