A comparative scanning electron microscopic study on degradation of absorbable ligating clipsin vivo andin vitro

Abstract

Using scanning electron microscopy, the degradation characteristics of two absorbable ligating clips, Absolok (polydioxanone) and Lactomer (poly-L-lactide-co-30%-glycolide) have been studied under in vivo and in vitro conditions. The rate of Absolok clip degradation was significantly greater than that of Lactomer clip degradation both in vitro and in vivo. The rate of degradation of Lactomer clips significantly increased and they showed a greater change in proportion of breakdown in vivo than in vitro compared to Absolok clips. The Absolok clip breakdown began with the formation of surface undulations which later developed into fissures. The undulations appeared on the clip surface as early as 7 days and by 2 weeks developed into fissures. The initial appearance of the fissures was at the edge of the clips particularly at the mating surface. The thickness of layers forming the fissures gradually decreased and by 15 weeks the layers appeared as very thin sheets of materials. The high energy areas (locking and molding points) were more resistant to breakdown and the remains of the clips were still present 25 weeks after initiation of the experiments. The Lactomer clips showed very little sign of degradation in vitro even after 10 weeks of incubation. However, in the in vivo experiments undulations formed on the clip surface as early as 2 weeks postimplantation. These clips also showed fissures similar to those observed on Absolok clips.