Knotless sutures including integrated closures

Abstract

Self-retaining sutures having a first end for penetrating tissue and an elongated suture body comprising a plurality of intermittent apertures structured to enable formation of knotless suture loop closures that securely hold opposing tissue faces together due to the presence of the intermittent apertures through the suture that permit one-way passage of the suture body thus forming a self-retaining or self-engaging loop in the suture that does not slip backwards. Once a desired loop size is formed between tissue faces by pulling the suture through one of the intermittent apertures in the suture thread, the suture thread is clipped and a further loop is begun using the remainder of the suture thread affixed to the suture needle.

1 . A self-retaining suture comprising:
 an elongated barbed suture filament affixed to a needle and a plurality of visually identifiable apertures arrayed at fixed intervals along a longitudinal axis of the elongated barbed suture filament, wherein the apertures are formed with opposing aperture walls having a thickness substantially similar to that of the suture filament, and wherein the apertures are dimensioned to admit one-way passage of the suture laterally through the apertures while barbs on the suture filament resist backwards movement of the suture filament in a direction substantially opposite a direction of deployment of the suture.   
     
     
         2 . The self-retaining suture of  claim 1 , wherein the opposing aperture walls are pliable and able to stretch. 
     
     
         3 . The self-retaining suture of  claim 1 , wherein the opposing aperture walls are pliable and flatten under tension. 
     
     
         4 . The self-retaining suture of  claim 1 , wherein the self-retaining suture is formed of a bioresorbable material. 
     
     
         5 . The self-retaining suture of  claim 1 , wherein the self-retaining suture is formed of a non-bioresorbable material. 
     
     
         6 . The self-retaining suture of  claim 1 , wherein the each of the plurality of apertures has a visually identifiable distinctive coloring or is located one of a plurality of locator bands having visually identifiable distinctive coloring. 
     
     
         7 . The self-retaining suture of  claim 1 , comprising a terminal self-locking aperture. 
     
     
         8 . The self-retaining suture of  claim 1 , wherein the suture filament is circular or generally circular in cross section. 
     
     
         9 . The self-retaining suture of  claim 1 , wherein the suture filament is non-circular and may be ovoid or have a flattened ribbon like form. 
     
     
         10 . The self-retaining suture of  claim 1 , wherein the barbs are disposed on the body of the suture filament in a disposition selected from: unidirectional or bidirectional, evenly spaced down the length of the suture filament in symmetrical pairs, helically placed along a longitudinal axis of the suture filament, in a staggered disposition along the longitudinal axis of the suture filament, in a twist cut multiple spiral disposition along the longitudinal axis of the suture filament, in an overlapping disposition along the longitudinal axis of the suture filament, in a random disposition along the longitudinal axis of the suture filament, and combinations thereof 
     
     
         11 . A self-retaining suture comprising:
 a plurality of visually identifiable apertures interconnected by barbed suture filament, wherein the apertures are formed with opposing aperture walls having a thickness substantially similar to that of the suture filament, and wherein the apertures are dimensioned to admit one-way passage of the barbed suture filament laterally through the apertures while the barbs on the suture filament resist backwards movement of the suture filament through the apertures in a direction substantially opposite a direction of deployment of the suture between opposing tissue surfaces of a wound thus permitting a succession of one-way self-retaining loops to be formed across the wound without use of knots.   
     
     
         12 . The self-retaining suture of  claim 11 , wherein each of the visually identifiable apertures is identified with a distinctive coloring or is located one of a plurality of locator bands having visually identifiable distinctive coloring. 
     
     
         13 . A method of suturing tissue comprising:
 a) providing a self-retaining suture including a barbed suture body attached to a suture needle and a plurality of visually identifiable apertures arrayed at fixed longitudinal intervals along the suture body, wherein the visually identifiable apertures are adapted and dimensioned to admit one-way passage of the suture body laterally through the visually identifiable apertures while the barbs on the suture body resist backwards movement of the suture in a direction substantially opposite the direction of deployment of the suture;   b) deploying the needle through tissue of first and second sides of a wound;   c) pulling the suture body through the first and second sides of the wound and leaving a terminal tail of the suture including at least one aperture disposed outside of the first side of the wound;   d) locating an aperture in the terminal tail of the suture and pulling the suture body through the aperture until a loop is formed that pulls the first and second sides of the wound together;   e) clipping the suture thread past the aperture that forms the loop; and   f) using the remaining suture body to form further stitches by repeating steps a)-e).   
     
     
         14 . The method of  claim 13 , wherein the barbed suture body comprises barbs disposed on the suture body in a disposition selected from: evenly spaced along the longitudinal axis of the suture body in pairs, helically placed along the longitudinal axis of the suture body, in a staggered disposition along the longitudinal axis of the suture body, in a twist cut multiple spiral disposition along the longitudinal axis of the suture body, in an overlapping disposition along the longitudinal axis of the suture body, a random disposition along the longitudinal axis of the suture body, and combinations thereof. 
     
     
         15 . The method of  claim 13 , wherein each of the visually identifiable apertures is identified with a distinctive coloring or is located one of a plurality of locator bands having visually identifiable distinctive coloring. 
     
     
         16 . The method of  claim 13 , wherein the visually identifiable apertures are formed with opposing aperture walls having a thickness substantially similar to that of the suture body rather than as holes in the suture body that reduce a thickness of the suture body at an aperture.