MONOSORB
Poly[glycolic(75%)-co-caprolactone(25%)] (PGCL) SUTURE
SYNTHETIC ABSORBABLE MONOFILAMENT SUTURES, USP/EP

DESCRIPTION
Monosorb is a short-term absorbable synthetic monofilament suture made of glyconate available in undyed color for the closure of superficial wounds and in violet color for the rest of indications. Monosorb offers excellent handling properties and high knot security.

INDICATIONS
Monosorb is recommended for all soft tissue approximations and/or ligations including gastrointestinal surgery, gynaecology / obstetrics, urology, plastic and reconstructive surgery, skin closure (intra, sub, skin) .But it shouldn't be used in cardiovascular or neurological tissues; microsurgery or ophthalmic surgery. MONOSORB suture is for single use only.

CONTRAINDICATIONS
This suture, being absorbable, should not be used where extended approximation of tissue under stress is required.

ACTIONS
PGCL suture elicits a minimal acute inflammatory reaction in tissue and ingrowth of fibrous connective tissue. Progressive loss of tensile strength and eventual absorption of PGCL suture occurs by means of hydrolysis gradually and decreases the strength in the the body. After hydrolysis its executed from the body as carbon dioxide and water. Absorption begins as a loss of tensile strength followed by a loss of mass. PGCL suture retains 45-70% of the original tensile strength in  7 days  after implantation. At two weeks, approximately 20% of the original strength is retained. Complete mass is absorbed in 60 to 90 days.

WARNINGS
Users should be familiar with surgical procedures and techniques involving absorbable sutures before employing MONOSORB suture for wound closure, as risk of wound dehiscence may vary with the site of application and the suture material used. Physicians should consider the in vivo performance when selecting a suture for use in patients. The use of this suture may be inappropriate in elderly, malnourished, or debilitated patients, or in patients suffering from conditions which may delay wound healing.
Do not resterilize. Discard opened packages and unused sutures.
As with any foreign body, prolonged contact of any suture with salt solutions, such as those found in the urinary or biliary tracts may result in calculus formation. As an absorbable suture, MONOSORB suture may act transiently as a foreign body. Acceptable surgical practice should be followed for the management of contaminated or infected wounds. As this is an absorbable suture material, the use of supplemental nonabsorbable sutures should be considered by the surgeon in the closure of the sites which may undergo expansion, stretching or distension, or which may require additional support.
 
PRECAUTIONS
Skin sutures which must remain in place longer than 7 days may cause localized irritation and should be snipped off or removed as indicated. Subcuticular sutures should be placed as deeply as possible to minimize the erythema and induration normally associated with absorption. Under some circumstances, notably orthopaedic procedures, immobilization of joints by external support may be employed at the discretion of the surgeon. Consideration should be taken in the use of absorbable sutures in tissue with poor blood supply as suture extrusion and delayed absorption may occur.
In handling this or any other suture material, care should be taken to avoid damage from handling. Avoid crushing or crimping damage due to application of surgical instruments such as forceps or needle holders.
MONOSORB suture knots must be properly placed to be secure. Adequate knot security requires the accepted surgical technique of flat and square ties with additional throws as warranted by surgical circumstance and the experience of the surgeon. The use of additional throws may be particularly appropriate when knotting monofilaments.
Avoid prolonged exposure to elevated temperature.
To avoid damaging needle points and swage areas, grasp the needle in an area one-third (1/3) to one-half (1/2) of the distance from the swaged end to the point. Reshaping needles may cause them to lose strength and be less resistant to bending and breaking. Users should exercise caution when handling surgical needles to avoid inadvertent needle sticks. Discard used needles in "sharps" containers. ADVERSE REACTIONS
Adverse effects associated with the use of synthetic absorbable sutures include wound dehiscence, failure to provide adequate wound support in closure of the sites where expansion, stretching, or distension occur, failure to provide adequate wound support in elderly, malnourished or debilitated patients or in patients suffering from conditions which may delay wound healing, infection, minimal acute inflammatory tissue reaction, localized irritation when skin sutures are left in place for greater than 7 days, suture extrusion and delayed absorption in tissue with poor blood supply, calculi formation in urinary and biliary tracts when prolonged contact with salt solutions such as urine and bile occurs, and transitory local irritation at the wound site. Broken needles may result in extended or additional surgeries or residual foreign bodies. Inadvertent needle sticks with contaminated surgical needles may result in the transmission of blood borne pathogens.

HOW SUPPLIED
MONOSORB  sutures are available  in undyed, dyed (violet) strands, in sizes USP 6/0 (0,7 metric) to USP 1 (4 metric), in a variety of lengths with a variety of needles. MONOSORB sutures are available in one, two, and three dozen boxes.
MONOSORB suture is supplied sterile.

STORAGE
Store below 25oC, Keep away from, sunlight
Protect from humidity.
Do not use after expiry date.