Abstract: A surgical suture includes a plurality of intertwined unbarbed filaments defining a longitudinal axis and a barbed filament including an elongate body and a plurality of barbs disposed along a length thereof. The plurality of barbs extends radially outward from a surface of the elongate body, wherein the barbed filament at least partially intertwines with the plurality of unbarbed filaments.

Abstract: A method of suturing a wound using a length-control technique. The method includes the step of placing a first pass of suture having barbs, with a first pre-attached needle, completely through the skin of the wound, from the undersurface to the outside, at a shallow angle just beyond one apex of the wound. The method also includes the step of placing the opposite end of the suture, with a second pre-attached needle, completely through the skin of the wound, from the undersurface to the outside, at a shallow angle just beyond the opposite apex of the wound. When the skin is pushed down on the suture, the suture pulls both apices towards the center of the wound to connect both apices to each other.

Abstract: A bone anchor has a central bore allowing for uniquely attaching a suture thereto. The bore is shaped so that it is wider at the bottom of the anchor than at the top of the anchor. A peg fits within the bore. The suture is looped around the peg and the peg is inserted into the bore. Friction between the bore, peg and suture holds the suture in place. A suture for use with the bone anchor may be formed by fusing together the ends of a plurality of fibers to form a loop.

Abstract: Sutures are provided having a first elongate body and a separate, second elongate body. The first elongate body includes a first connection structure and the second elongate body may include a second connection structure.

Abstract: A surgical suture is made of an elongate, hollow braid of high strength fibers. The braid defines an elongate, longitudinally-extending, central chamber that is open and without any core material extending therein so that, when a surgeon's knot is tied with the suture, the cross-sectional shape of the braid collapses upon itself and is reduced in size in response to pressures experienced when the knot is tightened thereby producing a low profile knot that resists slippage. Preferably, the braid is of a size corresponding to a USP size 5-0 to USP size 7 suture and has one or more, preferably a pair, of color contrasting monofilaments woven therein to enhance suture visibility. Methods of making a flattened suture and of utilizing the high strength suture to maintain body tissues in an engaged position to promote healing are also provided.

Abstract: A method and device for anchoring a length of self-retaining suture. The method of anchoring includes providing for an assembly having a length of self-retaining suture and a suture insertion device. The length of suture includes at least a portion of the length having a plurality of retainers thereon extending in a first direction. The insertion device has a length and a recess to receive a portion of the suture length. The method further includes placing a portion of the suture length in the recess and inserting the device into the body of a mammal until the recess reaches a predetermined location thereby forming an insertion pathway. The method further includes retrieving the insertion device from the body by moving the insertion device in a direction substantially opposed to the insertion pathway.

Abstract: Methods for spinal stabilization operative to prevent lateral bending, extension, and rotation across two or more adjacent vertebrae are described. Broadly, the method includes placing two or more anchors at each vertebral level, passing one or more sutures through each anchor at each level, applying tension to the sutures and joining the sutures in a cross-braced arrangement over the disc space between two or more vertebrae to prevent lateral bending, extension, and rotation of the spinal segment. The sutures can be welded in any combination of diagonal and vertical patterns across the adjacent vertebrae. In some embodiments, two or more sutures can be threaded through some of the suture anchors such that multiple vertebral levels can be joined in a cross-braced arrangement. Two or more sutures can also be used in multiple anchors in two adjacent vertebrae to provide additional reinforcement or stabilization across different portions of the two vertebrae.

Abstract: A method is provided for forming a barbed medical device which includes the steps of providing a blank workpiece and forming at least one barb on the blank workpiece by applying vibrational energy to a tool and bringing the tool and the blank workpiece into contact with each other at an angle such that the tool cuts into the surface of the blank workpiece. A barbed medical device formed by this method is also provided.

Abstract: A method of making a packaged antimicrobial suture comprising the steps of providing a containment compartment that is substantially free of an antimicrobial agent; positioning a suture within the containment compartment, said suture comprising one or more surfaces having an antimicrobial agent disposed thereon, said antimicrobial agent being selected from the group consisting of halogenated hydroxyl ethers, acyloxydiphenyl ethers, and combinations thereof; placing the containment compartment having the suture in an outer package; and subjecting the outer package, the containment compartment and the suture to time, temperature and pressure conditions sufficient to vapor transfer an effective amount of the antimicrobial agent from the suture to the containment compartment, while retaining an effective amount of said antimicrobial agent on the suture, thereby substantially inhibiting bacterial colonization on the suture and the containment compartment.

Abstract: This method comprises the use of a repair equipment including a humeral rod (2) intended to be placed in the medullary cavity of the humerus, comprising at least one hole (6) for receiving a thread (11) for repositioning the tuberosities (101, 102) and for maintaining the latter with respect to the rest of the bone. Said hole (6) is formed in the metaphyseal portion of the humeral rod (2), in the anteroposterior direction thereof; and the repair equipment further comprises a so-called “guying” subassembly (3), to maintain the tuberosities (101, 102) when they re-installed, two second so-called “traction” subassemblies (4), for pulling of the tuberosities (101, 102) one toward the other, and two so-called third “pressing” subassemblies (5), for tackling the tuberosities (101, 102); each of these sub-assemblies comprises a needle and thread (11) connected to this needle, this thread (11) forming a loop.

Abstract: A method for the placement of sutures in tissue prior to forming an opening in the tissue, the sutures for use in closing the opening, the method includes the steps of passing a first length of suture through a first portion of a tissue in a first direction relative to a target area to be incised, passing the first length of suture through a second portion of the tissue in the first direction, passing a second length of suture through a third portion of the tissue in a second direction relative to the target area to be incised, passing the second length of suture through a fourth portion of the tissue in the second direction, performing a surgical procedure including forming the opening in the tissue, and applying tension to the first length of suture and the second length of suture to close the opening in the tissue.

Abstract: Sutures are provided having an elongate body and a separately connectable end effector. The elongate body includes a first connection structure, which connects the end effector to the elongate body.

Abstract: A method of manufacturing a prosthetic valve is provided. A substantially tubular metallic frame is formed with intersecting bars having diameters in the range of 0.1 to 0.6 mm. The frame is constructed to be radially collapsible for advancement into a native aortic valve using a catheterization technique. The frame is constructed to be radially expandable for embedding the frame within the native aortic valve and resisting the recoil forces of the native aortic valve. A valvular structure is constructed from pericardial tissue. An internal cover is constructed from pericardial tissue to form a substantially impermeable tubular sleeve. An upper end of the internal cover is sutured to a lower end of the valvular structure. The valvular structure and internal cover are sutured to the bars for securement within the frame.

Abstract: A graft tube is percutaneously placed inside the lumen of a vessel and attached to the lumen wall by loops of suture material. The short sutures are made in the shape of a loop with a sharp and a blunt end then forced into a plurality of first tunnels located in sections of circular cuffs that are attached to graft tube ends. The short sutures are pushed out the first tunnel by push rods and curve back to their original shape through the adjacent lumen wall and into a plurality of second tunnels where the short sutures are lodged.

Abstract: According to an aspect of the present disclosure, a surgical suture needle assembly is provided including an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. The present disclosure further provides for methods of using the surgical suture needle assembly in anastomotic procedures and the like.

Abstract: Novel bioabsorbable polymeric blends are disclosed. The blends have a first component that is a polylactide polymers or a copolymer of lactide and glycolide and a second component that is poly(p-dioxanone) polymer. The novel polymeric blends provide medical devices having dimensional stability. Also disclosed are novel bioabsorbable medical devices made from these novel polymer blends, as well as novel methods of manufacture.

Abstract: An internal tissue puncture closure method and apparatus. The method and apparatus provide a folded sealing plug that provides more surface area than conventional plugs to more fully cover and seal an external situs of an internal tissue puncture. The folded sealing plug may have a weave pattern that tends to cause the sealing plug to corkscrew into the internal tissue puncture as it is compressed toward an anchor placed inside of the tissue puncture.

Abstract: A lattice stitch and stitching method for closing wounds are characterized by the use of a tension limiting device. First and second anchor stitches are arranged in a tissue layer spaced from and generally parallel to the wound, with the first and second anchor stitches being on opposite sides of the wound. A closing stitch is looped around the fist and second anchor stitches and tied to draw the wound to a closed condition. The tension limiting device is used during stitching of the anchor stitches. The device is arranged between the anchor stitches and the tissue layer adjacent to the wound to prevent over-tightening of the anchor stitches and lend support to the closure. The tension limiting device can be used in any soft tissue surgical application to displace and disperse suture tension at the surface of the underlying soft tissue, to fasten a dressing to the surface of a wound, and to bolster skin graft repairs of wounds.

Abstract: A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Abstract: A method for making an antimicrobial suture comprising the steps of positioning an antimicrobial agent source within a package comprising an inner surface, said antimicrobial agent being selected from the group consisting of halogenated hydroxyl ethers, acyloxydiphenyl ethers, and combinations thereof; positioning a medical device within the package; and subjecting the package, the antimicrobial agent source and the medical device to time, temperature and pressure conditions sufficient to vapor transfer an effective amount of the antimicrobial agent from the antimicrobial agent source to the medical device, thereby substantially inhibiting bacterial colonization on the medical device.

Abstract: A surgical thread includes an elongate, preferably braided, thread body and a coating surrounding the thread body at least partially and preferably completely, wherein the thread body includes polyethylene and/or polypropylene and the coating consists of a resorbable material and optionally additives.

Abstract: A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Abstract: Methods and devices are disclosed for the in-vivo creation and maintenance of contiguous fluid passages in tissue through the use of tissue buttressing portions with interrupted perimeter walls. These portions can be formed from hollow fiber or extruded components. One end of the tissue-buttressing portion is connected to a hollow tube, which may be connected to a fluid source. The other end of the buttressing portion may be attached to a needle or other device suitable for the penetration of tissue and the formation of passageways in tissue. When the device is installed in tissue, the hollow tube portion of the device is passed part way through the surface of the patient and serves as the conduit for the transfer of fluid to the implanted tissue-buttressing portion of the device. The presence of the buttressing portion within the tissue causes a bridging of the local tissue thereby forming an infusion passage between the external surface of the buttressing portion and the abutting tissue.

Abstract: Biocompatible coatings and spin finishes that can be applied to polyhydroxyalkanoate (PHA) polymers, and medical devices made from PHA polymers, have been developed. The coatings impart good lubricity to PHA polymers, particularly to fibers and braids made from these materials, making the coatings ideal for use on medical devices such as PHA braided sutures. The spin finishes can be applied to PHA fibers to facilitate their manufacture, and also for their conversion to other products, including medical textiles. The spin finishes serve to protect multifilament fiber bundles, and keep them intact following extrusion, and also to impart lubricity to the fiber bundles and monofilament fibers so that they are not damaged in subsequent processing steps particularly in textile processing. The coating reduces tissue drag of, for example, braided sutures.

Abstract: A self-retaining suture comprises a composite filament. The filament has retainers on the surface such that the filament can engage and retain tissue without knots. The filament comprises at least two materials having different properties. A surface material of the filament has properties which enhance the formation, elevation and/or deployment of the retainers. A core material of the filament has properties which enhance the tensile strength of the filament. The surgical filament is thin and flexible and may be used for suturing. Methods for manufacturing the filament and retainers are also described.

Abstract: A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Abstract: A novel bridge clip tissue connector includes two clips separated by a bridge portion. The clips allow for the connecting of tissue at two positions that are maintained by the bridge portion. The connector can be used for performing a wide variety of surgical procedures, including anastomosis and a horizontal mattress suture-like connection.

Abstract: A tissue engageable suture having antimicrobial properties is provided. The suture includes a plurality of thread members. The thread members include a plurality of structural thread members having a structural portion and an antimicrobial portion. The thread members also include a plurality of adhesive thread members. The plurality of structural thread members and the plurality of adhesive thread members are woven together to form a multiple thread-containing cabled suture wherein the adhesive thread members bond the structural thread members within the cabled structure.

Abstract: A novel high tensile strength semi-absorbable composite suture with minimized non-absorbable mass. The suture has a core made from a bioabsorbable polymer. The core is covered by a braided sheath. The braided sheath is made from an absorbable yarn and a bioabsorbable yarn. The bioabsorbable yarn is made from a least one filament of a bioabsorbable polymer. The nonabsorbable yarn is made from at least one filament of ultra high molecular weight polyethylene.

Abstract: The present invention provides, in some embodiments, a medical securement device such as sutures, yarns, meshes, filaments, tapes, knits, and composite braids made from fiber materials like UHMWPE which are coated in whole or in part with a colored coating solution. This invention provides surgeons with improved recognition of suture ends in surgery by construction of sutures with ends having different colors. Additionally, the invention provides surgeons with a means for color coding or marking of medical devices for proper recognition of various devices used in surgery for particular tasks and surgical procedures.

Abstract: The present invention relates to a reflux disease treatment apparatus, comprising two or more movement restriction device segments adapted to form an implantable movement restriction device with an elongated shape that maintains cardia in the correct position. The movement restriction device has proximal and a distal end, wherein the distal end is adapted to stabilize and hold the proximal end. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The distal end can be further adapted to treat obesity, for example by stretching the wall of the stomach or filling out a volume of the stomach.

Abstract: A barbed suture for connecting tissue, and a combination surgical needle with a barbed suture. The suture includes an elongated body and a plurality of barbs projecting from the body. Each barb causes the suture to resist movement in an opposite direction from which the barb faces. The disposition of the barbs on the body may be staggered, twist cut multiple spiral, overlapping, or random. Also, the configuration of the barbs may be a certain spirality angle ?, barb cut angle ?, barb cut depth, barb cut length, barb cut distance, corrugated barb underside, arcuate barb base, or varying barb size.

Abstract: A barbed suture includes a flexible thread having a leading end and a trailing end, and a plurality of barbs projecting from the flexible thread. The flexible thread has a plurality of web-like openings formed therein, whereby each of the openings is disposed adjacent one of the barbs. The openings enhance the flexibility of the barbs and provide space for the barbs to collapse inwardly as the leading end of the flexible thread is pulled through a medium such as tissue. When the barbs are collapsed, the diameter of the barbed sections is preferably no greater than the diameter of the non-barbed sections. In one embodiment, a support element interconnects at least one of the barbs and the flexible thread for reinforcing the at least one barb and resisting flexure of the at least one barb toward the leading end of the flexible thread.

Abstract: Devices and treatments for various joint conditions include a resilient elongate orthopedic device inserted into a joint space using a suture. The suture is passed through the joint space and used to pull the orthopedic device into the joint space. The suture may be using a percutaneously inserted needle or other type of needle-based delivery instrument. The resilient elongate orthopedic device may be restrained to a reduced profile that permits minimally invasive implantation, but assume an enlarged profile when positioned at an implantation site.

Abstract: A suture system includes a plurality of double-stranded needles connected in sequence with a single-stranded needle at each end. The double-stranded suture needles incorporates two suture strands into a single needle. The suture system of the present invention facilitates the implantation of valve prostheses.

Abstract: An auto-graft bio-synthetic mesh and a method of application for wound closure is described. The mesh is utilized for wound closure wherein an abdominal incision is effected through the peritoneum and the rectus abdominal sheath of the rectus muscle such as when repairing ventral or paracoslostomy hernias. The mesh comprises a flexible patch of woven fibers and wherein the patch is one of a substantially circular patch or a patch having a substantially circular delineation thereon whereby to provide guidance for the formation of stitches in at least one circle to secure the patch to the peritoneal peritoneum and the rectus abdominal sheath of the rectus muscle. The patch is secured by applying stitches all about an outer circular edge of the patch and an inner circle thereof.

Abstract: A system for forming a looped suture having a tapered cut is provided. The system includes a base for selectively retaining a portion of thread, a clamping device for receiving a first end of the thread, a tensioning device for receiving a second end of the thread, a welding assembly configured to join a first and second section of the thread to form a loop, and a cutting assembly configured to form a tapered end on the first section of the thread.

Abstract: Blood-derived plastic articles prepared from compositions including blood and, in some embodiments, at least one crosslinking agent and/or at least one biological response modifier, that can be useful for biological applications such as wound repair and tissue grafts; methods of making and using the same; methods for assessing the concentration of a biological response modifier in an article; and systems for preparing blood-derived plastic articles are provided.

Abstract: The attenuation or isolation of environmental parameters on a gastric lumen is described herein. Once tissue plications are formed into a gastric lumen or sleeve within a stomach, the newly formed lumen is subjected to a multitude of fluctuating stresses or pressure from food or fluids passing therethrough, from naturally-occurring contractions, and/or from changes in pH levels from caustic stomach acids and hormones. The tissue interface between these plications can be isolated from such environmental fluctuations, or the fluctuations can be attenuated, by a number of methods. One example is to place a gastric stent or sleeve within the newly formed lumen. Another example is to utilize multiple rows of anchors, clips, or sutures along the interface. Alternatively, bio-adhesives can be dispensed to buttress the tissue interface. In another variation, the tissue can be approximated in different configurations which effectively reduce or isolate the adhered tissue region.

Abstract: A surgical suture is made of an elongate, hollow braid of high strength fibers. The braid defines an elongate, longitudinally-extending, central chamber that is open and without any core material extending therein so that, when a surgeon's knot is tied with the suture, the cross-sectional shape of the braid collapses upon itself and is reduced in size in response to pressures experienced when the knot is tightened thereby producing a low profile knot that resists slippage. Preferably, the braid is of a size corresponding to a USP size 5-0 to USP size 7 suture and has one or more, preferably a pair, of color contrasting monofilaments woven therein to enhance suture visibility. Methods of making a flattened suture and of utilizing the high strength suture to maintain body tissues in an engaged position to promote healing are also provided.

Abstract: A marked heterofunctional suture thread has two or more sections having different features. One or more sections of the suture thread are provided with laser-marked and non-laser marked indicia in order that they may be identified and differentiated from other sections. The suture thread may have retainers on the surface of one or more sections such that the suture thread can engage and retain tissue without knots. The markers may be used to indicate fixed features of a section of suture thread such as the presence and/orientation of retainers. In particular embodiments, laser-marked and non-laser marked indicia are used to identify the transition section of a bidirectional self-retaining suture.

Abstract: A suture system that includes at least one suture having an end portion, a loop portion configured to be disposed about a fixed point and an anchor configured to be connected to the end portion for anchoring the suture to tissue adjacent to the fixed point, wherein the loop portion of the suture is disposed about the fixed point so as to reduce a gap between the tissue and the fixed point. A kit including at least one suture system, a surgical tool for manipulating the suture and written instructions of use are disclosed. A method for using the suture system is also described.

Abstract: A compound barb medical device is provided which includes an elongated body having at least one barb formed along the length of the body, the barb defining an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the elongated body, and a second portion disposed at a second orientation relative to the longitudinal axis. Optionally, the barb defines a third portion disposed at a third orientation relative to the longitudinal axis. A method for forming a compound barb on a medical device is also provided.

Abstract: Vascular endothelial growth factor alternative splice variants and methods of their use are provided.

Abstract: Apparatus is provided, including an artificial-chordeae-tendineae-adjustment mechanism and at least one primary artificial chordea tendinea coupled at a distal portion thereof to the artificial-chordeae-tendineae-adjustment mechanism. A degree of tension of the at least one primary artificial chordea tendinea is adjustable by the artificial-chordeae-tendineae-adjustment mechanism. One or more loops are coupled at a proximal portion of the at least one primary artificial chordea tendinea. The one or more loops are configured to facilitate suturing of the one or more loops to respective portions of a leaflet of an atrioventricular valve of a patient. Other applications are also described.

Abstract: Provided herein are sutures for use in a procedure applied to tissue, and methods for forming such sutures. Some sutures include bi-directional retainers, each of which can be deployed in two directions, but once deployed in one direction, resist motion in the opposite direction. Other sutures include uni-directional retainers that are conical in shape, and include tissue engaging protrusions that extend from edges and/or angled walls of the conical retainers.

Abstract: A drawn surgical suture material includes an elongate main body and barbs for anchoring in biological tissues, wherein the barbs are formed by cuts made into the suture material in the undrawn state.

Abstract: A continuous-filament thread includes a continuous-filament thread body including a plurality of barbs projecting from the thread body.

Abstract: A medical product including a biocompatible material includes two mutually opposite main surfaces, wherein at least one of the two main surfaces that anchor biological tissues, wherein the barbs protrude from the at least one main surface and are formed by cuts made in the biocompatible material, and wherein the material between the two main surfaces is completely broken through in an area of the cuts.

Abstract: Vessel wound closure systems and method for sealing a puncture wound in a target vessel, such as those puncture wounds that occur from prior interventional procedures. A sealing member is deployed intravascularly into the target vessel, and an anchor member is deployed extravascularly of the target vessel. The sealing member and the anchor member are connected by a suture that may be drawn to tighten the sealing member and the anchor member relative to one another in order to effect the seal of the puncture wound. After tightening, the suture is secured to maintain the sealing member and the anchor member relative to one another in order to maintain the seal. Preferably, the anchor member, the suture and the sealing member are comprised of biocompatible, bioresorbable materials that are absorbed into the body after the sealing of the puncture wound has been achieved.