title: Effect of re-sterilization of surgical sutures by ethylene oxide.
abstract: BACKGROUND
  Surgical suture packs are opened (and external packaging removed) on the operating table prior to surgery. Some of these suture packs may not be used in the surgery for reasons of inappropriateness or change in the surgical technique or following accidental contact with a non-sterile surface. These unused sutures with their foil packs still unopened are sometimes re-sterilized using ethylene oxide to allow for reuse. This re-sterilization of unopened suture packs can be contentious, due to legislation and health regulations in developed countries. The purpose of the present paper was to measure the effect of such repeated gas sterilization on sutures.
  
  
  METHODS
  The knot tensile strength was measured for new sterile sutures and ethylene oxide re-sterilized sutures. The tests were conducted on two available brands of sutures, including both absorbable and non-absorbable synthetic sutures.
  
  
  RESULTS
  No statistically significant difference was observed in the tensile strengths between the two sets of sutures, before and after re-sterilization. Some foil packs showed slight crimping after re-sterilization, but remained intact. No humidity was observed inside the foil packs.
  
  
  CONCLUSIONS
  Re-sterilization of unused suture foil packs can be carried out without loss of tensile strength.
authors.affiliation: Narayana Hrudayalaya, Bommasandra Industrial Area, Anekal Taluk, Bangalore, Karnataka, India. dr.prem@indiatimes.com
authors.forename: Prem Anand
authors.initials: PA
authors.lastname: Nagaraja
authors.forename: Devi
authors.initials: D
authors.lastname: Shetty
mesh_terms: D001672:Biocompatible Materials; D004202:Disinfectants; D005027:Ethylene Oxide; D008422:Materials Testing; D011108:Polymers; D019064:Product Packaging; D013242:Sterilization / Q000379:methods*; D013537:Sutures; D013718:Tensile Strength
chemical_list: D001672:Biocompatible Materials; D004202:Disinfectants; D011108:Polymers; D005027:Ethylene Oxide