CA2140090C - Composite bioabsorbable materials and surgical articles made therefrom - Google Patents

Composite bioabsorbable materials and surgical articles made therefrom Download PDF

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Publication number
CA2140090C
CA2140090C CA002140090A CA2140090A CA2140090C CA 2140090 C CA2140090 C CA 2140090C CA 002140090 A CA002140090 A CA 002140090A CA 2140090 A CA2140090 A CA 2140090A CA 2140090 C CA2140090 C CA 2140090C
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Prior art keywords
bioabsorbable
composite
filament
shell portion
recited
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CA002140090A
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French (fr)
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CA2140090A1 (en
Inventor
Cheng-Kung Liu
Ying Jiang
Mark S. Roby
Steven L. Bennett
Richard P. Stevenson
Jeffrey P. Pietrangeli
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United States Surgical Corp
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United States Surgical Corp
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/40Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
    • A61L27/44Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
    • A61L27/48Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix with macromolecular fillers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/22Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
    • A61L15/26Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L17/00Materials for surgical sutures or for ligaturing blood vessels ; Materials for prostheses or catheters
    • A61L17/04Non-resorbable materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L17/00Materials for surgical sutures or for ligaturing blood vessels ; Materials for prostheses or catheters
    • A61L17/06At least partially resorbable materials
    • A61L17/10At least partially resorbable materials containing macromolecular materials
    • A61L17/12Homopolymers or copolymers of glycolic acid or lactic acid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L17/00Materials for surgical sutures or for ligaturing blood vessels ; Materials for prostheses or catheters
    • A61L17/14Post-treatment to improve physical properties
    • A61L17/145Coating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/12Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
    • A61L31/125Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
    • A61L31/129Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix containing macromolecular fillers
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S602/00Surgery: splint, brace, or bandage
    • Y10S602/904Film-forming bandage material

Abstract

The present invention relates to composite materials having a core portion formed from a first bioabsorbable material and at least one shell portion of a second bioabsorbable material joined to the core portion. The first and second bioabsorbable materials have different rates of bioabsorption. In a preferred embodiment, the core portion is coextruded with the shell portion to form a composite filament or sheet. The materials of the present invention may be used as sutures or formed into medical devices or surgical articles for implantation within a living organism.

Description

~14Q090 1478 (203-1183) COMPOSITE BIOABSORBABLE MATERIALS
AND SURGICAL ARTICLES MADE THEREFROM
BACKGROUND OF THE INVENTION
1. Field of the Invention The invention relates to bioabsorbable materials and, more particularly, to composite bioabsorbable materials such as filaments and sheets. The composite includes a core of a first bioabsorbable material and at least one shell joined to the core, the shell being formed of a second bioabsorbable material. The first and second bioabsorbable materials preferably have different absorption rates.
2. Description of the Related Art Bioabsorbable materials are known in the art for a variety of uses, particularly those uses in which the bioabsorbable material is implanted within a living organism for medical purposes. The term "bioabsorbable" is used to describe a material capable of being broken down into smaller constituents which can be metabolized and/or excreted by a living organism.
Hydrolysis is one mechanism by which many bioabsorbable materials are broken down following implantation within a living organism.
Such materials are useful for temporarily holding tissues in a desired position during healing, and being absorbed by the organism after a period of time.
Various bioabsorbable materials and medical devices made therefrom are known in the art. See, e.g., U.S. Patent Nos.
2,668,162: 2,703,316; 2,758,987; 3,225,766; 3,297,033; 3,422,181;
3,531,561; 3,565,077; 3,565,869 ;3,620,218; 3,626,948; 3,636,956;
3,736,646; 3,772,420; 3,773,919; 3,792,010; 3,797,499; 3,839,297;
3,867,190; 3,878,284; 3,982,543; 4,047,533; 4,052,988; 4,060,089;
4,137,921; 4,157,437; 4,234,775; 4,237,920; 4,300,565;
4,429,080; 4,441,496; 4,523,591; 4,546,152; 4,559,945; 4,643,191;
4,646,741; 4,653,497; and, 4,741,337; U.K. Patent No. 779,291;
D.K. Gilding et al., "Biodegradable polymers for use in surgery -- polyglycolide/poly(lactic acid) homo- and copolymers: 1", ~14Q~90 Polymer, Volume 20, pages 1459-1464 (1979), and D.F. Williams (ed.), Biocomt~atibility of Clinical Implant Materials Vol. II, ch. 9: "Biodegradable Polymers" (1981).
Fiber-reinforced compositions used for surgical implants have been described in U.S. Patent Nos. 4,279,249; 4,550,449;
4,539,931; 4,743,257; 5,080,665. The fiber-reinforcements in these compositions provide increased strength and rigidity as may be required for bone repair, but render these compositions unsuitable where flexibility is required.
The present invention provides an implantable composite having a bioabsorption rate which varies over time and which is suitable for use in making a variety of medical devices, including those in which flexibility is a desirable characteristic.
SUMMARY OF THE INVENTION
The present invention relates to composite materials having a core portion formed from a first bioabsorbable material and at least one shell portion formed from a second bioabsorbable material joined to the core portion. The first and second bioabsorbable materials have different rates of bioabsorption.
In a preferred embodiment, the core portion is coextruded with the shell portion to form a composite filament or sheet. The materials of the present invention may be used as sutures or formed into medical devices or surgical articles for implantation within a living organism.

g BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1A illustrates a filament having a core portion and a shell portion according to the present invention.
Fig. 1B illustrates a filament having a core portion and plural shell portions according to the present invention.
Fig. 2A illustrates a sheet having a core portion and a shell portion according to the present invention.
Fig. 2B illustrates a sheet having a core portion and plural shell portions according to the present invention.
Fig. 3 is a coextrusion die optionally used to form a composite filament_according to the present invention.
Fig. 4 is a coextrusion die optionally used to form a composite sheet according to the present invention.
Fig. 5 schematically illustrates a spinning process used to-form filaments according to the present invention.
DETAILED DESCRIPTION OF THE 'PREFERRED EMBODIMENTS
Referring now in detail to the drawings, Fig. 1A shows a filament l0 having a core portion 20 surrounded by a shell portion 30. Shell portion 30 is joined to core portion 20 in such a manner that the two portions form a single, structural element, i.e., filament 10. As such, filament 10 is a composite material in which all of the constituent elements contribute to the properties of the overall structure. Thus, filament 10 differs from coated filaments in that the coatings of such filaments, even for very thick coatings, do not contribute substantially to the strength of the filament.
Fig. 1B illustrates a composite filament 15 having a core portion 25, a first shell portion 35, and a second shell portion 38. In this embodiment, three separate materials may be used to form portions 25, 35, and 38 or the outer shell 38 may be the same material as the core portion 25. It is within the scope of the invention to produce filaments having any number of shell portions, depending upon the desired application of the filament.
Fig. 2A shows a composite sheet 40 having a core portion 50 and a shell portion 60. As with the composite filament of Fig.

~1~40~~

1, the composite sheet 40 is fabricated so that the core 50 is joined to shell 60 such that the sheet behaves as a unified structural entity.
Fig. 2B shows a composite sheet 45 having a core portion 55 and shell portions 65 and 75. As with the composite filament of Fig. 1B, the sheet of Fig. 2B may include any number of shell portions, depending upon its ultimate use.
The dimensions of the core portion and shell portion can vary widely depending on a number of factors including the materials from which the composite is made and the intended use of the composite. _Generally, the thickness of the core portion can range from about 0.001 mm to 10 mm or more, and the thickness of the shell portion can range from about 0.0001 mm to about 10 mm or more. For example, when the intended use is as a suture, a composite having a generally cylindrical core portion made from polydioxanone with a diameter in the range of about 0.01 mm to about 0.8 mm, with a shell portion made from polycaprolactone having a thickness of about 0.001 mm to about 0.5 mm will provide a filament having acceptable flexibility and strength. Where a more rigid, rod-like structure is desired, for example to be used as an osteosynthesis device, a generally cylindrical core portion made from polyglycolide with a diameter in the range of about 0.1 mm to about 1.0 mm with a shell portion made from polydiaxanone and having a thickness of about 0.001 mm to about 0.2 mm will provide suitable rigidity and strength. For laminated sheet-like composites, useful for example as an adhesion barrier, hernia repair device, organ support, artificial skin substrate, bone plate, or stent, a core portion made from polyglycolide having a thickness of about 0.0 mm to about 5 mm having a shell portion made from polydioxanone and having a thickness of about 0.01 mm to about 0.25 mm joined to at least one side of the core portion would provide a composite with suitable physical characteristics.
In particularly useful embodiments, the core portion and shell portion are substantially co-extensive. It is also contemplated, however, that composites wherein the shell portion only partially covers the core portion can be made in accordance with this invention.
In a preferred embodiment, the materials used to form the core and shell portions of composite filament 10 and composite sheet 40 are bioabsorbable materials. Bioabsorbable materials used to form the core portions of these composites include, but are not limited to absorbable polymers made from glycolide, glycolic acid, lactide, lactic acid, caprolactone, dioxanone, trimethylene carbonate and dimethyl trimethylene carbonate.
Copolymers (block or random) and mixtures and blends of such polymers or copolymers are also useful. Particularly useful absorbable polymers for the core portion include glycolide/lactide copolymers, polycaprolactone and polydioxanone.
Bioabsorbable materials used to form the shell portions of the composite filaments and sheets include, but are not limited to, absorbable polymers made from glycolide, glycolic acid, lactide, lactic acid, caprolactone, dioxanone, trimethylene carbonate and dimethyl trimethylene carbonate. Copolymers, (block or random) and mixtures and blends of such polymers and/or copolymers are also useful. Particularly useful polymers for the shell portion include polydioxanone, polycaprolactone, polylactide and polytrimethylene carbonate.
In one preferred embodiment of the present invention, the material used to form the core portion of the composite material has a higher rate of bioabsorption than the material used to form the shell portion of the composite material. This embodiment provides a strong, fiber-forming core material combined with a flexible shell material to provide a strong and flexible composite. Such core materials include, but are not limited to, bioabsorbable polymers, copolymers, or mixtures fabricated from glycolide or glycolic acid. Particularly preferred glycolide-containing polymers include copolymers of glycolide and lactide having 90% glycolide and 10% lactide, copolymers of glycolide and lactide having 92.5% glycolide and 7.5% lactide, and copolymers of glycolide and lactide having 18% glycolide and 82% lactide.

~14009fl Materials having a lower rate of hydrolysis relative to the above glycolide-containing polymers are used to form the shell portion of the above composite material. Such relatively lower hydrolysis rate materials include bioabsorbable polymers, copolymers, or mixtures fabricated from polydioxanone, polyactide, polycaprolactone, and polytrimethylene carbonate.
Particularly preferred combinations for composite materials having a core with a higher rate of hydrolysis than the shell include, but are not limited to: a core of a copolymer of 18%
glycolide and 82% lactide with a shell of polydioxanone; a core of a copolymer of 92.5% glycolide and 7.5% lactide with a shell of polydioxanone; a core of a copolymer of 25% glycolide and 75%
lactide backfilled with glycolide as shown in U.S. Patent No.
4,844,854 with a shell of polydioxanone; a core of a triblock copolymer glycolide and dioxanone (as described above) with a shell of polycaprolactone; and a core of polydioxanone with a shell of polycaprolactone.
In another preferred embodiment of the present invention the material used to form the core portion of the composite material has a lower rate of bioabsorption than the material used to form the shell portion of the composite material. A higher rate of bioabsorption for the shell may, in some applications, serve to enhance tissue ingrowth and subsequent healing and wound closure.
In this embodiment, the core may be of bioabsorbable polymers, copolymers, or mixtures fabricated from polydioxanone, polycaprolactone, and polytrimethylene carbonate. The shell may be of bioabsorbable polymers, copolymers, or mixtures fabricated from glycolide or glycolic acid. Particularly preferred glycolide-containing polymers include copolymers of glycolide and lactide having 90% glycolide and 10% lactide, copolymers of glycolide and lactide having 92.5% glycolide and 7.5% lactide, and copolymers of glycolide and lactide having 18% glycolide and 82% lactide.
The invention also contemplates using materials that are formed from the same composition for both the core and the shell portions. However, the morphology of the material of the core ~~~Ofl9~
layer is selected to be different from the morphology of the material of the shell layer such that the two layers have different rates of bioabsorption. In general, it is known that amorphous polymers have higher rates of hydrolysis than crystalline versions of the same polymer. For example, the core material may be formed from an amorphous glycolide-containing polymer while the shell may be formed from a crystalline glycolide-containing polymer. Materials may be added to the polymer melt during formation of the composite material to promote crystallinity in the shell layer.
Although the above descriptions of preferred-embodiments focus on bioabsorbable polymers, it is understood that those of skill may select any two bioabsorbable materials having different rates of bioabsorption to construct a bioabsorbable composite having the desired strength and bioabsorption characteristics needed for a particular medical or surgical application. Such bioabsorbable materials include, but are not limited to, collagen, chitin, chitin derivatives (e. g., chitosan), amino acid polymers (e. g., gelatin), and polysaccharides (e. g., dextran).
In another aspect of the present invention, composite materials having a core/shell structure may be fabricated using non-absorbable, biocompatible materials. Such materials include biocompatible polymeric materials which may be used in applications requiring a more permanent implantation of a prosthetic device. Core and shell polymeric materials include polyesters (e. g., polyalkyl terephthalates), polyamides (e. g., nylon), polyurethanes, polycarbonates, polyimides, fluoropolymers, polyolefins, vinyl polymers, etc.
Particularly preferred combinations include coextruded polyester and polyurethane fibers and coextruded low order and high order nylons such as nylon 6 or nylon 66 with nylon 12.
Biocompatible implants such as sutures, soft tissue patches, surgical mesh, wound dressings, surgical felts, vascular grafts, nerve repair devices, artificial skin and sternum tape may be fabricated from the composite biocompatible materials.

1~40~D
_8_ The composite filaments and sheets of the present invention may be fabricated by a number of known polymer processing techniques. One preferred technique is coextrusion. Extrusion is a polymer processing technique in which a viscous melt is fed, under pressure, through a die in a continuous stream. In coextrusion, plural polymer melt streams feed through individual flow channels to be shaped as a single polymeric article. The polymer melts may be combined in several ways. Plural melts may be extruded separately from a single die, plural melts may be extruded partly separately followed by combined extrusion, or plural melts may be coextruded together.
A coextrusion die which may be used to form a composite filament according to the present invention is illustrated schematically in Fig. 3. In Fig. 3, the polymer melt used to form core 20 of filament 10 passes through central flow channel 70 where it is shaped as it passes through channel exit 72. The polymer melt used to form the shell 30 of filament 10 passes through outer flow channel 80 where it is shaped as it passes through channel exit 82. The two concentric polymer melts-are joined at die exit 90, forming a continuous polymer melt.
A coextrusion die which may be used to form a composite sheet according to the present invention is schematically depicted in Fig. 4. In Fig. 4, the polymer used to form core portion 50 of sheet 40 is fed from an extruder to flow channel 100. The polymer used to form shell portion 60 of sheet 40 is fed from extruders to flow channels 110 and 120. The melts are in region 130 of the die and are formed into a sheet in region 140.
The dies and methods described above with reference to Figs.
3 and 4 are exemplary of coextrusion techniques used to form the filaments and sheets of the present invention. Any coextrusion process may be used to form the bioabsorbable composite filaments and sheets. Examples of other coextrusion processes suitable for use in forming the materials of the invention as well as examples of suitable extrusion apparatus which may be used with the dies of Figs. 3 and 4 are found in Vols. 4 and 6 of the Encyclopedia of Polymer Science and Enq~ineering, (John Wiley & Sons, New _9_ York), c. 1986, pp. 812-832 and 571-631, respectively.
In another preferred embodiment of the present invention, the composite materials may be spun into fibE~rs to be used as monofilament or multifilament sutures. An exemplary spinning process is schematically illustrated in Fig. 5. To produce fibers having the core/shell structure of Fig. 1, the core and shell constituent materials are separately melted. The constituent materials are separately fed as ~>olymer melts 213 to : spinneret 215 and are combined in the manner shown in Fig. 3 just before the spinneret exit orifice. Although a single filament is shown for clarity in Fig. 5, it is understood that spinnerets having any desired number of exit orifices in a range of exit diameters may be used.
Molten monofilament 216 exits spinneret 215, passes through air gap 214, and enters quench bath 217. Air gap 2i4 is the distance between the spinneret exit and bath 217. Preferably, the air gap distance ranges from 0.5 to 100 centimeters and, more preferably, from about 1 to 20 centimeters. As monofilament 216 passes through bath 21, it solidifies. In a preferred embodiment, quench bath 217 is a water bath.
Within the quench bath, filament 216 is driven by drive roller 218. As it emerges from the bath, a wiper may optionally remove excess water. Monofilament 216 wraps around a first godet 221 and is prevented from slipping by nip roll 222. Godets 301, 302, 303, and 304 engage and drive the filament prior to a stretching operation. The number of godets is not critical; any suitable godet system may be employed in the spinning process of the present invention.
During stretching, monofilament 216 is drawn through hot , water bath 223 by godets 224, 305, 306, 307, and 308 or any other suitable arrangement. This second godet system rotates at a higher speed than that of godet 104 to provide a desired stretch ratio.
Following stretching, monofilament 216 may be annealed within hot air oven chamber 225, driven by go~dets 226, 309, 310, 311, or 312, or. any other suitable drawing system. Take-up reel 313 winds the finished monofilament product.
Other suitable fiber manufacture processes, including other spinning processes, which may be used to forms the composite materials of the present invention are described in Volume 6 of the Encyclopedia of Polymer Science and Enqineerina, (John Wiley & Sons, New York), c. 1986, pp. 802-839.
' Other polymer processing techniques may be used to form the ~ composite filaments and sheets of the present. invention. These include, but are not limited to, casting, injection molding, and blow molding. In short, any polymer processing technique capable of creating composite materials having shell portions adequately joined with core portions are contemplated to form the composite bioabsorbable materials of the present invention.
In general, the formation of a composite: depends on both materials being heated to a temperature at which fusion of at least the surface of the materials begins. Where coextrusion is the method used to from the composite, both miaterials are heated to a temperature above their respective melting points. Where pressing is used to from the composites, the combination of temperature and pressure should be such that at least the surface of the core portion and the surface of the shell portion in contact therewith begin to fuse so that the t.wo portions are joined into a unitary structure.
As will be appreciated by those skilled in the art, a certain amount of mixing of the core and shell materials will occur at the interface of those two portions. The amount of mixing may be only at the molecular level and. thus, as a practical matter undetectable. However, in some instances the, amount of mixing may be sufficient to produce: a micro-shell layer at the interface between the shell and core portions. This micro-shell layer is made from a mixture of the core and shell materials and has its own bioabsorption profile.
The composite bioabsorbable materials of the present invention may be used to form various surgical devices. The ~.14~ ~'~ ~

composite filaments may be used as monofilament sutures or combined to make multifilament sutures. The filaments may be woven to form sheets which may be used to form various prosthetic devices such as vascular grafts, muscle grafts, bone fillers, etc. Alternatively the filaments can be formed into non-woven fabrics by lamination with or without additional polymeric matrix. Such non-woven fabrics may be used for the same purposes as the woven fabrics listed above.
The composite bioabsorbable sheets of the present invention may also be used to form prosthetic devices. Devices may be formed by molding the composite sheets into the above named devices. The sheets may also be formed into other surgical implants such as surgical clips, surgical fasteners, staples, bone pins, bone screws, anastomosis rings; wound dressings, drug delivery devices, etc.
It is within the scope of this invention to coat or impregnate the bioabsorbable composite materials of the present invention as well as implants and prosthetic devices made therefrom with one or more materials which enhance its functionality, e.g., surgically useful substances, such as those which accelerate or beneficially modify the healing process when the material is implanted within a living organism. Thus, for example, antimicrobial agents such as broad spectrum antibiotics (gentamicin sulphate, erythromycin or derivatized glycopeptides) which are slowly released into the tissue can be incorporated to aid in combating clinical and sub-clinical infections in a surgical or trauma wound site.
To promote wound repair and/or tissue growth one or several substances can be introduced into the composite bioabsorbable materials of the present invention or impregnated into fabrics or prostheses made from the composite bioabsorbable materials.
Exemplary substances include polypeptides such as human growth factors. The term "human growth factor" or "HGF" embraces those materials, known in the literature, which are referred to as such and includes their biologically active, closely related derivatives. The HGFs can be derived from naturally occurring sources and are preferably produced by recombinant DNA
techniques. Specifically, any of the HGFs which are mitogenically active and as such effective in stimulating, accelerating, potentiating or otherwise enhancing the wound healing process are useful herein. Growth factors contemplated for use in the materials.of the present invention include hEGF
(urogastrone), TGF-beta, IGF, PDGF, FGF, etc. These growth factors, methods by which they can be obtained and methods and compositions featuring their.use to enhance wound healing are , variously disclosed, inter alia, in U.S. Patent Nos. 3,883,497;
3,917,824; 3,948,875; 4,338,397; 4,418,691: 4,528,186, 4,621,052;
4,743,679 and 4,717,717; European Patent Applications 0 046 039;
0 128 733; 0 131 868; 0 136 490; 0 147 178; 0 150 572; 0 177 915 and 0 267 015; PCT International Applications WO 83/04030; WO
85/00369; WO 85/01284 and WO 86/02271 and UK Patent Applications GB 2 092 155 A; 2,162,851 A and GB 2 172 890 .A
When incorporating wound healing substances such as those discussed above, it may be advantageous to use composite materials having at least,one shell layer are formed from a bioabsorbable material having a relatively high rate of bioabsorption. By incorporating wound healing substances in a high rate bioabsorption layer, the substance will be more quickly absorbed while the remaining composite material will still retain sufficiently good mechanical properties to perform its medical or surgical function.
To decrease abrasion, increase lubricity, etc., the bioabsorbable composite materials can be coated with various substances. Copolymers of glycolide and lactide and polyethylene oxide, calcium salts such as calcium stearate, compounds of the pluronic class, copolymers of caprolactone, c;aprolactone with , PEO, polyHEMA, etc. may be employed.
Table I below sets forth. typical conditions for extruding, stretching composite monofilament sutures in accordance with this invention.

TABLE I
CONDITIONS OF MANUFACTURING COMPOSITE
MONOFILAMENT OF THE PRESENT INVENTION
EXAMPLE
Suture Size 3/0 Material Polycaprolactone Polydioxanone Process Conditions Eutrusion Operation Extruder _ Extruder 1 (shell) Extruder 2 (core) extruder screw, rpm 0.6 1.3 pump rpm 4.4 5.8 barrel temp., C, zone A 80 52 barrel temp., C, zone B 120 135 barrel temp., C, zone C 120 135 clamp temp., C 120 135 adapter temp., C 120 130 Process Conditions Extrusion Operation pump temp., C 120 135 barrel melt temp, C 117 149 pump melt temp., C 117 150 spinneret melt temp., C 118 118 barrel pressure, psi 760 1250 pump pressure, psi 500 1000 spinneret pressure, psi 840 1980 pump size, cc perrevolution outside diameter of 0.16 0.16 spinneret orifices, mm inside diameter of 0.28 --spinneret orifices, mm -- 0.25 quench bath temp., °C 18 18 stretching (orienting) Operation EXAMPLE

draw bath temp., C 50 first godet, mpm 4.2 second godet, mpm 19.7 second oven temp., C 70 third godet, mpm 24.6 draw ratio 5.9 . 1 Annealing Operation EXAMPLE
oven temp., °C 50 time (hrs.) 18 The physical properties of the sutures and the procedures employed for their measurement are set forth in Table II as follows:
TABLE II
PROCEDURES FOR MEASURING PHYSICAL PROPERTIES OF
COMPOSITE MONOFILAMENT SUTURES OF THE PRESENT INVENTION
Physical Property Test Procedure knot-pull strength, kg U.S.P. XXI, tensile strength, sutures (881) straight-pull strength, kg ASTM D-2256, Instron Corporation elongation, % ATSM D-2256 tensile strength, kg/mm2 ASTM D-2256, Instron Corporation Series IX Automated Materials Testing System 1.03A

~. ~_ ~.Q a ~ ~~

Table III below sets forth the physical properties of the composite monofilament suture of the present invention.
TABLE III
Physical Property diameter (mm) 0.295 shell thickness (mm) 0.036 core thickness (mm) 0.223 knot-pull strength (kg) 2.2 straight-pull strength (kg) - 3.0 elongation (~) 26 tensile strength (kg/mm2) 47 Although the composite bioabsorbable materials and processes for their manufacture have been described in terms of the preferred embodiments, numerous modifications will be readily apparent to those skilled in the art. For example, composite medical or surgical articles having a composite core/shell structure may be formed directly by coextrusion, injection molding, casting, etc. Composite materials having a core/shell structure may also be fabricated by lamination bonding techniques, e.g., hot isostatic pressing. Such techniques also result in composite materials whose mechanical properties may be described using the above rule of mixtures equation.
While the invention has been shown and described with reference to the preferred embodiments, it will be understood by those skilled in the art that various modifications in form and detail may be made without departing from the scope and spirit of the invention. Accordingly, modifications such as those suggested above, but not limited thereto, are to be considered within the scope of the invention.

Claims (22)

1. A composite bioabsorbable filament implantable within a living organism comprising:
a core portion formed from a first bioabsorbable material;
a shell portion joined to said core portion, said shell portion formed from a second bioabsorbable material;
said first and second bioabsorbable materials having different rates of bioabsorption; and wherein said bioabsorbable filament is formed by co-extruding said core portion and said shell portion.
2. The bioabsorbable filament as recited in claim 1, wherein said first bioabsorbable material has a greater rate of bioabsorption than said second bioabsorbable material.
3. The bioabsorbable filament as recited in claim 1, wherein said second bioabsorbable material has a greater rate of bioabsorption than said first bioabsorbable material.
4. The bioabsorbable filament as recited in any once of claims 1 to 3, wherein said first and second bioabsorbable materials are selected from the group consisting of polymers, copolymers and block copolymers of glycolide, glycolic acid, lactide, lactic acid, caprolactone, dioxanone, trimethylene carbonate, dimethyl trimethylene carbonate, 1,3-dioxane-2-one, 1,4-dioxane-2-one and mixtures or blends thereof.
5. The bioabsorbable filament as recited in claim 1, wherein said first bioabsorbable material comprises a glycolide-containing polymer and said second bioabsorbable material comprises polydioxanone.
6. The bioabsorbable filament as recited in claim 1, wherein said first bioabsorbable material comprises polydioxanone and said second bioabsorbable material comprises polycaprolactone.
7. The bioabsorbable filament as recited in any one of claims 1 to 6, wherein said shell portion is coextensive with said core portion.
8. A woven prosthetic device made from the composite filament of any one of claims 1 to 7.
9. A non-woven prosthetic device made from the composite filament of any one of claims 1 to 7.
10. The bioabsorbable filament as recited in claim 1, wherein said shell portion comprises a first shell portion formed from said second bioabsorbable material and a second shell portion formed from a third bioabsorbable material, said second and third bioabsorbable materials having different rates of bioabsorption.
11. The bioabsorbable filament as recited in any one of claims 1 to 7, further comprising a coating formed over said shell portion.
12. A suture formed from the bioabsorbable filament of any one of claims 1 to 7.
13. A composite bioabsorbable sheet implantable within a living organism comprising:
a core portion formed from a first bioabsorbable material;
a shell portion joined to said core portion, said shell portion formed from a second bioabsorbable material;
said first and second bioabsorbable materials having different rates of bioabsorption; and wherein said bioabsorbable sheet is formed by co-extruding said core portion and said shell portion.
14. The bioabsorbable sheet as recited in claim 13, wherein said first bioabsorbable material has a greater rate of bioabsorption than said second bioabsorbable material.
15. The bioabsorbable sheet as recited in claim 13 or 14, wherein said first and second bioabsorbable materials are selected from the group consisting of polymers, copolymers and block copolymers of glycolide, glycolic acid, lactide, lactic acid, caprolactone, dioxanone, trimethylene carbonate, dimethyl trimethylene carbonate, 1,3-dioxane-2-one, 1,4-dioxane-2-one and mixtures or blends thereof.
16. The bioabsorbable sheet as recited in claim 13, wherein said shell portion comprises a first shell portion formed from said second bioabsorbable material and a second shell portion formed from a third bioabsorbable material, said second and third bioabsorbable materials having different rates of bioabsorption.
17. A method for making a composite bioabsorbable material comprising:, forming a first melt of a first bioabsorbable material;
forming a second melt of a second bioabsorbable material, said second bioabsorbable material having a different rate of bioabsorption than said first bioabsorbable material;
co-extruding said first and second material melts to form a composition bioabsorbable material having a core portion and a shell portion integral with said core portion such that said first melt forms said core portion and second second melt forms said shell portion.
18. The method for making a composite bioabsorbable material as recited in claim 17 wherein said coextrusion is performed through a spinneret to form a filament.
19. The method for making a composite bioabsorbable material as recited in claim 18, further comprising stretching said filament to form a monofilament suture.
20. Use of a composite material comprising the composite material defined in any one of claims 1 to 7 as a bioabsorbable filament.
21. Use of a composite material comprising the composite material defined in any one of claims 1 to 7, as a bioabsorbable sheet.
22. Use of a composite material comprising the composite material defined in any one of claims 1 to 7 as a prosthetic device.
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