Vicryl Suture vs Vicryl RAPIDE Suture

VICRYL Suture is a synthetic absorbable violet dyed or undyed suture made of Polyglactin 910 compound, use in hospitals and trauma centers to close surgical wounds and indicated for general soft tissue wound ligation and closure except for cardiovascular and neurological tissues. Absorption Rate 56-70 days.

VICRYL RAPIDE is a suture made from the same polyglactin 910, composed of 90% glycolide and 10% L-lactide copolymer, is a synthetic absorbable suture intended to mimic the performance of collagen (surgical gut) suture with less tissue reaction, Absorption Rate 21- 42 days, intended for use in soft tissue.

All About Vicryl Suture

Vicry suture vs Vicryl RAPIDE Suture
Vicry suture vs Vicryl RAPIDE Suture
Variety of vicryl sutures
Variety of vicryl sutures

VICRYL Suture is a sterile, synthetic absorbable, surgical suture composed of a copolymer made of 90% Glycolide and 10%l-lactide.The empirical formula of the Copolymer is (C2H2O2)m(C3H4O2)n. VICRYL suture is available as a coated or uncoated suture.

VICRYL sutures are coated with a mixture containing equal parts of Glycolide and lactide copolymer (Polyglactin 370) along with calcium stearate. This combination of Polyglactin 910 copolymer and Polyglactin 370 with calcium stearate has been determined to be nonantigenic and nonpyrogenic, inducing only a minimal tissue reaction during the absorption process.

Differences between VICRYL and VICRYL RAPIDE in the table below.

VICRYL VICRYL RAPIDE
Absorption Rate:
It is absorbed by the body over a period of about 56 to 70 days.
Absorption Rate:
It is typically absorbed in about 42 days.
Tensile strength :
Can hold tissues together longer and more effectively .
Tensile strength :
slightly weaker than regular VICRYL due to its faster absorption rate.
Used:
General soft tissue wound closure and ligation.
Used
In procedures where the wound healing process is expected to be quicker.
Coated
with a mixture of calcium stearate and polyglactin. This coating helps reduce
tissue drag and facilitates smooth passage through tissues.
Coated
to improve handling characteristics, but the exact composition differ slightly.
The main difference between VICRYL and VICRYL RAPIDE lies in their absorption rates, with VICRYL RAPIDE being absorbed faster. The choice between the two depends on the specific requirements of the surgical procedure, such as the expected healing time and tissue type. It’s important for healthcare professionals to carefully consider these factors when choosing a suture material.
VICRYL Suture
VICRYL Suture

5 Types of Vicryl suture available

1. Coated and Uncoated:

The surface is covered with a blend comprising an equal ratio of glycolide and lactide copolymer (Polyglactin 370) combined with calcium stearate.

coated vicryl

Coated vicryl

2. Undyed & Dyed

Beside being available coated and uncoated VICRYL suture is available undyed and dyed with D&C Voilet #2(color Index 60725) this purpose is to enhance visibility in the surgical field.

Undyed Coated VICRYL different size

Undyed Coated VICRYL different size

dyed VICRYL suture

dyed VICRYL suture

3. Gauge size and lengths

Sutures are available in various sizes denoted by gauge, as well as different lengths.

Table below show an example of suture sizes

Different sizes of vicryl suture
A box of 4-0 vicryl RAPIDE
A box of 4-0 vicryl RAPIDE
Vicryl RAPIDE suture
Vicryl RAPIDE suture
Vicryl suture in many sizes.
Vicryl suture in many sizes

4. Types: VICRYL rapide & VICRYL plus

for example VICRYL rapide and VICRYL plus antibacterial are two different types .

Vicryl plus suture comes with 8 needles
Vicryl plus suture comes with 8 needles

5. Non-needle or attached needle:

VICRYL without needle we operating room staff and surgeon refer to them as ties. Usually use to ligate a blood vessel.

Vicryl without needle in image below

vicryl ties
vicryl ties

Step-by-step guide for handling Vicryl suture surgical needles safely

1. Grasp the Needle Properly: When handling the surgical needle, grasp it in an area that is one-third (1/3) to one-half (1/2) of the distance from the attachment end to the point. Avoid grasping at the point area to prevent impairment of penetration performance and potential needle fracture. Similarly, avoid grasping at the attachment end to prevent bending or breakage.

2. Avoid Reshaping: Do not attempt to reshape surgical needles as this may cause them to lose strength and be less resistant to bending and breaking.

4-0 Vicryl RAPIDE suture
4-0 Vicryl RAPIDE suture

3. Exercise Caution: Use caution when handling surgical needles to prevent inadvertent needle-stick injuries. Broken needles can lead to extended or additional surgeries, or residual foreign bodies in patients.

4. Dispose Properly: After use, discard used needles in designated ‘Sharps’ containers immediately. This helps prevent accidental needle-stick injuries and ensures safe disposal of potentially contaminated needles.

5. Do Not Resterilize or Reuse: Do not attempt to resterilize or reuse surgical needles. Reusing needles or portions of needles can lead to product degradation, which may result in device failure, cross-contamination, and increased risk of infection or transmission of blood-borne pathogens to patients and users.

Vicryl plus suture
Vicryl plus suture

Warning & Instances where you should never use VICRYL & VICRYL RAPIDE Suture

1. Allergic Reaction: If the patient has a known allergy to any components of Vicryl sutures, such as polyglactin 910, its use should be avoided.

2. Infected Wounds: In cases of infected wounds, Vicryl sutures may not be the best choice, as they can potentially harbor bacteria within the absorbable material, prolonging or exacerbating the infection.

3. Tissue Sensitivity: Some tissues may react poorly to Vicryl sutures, leading to increased inflammation, delayed wound healing, or other complications. In such cases, alternative suture materials should be considered.

4. High Tension Wounds: Vicryl sutures have moderate tensile strength and may not be suitable for wounds under high tension, as they can result in wound dehiscence or poor wound approximation. In such instances, stronger non-absorbable sutures may be preferred.

5. Wound Closure in Areas Prone to Movement: In areas where there is significant movement or tension, such as joints or areas prone to flexion, Vicryl sutures may not provide adequate support and may lead to wound breakdown. Non-absorbable sutures or techniques such as tape closures may be more appropriate.

6. Long-Term Support Requirement: Vicryl sutures are absorbable and lose their tensile strength over time. If long-term wound support is needed, such as in certain orthopedic surgeries, non-absorbable sutures or other fixation methods should be considered.

7. Precise Tissue Apposition Needed: In cases where precise tissue apposition is critical for optimal wound healing, such as in cosmetic procedures or delicate surgeries, the potential for Vicryl sutures to cause tissue reactivity or inflammation may make them less desirable compared to finer, non-absorbable sutures.

8. Vessels less than 2 mm diameter: In cases where anastomosis and microsurgery for vessels is being done and the vessels is smaller than 2mm.

9. Tissue with poor blood supply: Do not use in such areas, as suture extrusion and delayed absorption may occur. Subcuticular sutures should be placed as deeply as possible to minimize the erythema and induration normally associated with the absorption process.

10. Extended exposure of sutures to salt solutions: like those present in the urinary or biliary tracts, can lead to the development of calculi.

vicryl vs vicryl Rapide
vicryl vs vicryl Rapide

Which types of Patients & conditions Vicryl is not appropriate to be Used on

Vicryl Rapide suture P-3 needle
Vicryl Rapide suture P-3 needle
Patient TypeConditions That May Delay Wound Healing
ElderlyMalnutrition, debilitation, chronic illnesses
MalnourishedMalnutrition, chronic illnesses
DebilitatedChronic illnesses, compromised immune system
Patients with Delayed HealingDiabetes, peripheral vascular disease
Immunocompromised PatientsHIV/AIDS, organ transplant recipients
Patients on Immunosuppressive DrugsChemotherapy, corticosteroid therapy
Patients with Chronic DiseasesCardiovascular diseases, renal failure

Surgical procedures for which Vicryl and Vicryl RAPIDE sutures are commonly used

Vicryl SutureVicryl RAPIDE Suture
General Surgery: Closure of abdominal incisions, fascia, muscle layersGeneral Surgery: Closure of abdominal incisions, fascia, muscle layers, where rapid absorption is desired
Obstetrics and Gynecology: Closure of episiotomies, perineal repair after childbirthObstetrics and Gynecology:
Closure of episiotomies, perineal repair after childbirth, where rapid absorption is desired
Orthopedic Surgery: Closure of subcutaneous tissue, deep dermal layersOrthopedic Surgery:
Closure of subcutaneous tissue, deep dermal layers, where rapid absorption is desired
Cardiovascular Surgery:
Not typically used
Cardiovascular Surgery:
Closure of vascular tissue where rapid absorption is desired
Plastic Surgery:
Closure of subcutaneous tissue, deep dermal layers
Plastic Surgery:
Closure of subcutaneous tissue, deep dermal layers, where rapid absorption is desired
Ophthalmic Surgery: Closure of conjunctiva, scleral tissueOphthalmic Surgery: Closure of conjunctiva, scleral tissue, where rapid absorption is desired
From my experiences specific usage of these sutures may vary based on surgeon preference, patient factors, and other clinical considerations.

Performance /Actions of VICRYL suture

  • Absorption: VICRYL is absorbed by the body through hydrolysis, a process where the suture gradually breaks down in tissue fluids. This typically occurs over a period of about 56 to 70 days.
  • Tensile Strength: Vicryl suture provides good initial tensile strength, which is important for holding tissues together during the initial healing phase.
  • Knot Security: It is known for its excellent knot security, which means that knots tied with VICRYL tend to stay in place without slipping.
  • Flexibility: VICRYL is relatively flexible, making it suitable for use in areas where the tissue may undergo movement or stretching.
  • Reduced Tissue Reactivity: Compared to some other sutures, Vicryl generally elicits a milder tissue reaction, making it a good choice for delicate or sensitive tissues.
  • Minimal Tissue Drag: VICRYL has a smooth surface that reduces friction as the suture is passed through tissues, minimizing trauma.
  • Predictable Absorption: Its absorption rate is fairly consistent, which allows for more accurate planning of suture removal or estimation of how long the suture will provide wound support.
  • Sterilization: VICRYL sutures are supplied sterile and are intended for single-use to minimize the risk of infection.
  • Various Sizes and Needle Types: Like most sutures, VICRYL is available in a range of sizes (gauges) and lengths, as well as with different types of needles (e.g., tapered, cutting, round).
  • Versatile Applications: VICRYL is used in a variety of surgical procedures, including gynecology, urology, general surgery, and obstetrics.
  • Biocompatibility: It is generally considered biocompatible, meaning it is well-tolerated by the body without causing significant adverse reactions.

It’s important to note that while VICRYL is an excellent choice for many situations, the choice of suture material depends on a variety of factors including the type of tissue being sutured, the location of the wound, and the specific needs of the patient. Always consult a healthcare professional for specific medical advice or recommendations.

VICRYL Suture percentage of strength days after it is implanted

Box of 4-0 vicryl Rapide sutures
Box of 4-0 vicryl Rapide sutures
P-3 cutting needle 4-0 vicryl Rapide
P-3 cutting needle 4-0 vicryl Rapide
Days Implantation Approximate % Original
strength Remaining
14 Days75 %
21 days USP 6-0(metric 0.7)
and lager
50%
21 days USP 7-0 (metric 0.5)
and smaller
40%
28 days USP 6-0 (metric 0.7)
and larger
25%
Table show days and percentage of strength of VICRYL suture after it is implanted

Absorption begins as a loss of tensile strength followed by loss of mass. All of the original tensile strength is lost by 5 weeks post implantation.

Absorption is essentially complete between 56 to 70 days

Disadvantages of Vicryl Suture

DisadvantageExplanation
Tissue Reaction Some patients may experience
an inflammatory reaction to Vicryl,
leading to redness, swelling, or pain.
Knot SecurityVicryl knots may be less secure
compared to other suture
materials, increasing the risk of unraveling.
Absorption RateVicryl absorbs relatively quickly,
which may not provide sufficient
long-term wound support in
some cases.
Handling CharacteristicsVicryl can be more difficult to
handle compared to other
sutures, requiring skill and
practice for use.
Tensile StrengthVicryl may have lower tensile
strength compared to non-absorbable sutures, affecting
wound closure integrity.
Wound closureNot a good choice for cutaneous
wound exposed to air. It draw
moisture from the healing tissue
to the skin that allow bacteria
and irritants to migrate to the wound.

What is Vicryl Rapide

VICRYL RAPIDE is a brand name for a type of absorbable surgical suture. It is a product of Ethicon, a subsidiary of Johnson & Johnson, which is a well-known medical equipment company.

Sutures are used by surgeons and medical professionals to stitch together wounds or surgical incisions. What makes VICRYL RAPIDE “rapid” is its characteristic of being absorbed by the body at a faster rate compared to traditional VICRYL sutures. This means that VICRYL RAPIDE typically does not need to be removed manually, as the body will naturally break down and absorb the suture material over time.

VICRYL RAPIDE

VICRYL RAPIDE marks a significant advancement in absorbable sutures, engineered for expedited absorption and prompt wound recovery. Crafted from the reliable polyglactin 910 material, it seamlessly blends strength with swift breakdown, making it an optimal choice for procedures demanding efficiency.

 Due to its absorption profile VICRYL RAPIDE is useful for skin closure, particularly in pediatric surgery, episiotomies, circumcision and closure of oral mucosa.

Per Manufacturer Coated VICRYL RAPIDE suture is not intended for use in ligation ophthalmic, cardiovascular or neurological procedure.

Key Actions of Vicryl RAPIDE

Coated VICRYL RAPIDE suture when use in closure of skin and mucous membranes, typically begins to fall off 7- 10 days post-operatively and can be wiped off subsequently with sterile gauze.

Similarities between VICRYL and VICRYL RAPIDE

  1. Needle Types:
    • Both VICRYL and VICRYL RAPIDE are available with various types of needles (e.g., cutting, taper, etc.) to suit different surgical needs.
  2. Color:
    • Both VICRYL and VICRYL RAPIDE are typically violet or undyed, which helps in their identification during surgery.
  3. Cost:
    • The cost of VICRYL and VICRYL RAPIDE may vary based on factors like location, supplier, and quantity purchased. In general, VICRYL RAPIDE might be slightly more expensive due to its specialized properties.

Resources

https://www.jnjmedtech.com/en-US/product/vicryl-rapide-polyglactin-910-suture

https://www.accessdata.fda.gov/cdrh_docs/pdf/K944110.pdf

NSG Suture Training for Operating room On the job and my years of working as a scrub nurse and circulating nurse in the Operating room.


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