Molded suture retainer

Abstract: A molded suture retainer (20) is provided for retaining and storing sutures. Both absorbable and nonabsorbable sutures fabricated from natural or synthetic materials can be advantageously retained and stored therein. The retainer (20) is characterized by a wide spiraling oval passageway (26) with minimal convolutions covered by a cover sheet (30). The length of the passageway (26) is preferably proportional to 1/3 to 1/2 the overall length of the suture to be retained therein. Recesses (61) are provided for receiving package stabilizing agents (60) and/or needle parks (42). Sutures packaged in accordance with the invention exhibit fewer kinks and bends than prior packaged sutures.

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to packaging of sutures and, more particularly, to packages for sutures to improve loading and handling characteristics thereof. Suture packages are disclosed in e.g. EP-A-471458 which was not published until February 19, 1992, later than the present filing date. 2. Description of the Related Art This invention relates to molded suture retainers and their use for packaging sutures, including nonabsorbable and synthetic absorbable sutures, to improve the out of package flexibility and handling characteristics of the sutures after storage. Sutures can be either monofilament or braided and are available in a wide variety of materials including cotton, silk, stainless steel, catgut, and dacron, nylon or other synthetic materials. Synthetic absorbable sutures are typically formed using polymers and copolymers of glycolic acid (i.e., hydroxyacetic acid), the cyclic diner of glycolic acid ("glycolide"), lactic acid, the cyclic dimer of lactic acid ("lactide") and related monomers, polydioxanone, polytrimethylene carbonate, polyalkylene glycol, polycaprolactone, their copolymers, etc. Many types of packages for sutures are known in the art including those described in U.S. Patent Nos. 2,917,878; 2,949,181; 2,965,225; 3,043,067; 3,143,209; 3,147,861; 3,163,288; 3,202,272; 3,221,873; 3,256,981; 3,280,971; 3,315,802; 3,319,782; 3,338,401; 3,357,549; 3,490,192; 3,613,879; 3,627,120; 3,642,126; 3,648,949; 3,8766,068; 3,939,969; 4,014,433; 4,069,912; 4,089,410; 4,135,623; 4,168,000; 4,249,656; 4,261,463; 4,284,194; 4,369,880; and, 4,549,649. Nonabsorbable sutures may be packaged and/or sterilized using conventional techniques without concern for degradation of the suture material through hydrolysis. Synthetic absorbable sutures, in contrast, typically are packaged in moisture impervious foil laminate envelopes wherein the suture is wound in a figure 8 pattern on a paper retainer. Typical retainers of this type are shown in U.S. Patent Nos. 4,131,195, 4,192,420, 4,249,656, 4,253,563 and 4,063,638. Molded suture packages having narrow convoluted passageways configured to predetermine the coil of the suture are also known. For example, U.S. Patent Nos. 3,338,401 and 3,490,192 disclose molded suture packages wherein one or more elongated sutures are retained in a coiled narrow passageway having a plurality of convolutions therein. These passageways are proportioned to accommodate an entire length of the suture end to end without folding. These passageways are typically molded into a plastic carrier material and define a small diameter hollow plastic tube. The patents also discuss the loading of sutures into the passageways using a vacuum. Molded retainers have been used to package some nonabsorbable sutures, but have not been adopted for widespread use in packaging sutures, particularly synthetic absorbable sutures. Typical commercially available synthetic absorbable sutures are packaged under extremely dry conditions, and are relatively stiff and inflexible upon removal from the packaging. Such sutures exhibit "memory" which causes the suture to retain or resume the customary or coiled shape assumed by sutures packaged in such a configuration in a cardboard or paper retainer. This effect is undesirable since the suture must be straightened prior to use. It is believed that the extremely dry conditions required for packaging prior synthetic absorbable sutures, together with the suture memory effect created by such packaging and the number and radius of curvature of the convolutions required to accommodate full length sutures may combine to make it difficult or impossible to withdraw the suture from such packaging without breaking the suture or detaching the needle from an armed suture. This is particularly believed to be true in the case of sutures having lengths in excess of 20 inches wherein the passageways must be compressed and convoluted in order to accommodate the suture end to end. Therefore, it would be highly desirable to provide a molded suture retainer and improved method of loading same. Accordingly, it is one object of the invention to provide a molded suture retainer which permits easy installation, storage and removal of sutures without kinks and bends therein. It is a further object of the present invention to provide a molded suture retainer and method of loading same which provides more efficient loading, storage and removal of long length sutures. It is another object of the present invention to provide a molded suture retainer for efficiently storing surgical sutures fabricated from hydrolytically unstable polymers. These and other highly desirable and unusual results are accomplished by the present invention in a molded suture retainer which permits the loading and efficient storage of sutures and easy removal without kinks and bends. Objects and advantages of the invention are set forth in part herein and in part will be obvious herefrom, or may be learned by practice with the invention, which is realized and attained by means of the instrumentalities and combinations pointed out in the appended claims. The invention consists of the novel parts, constructions, arrangements, combinations, steps and improvements herein shown and described. SUMMARY OF THE INVENTION A molded suture retainer with the features defined in claim 1 below is provided for retaining and storing sutures constructed of natural or synthetic materials including both absorbable and nonabsorbable sutures. In some embodiments, the retainer comprises a molded member defining a wide passageway open at the top and sufficient for holding a plurality of strands of sutures therein. These passageways are formed in an oval configuration spiraling toward the interior of the retainer with a minimum number of convolutions. For long sutures the length of the passageway is preferably proportional to 1/3 to 1/2 the overall length of the suture to be retained therein. Other proportions are also contemplated. One end of the passageway serves as a suture receiving section to facilitate loading of the sutures. A vacuum receiving section is placed at the opposite end of the passageway to allow a vacuum to be drawn through the passageway to help position the sutures therein. This vacuum receiving section is formed in an angular configuration It has a vacuum hole offset from the end of the passageway to facilitate loading without the risk of drawing the suture end out of the hole. The present invention contemplates the loading and storage of both armed sutures, i.e. sutures having needles attached thereto, and unarmed sutures without needles attached. The molded suture retainer is provided with a recessed compartment for containing a package stabilizing element and, where desired, a molded needle park for safely and securely retaining the needles of retained armed sutures. The term "package stabilizing element" as used herein refers to a material which maintains a stabilizing agent solvent level within a sealed package against any substantial increase or decrease, and specifically includes but is not limited to a mass of stabilizing agent within the package separate and apart from the retained suture. The term "stabilizing agent" as used herein refers to a material which, when associated with a polymeric article susceptible to hydrolysis, improves the storage stability of the polymeric article and eliminates any need to store the article in an artificially-maintained very dry environment. In the context of the preferred embodiment of the invention, water is the stabilizing agent solvent and the package stabilizing element will hereinafter be discussed in the context of water based systems, but should not be construed to be limited thereto. The stabilizing element and/or needle park compartments are preferably recessed within the confines of the spiral passageway and do not extend in height beyond the dimensions of the molded suture retainer. This configuration facilitates easy and efficient stacking of multiple retainers. A cover sheet is used to overlie the open top of the retainer. The cover sheet has a vacuum aperture and suture entrance aperture formed therein. The vacuum aperture aligns and communicates with the vacuum receiving section of the passageway while the suture entrance aperture aligns and communicates with the suture receiving section of the passageway. Where desired, special needle holding sections or a foam needle park can be added to the retainer for convenient needle positioning. The cover sheet may also include a fold over section to cover the needle when packaged, but which is moved to an open position upon opening the outer pouch in order to reveal the needle. The retainer, when loaded with synthetic absorbable suture material, is preferably placed into an open foil laminate envelope where it is subject to treatment in an ethylene oxide gas sterilization cycle. The sterile retainer and its contents are then equilibrated, such as in a dew point controlled environment, until a desired moisture level is attained, and sealed. When loaded with nonabsorbable sutures the retainer may be sealed in a "breather pouch", i.e. a two layer package consisting of a porous fibrous layer sealed to a plastic sheet material and sterilized. In one embodiment of this invention, the suture is advantageously folded prior to positioning within the passageway. For double armed or long length sutures, the suture preferably is folded either in half or in thirds. Where exceptionally long sutures are contemplated, folding can be in fourths or fifths or close approximations thereof. For an armed suture, loading is accomplished by feeding the end opposite the needle into the suture entrance aperture. A vacuum is drawn on the passageway adjacent the vacuum aperture and serves to draw the suture, which may be folded, into the passageway. BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings, referred to herein and constituting a part hereof, illustrate the preferred embodiments of the molded suture retainer of the present invention, and together with the description serve to explain the principles of the invention. Figs. 1 to 8 of the original specification are cancelled. Figures 4 to 8 appear in Applicant's earlier EP-A-471458. Fig. 9 is a perspective view of the top, and Figure 10 is a perspective view of the bottom, of a molded suture retainer in accordance with the invention. Fig. 11 is a bottom plan view of the molded suture retainer of Fig. 9. Figs. 12 and 13 are end views of the molded suture retainer of Fig. 9. Figs. 14 and 15 are side views of the molded suture retainer of Fig. 9. Fig. 16 is an end view in cross section taken along line 16-16 of Fig. 14. Fig. 17 is a perspective view of the top of a molded suture retainer in accordance with another embodiment of the present invention. Fig. 18 is a perspective view of the bottom of a molded suture retainer in accordance with the embodiment of Fig. 17. Fig. 19 is a bottom view of the molded suture retainer of Fig. 17. Figs. 20 and 21 are end views of the molded suture retainer of Fig. 17. Figs. 22 and 23 are side views of the molded suture retainer of Fig. 17. Fig. 24 is an end view in cross section taken along lines 24-24 of Fig. 22. Fig. 25 is a bottom plan view of an embodiment of the present invention showing the package stabilizing element in place. Fig. 26 is a perspective view in partial cross section of the embodiment of Fig. 25. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS For a description of what is shown in Figures 1 to 8, readers are invited to refer to EP-A-471458. In the embodiment of the present invention shown in Figs. 9-16, a molded suture retainer 62 is provided for retaining at least one suture therein. As shown, retainer 62 has a base portion 64 and an enlarged suture receiving section 66 communicating with a spiraled passageway 68 spiraling toward the approximate central portion of retainer 62. Spiraled passageway 68 terminates at a unique vacuum receiving section 70 which is angularly offset from the terminus of the spiral passageway. This angular offset communicates with the vacuum aperture 72 in cover sheet 74 and serves to prevent the end of the suture from being drawn out of vacuum aperture 72 where it would be exposed to damage, entanglement, etc. Cover sheet 74 is configured and dimensioned to overlie the open top of retainer 62 and to be adhesively attached thereto in a manner as described in EP-A-471458 In addition to the vacuum aperture 72, cover sheet 74 has a suture entrance aperture 76 in alignment with suture receiving section 66 and a needle park aperture 77 for accessing the recessed needle park 79 from the top of the retainer. This configuration allows needles to be at least partially inserted into needle park 79 from the top of the retainer through needle park aperture 77. As in previous embodiments, cover sheet 74 is constructed of a material impervious to bacteria while still being pervious to ethylene oxide sterilizing gas. Cover sheet 74 may include a fold-over panel 78 joined to the main section of the cover sheet to facilitate removal thereof and to cover and protect the suture entrance aperture 76 and the needle park aperture 77 and needles therein. This fold-over panel 78 also serves to prevent the needles form contacting and possibly puncturing the packaging material. Figs. 17-24 show a variation of the molded suture retainer of Figs. 9-16 configured to retain a longer suture therein. The added length is accommodated by extending the spiral passageway 80. Other elements of the retainer 82 are substantially the same as those described above with respect to the molded suture retainer of Figs. 9-16. Figs. 25 and 26 show a preferred embodiment of the present invention incorporating both a recess for receiving a package stabilizing element 61 and a recessed needle park 79 in substantially the same horizontal plane as the spiral passageway 80. This configuration demonstrates the maximum efficient use of spacing in the retainer without the need to extend the height of the retainer.

Claims: A suture retainer (62) for packaging sutures comprising: a molded cover member (74) having a substantially spiral passageway (68) formed therein, said passageway defining a channel, open at the top and interconnecting a suture receiving section (66) at a proximal end thereof, with a vacuum receiving section (70) at a distal end thereof; and a cover sheet (74) adhered to said molded cover member to close said channel, said cover sheet including a suture entrance aperture (76) aligned with said suture receiving section and a vacuum aperture (72) aligned with said vacuum receiving section; and said vacuum receiving section is angularly offset from said distal end of the channel: the retainer being characterised in that: the spiral passageway has oval shape, and surrounds the offset vacuum receiving section and a molded recess (61) for receiving a package stabilizing element (60). A suture retainer as claimed in claim 1, wherein the distal end of the channel comprises a terminus section formed at a slight angle to the longitudinal axis of the retainer (62) A retainer as claimed in claim 1 or 2 wherein the recess for receiving a package stabilizing element (61) is a rectangular recess. A retainer as claimed in claim 1 or 2 wherein the recess wall follows the curve of the spiral passageway (68). A retainer as claimed in claim 4 wherein said recess for receiving a package stabilizing agent is confined by the spiral passageway (68) A retainer as claimed in claims 3, 4 or 5 wherein said recess for receiving a package stabilizing element is dimensioned to receive and retain a package stabilizing element without increasing the thickness of the molded cover member and cover sheet. A retainer as claimed in any one of claims 3 to 6 wherein said recess for receiving a package stabilizing element is dimensioned to retain a flat package stabilizing element substantially flush with said cover sheet. A retainer as claimed in any one of claims 3 to 7 further comprising a package stabilizing element (61) disposed in said recess for receiving a package stabilizing element. A retainer as claimed in any one of the preceding claims further comprising a recess (77) for receiving a needle park (79) therein. A retainer as claimed in claim 9 wherein said recess for receiving a needle park therein is dimensioned to retain a needle park substantially flush with said cover sheet. A retainer as claimed in claim 9 or 10 wherein said recess for receiving a needle park is disposed within the confines of the spiral passageway. A retainer as claimed in claim 9, 10 or 11 wherein said recess for receiving a needle park is dimensioned to receive and retain a needle park without increasing the thickness of the molded cover member and cover sheet. A retainer as claimed in any one of the preceding claims and further comprising a needle park (79). A retainer as claimed in claim 13 wherein the needle park is adhered to the cover sheet. A retainer as claimed in any one of the preceding claims wherein said molded cover member is formed from a moldable plastic material. A retainer as claimed in claim 15 wherein said molded plastic material is substantially transparent. A retainer as claimed in any one of the preceding claims wherein said cover sheet is constructed of a material which is pervious to ethylene oxide sterilising gas. A retainer as claimed in any one of the preceding claims wherein said molded member is rectangular and said spiral passageway is configured in an oval pattern centred on the approximate centre of said molded member. A method of packaging a suture in a molded suture retainer (62) including the steps of: providing a molded suture retainer comprising a molded cover member (74) having a substantially oval spiral passageway (68) formed therein, said passageway defining a channel, open at the top and interconnecting a suture receiving section (66) at a proximal end thereof with a vacuum receiving section (70) at a distal end thereof, surrounded by the spiral passageway, the molded cover member also including a molded recess (61) surrounded by the passageway (68), and also having an angular offset between the vacuum receiving section and the distal end of the channel, to prevent the end of the suture being drawn by the vacuum out of a vacuum aperture (72), and a cover sheet (74) adhered to said molded cover member to close said channel, said cover sheet including a suture entrance aperture (76) aligned with said suture receiving section and the vacuum aperture (72) aligned with the vacuum receiving section; loading a suture into said spiral passageway to form a loaded molded suture retainer; and placing a package stabilizing element (60) within the recess (61). A method according to claim 19 including i) providing a needle park (79) in the cover member, and a needle park aperture aligned therewith; ii) providing the suture as an armed suture; ii) inserting at least one needle of the armed suture into the needle park through said park aperture to form a loaded retainer.

Inventors: BROWN DAVID L, HOLZWARTH HENRY A, BROWN, DAVID L., HOLZWARTH, HENRY A.
Applicants: UNITED STATES SURGICAL CORP, UNITED STATES SURGICAL CORPORATION
Application year: 1992
Main classification: A61B17
IPC codes: A61B17