1. Biozip Suture Group 24 Katie Good and Emily Schaefer Advisors: Bruce Beyer, M.D. Paul King, Ph.D.

2. Problem Statement Gynecological procedures - confined areas Difficult to apply tension Suture integrity compromised Alternative method for closing tissue or pedicles Require tension in one direction

3. Desired Qualities Bioabsorbable Tensile strength 80 – 100 N Degradation time 3 -4 weeks Unidirectional Tension Maintain suture integrity Simple closure procedure

4. Design Significance C-section - 1.2 Million surgeries/year Hysterectomy - 600,000 surgeries/year Improved suture design will Decrease surgery time and therefore potential for infection Easier closure procedure Greater confidence in suture integrity

5. Competing Technologies Traditional suture tension in opposite directions, form knots Laparoscopic technique Quik-Stitch® LIGA – CLIPS (Ethicon) Metal surgical clips Electrocautery Sealing pedicles http://www.paresurgical.com

6. Twist Tie Approach Vicryl 0 and 2 gauge Braided Coated Dexon 3 gauge Braided Uncoated Clamp & Fuse

7. Budget Hemostat 7.25” ~ $21.00 Suture material Vicryl 0 (qty 6) ~ $1.57 ea Vircyl 2-0 (qty 6) ~ $1.50 ea Dexon 3-0 (qty 3) ~ $15.96 ea Total ~ $87.30 Heated tweezers ~ $209

8. Fusing Sutures Dexon did not fuse Vicryl 3 sutures per trial Trials Gauge Heat Setting Temperature (°F) Exposure Time (sec) Tensile Strength 07.516540 0919840 27.516540 2919840

9. Testing Our Sutures Instron Tensiometer BlueHill software Ideal for < 2kN 0.4% accuracy Output Tensile strength Elongation Breaking Point Located in VUMC SDRCC http://www.instron.us/wa/products/universal_material/5840.aspx

10. Heating Element Heated Tweezers Wax Connections Pedal controls power to tweezers No specific temperature listed http://www.waxconnections.com/Page11.html

11. Current Status Purchased sutures from Hospital Supply Fused Vicryl sutures w. hair straightener Meeting – Dr. DasGupta on Thursday Learn to use tensiometer Test samples Meet with Dr. Beyer Ask to tie sutures for comparison testing

12. Future Work Research other heating element options Research current surgical heating techniques Dr. Beyer test procedure for ease of application Paper and poster