FI71666C - SURGICAL SUTUR. - Google Patents

Description

\ ua * r * ADVERTISEMENT 71666 «ISMI B (11) UTLÄGGNINGSSKRIFT '' O ° 0 C (45) Patent r.yjnnzity '^ jn O ·' r 'v *' -, - *. 1 1. y .... l λ o (51) Kv.lk.7int.Ci.4 A 61 L 17/00 FINLAND »FINLAND (21) Patents» kemus— Patentansökning 772472 (22) Application date - Ansökningsdag 1 8.08.77 (F ») (23) Start date - Giltighetsdag 1 8.08.7 7 (41) Become public - Blivit offentllg 21.03 - 78

National Board of Patents and Registration / 44) Date of display and publication. - 31.IO.86

Patent and registration authorities '' Ansökan utlagd och utl.skriften publicerad (86) Kv. application - Int. ansökan (32) (33) (31) Privilege claimed — Begärd priority 20.09.76 20.09.76 USA 724804, 724876 (71) American Cyanamid Company, Wayne, New Jersey, USA (72) Vincent Anthony Perciaccante , Long Island City, New York,

Henry Patrick Landi, Yorktown Heights, New York, USA (74) Oy Koi ster Ab (54) Surgical su Tuura lanka - Kirurgi sk sutur

The invention relates to a surgical suture yarn comprising a polymeric multifilament yarn and having improved knot slip properties and low friction in tissues.

The main processing characteristics of surgical sutures are related to the location of the node. In one frequently used method, a sailor's knot is made, which is pulled firmly firmly into the tissue from its external knot. Depending on the situation, the surgeon pulls the knot appropriately tight and makes additional rounds on top of the first rounds of the sailor knot. In some cases, the first round is a double round, which together with the next single round forms a surgical node. If necessary, sailor knots can be made on top of this.

The opposite of easy node placement is its strength. Although knotting must be easy, it is essential that the knot lasts long enough without slipping.

Some stitching materials are so smooth that the knot goes into place very easily and sometimes opens easily. There are sutures with 2 71 6 6 6 materials in which the knot tends to “lock” or does not travel, making it difficult to tighten the turns in the tissue and only a few turns are needed and no security is a problem.Knots in constantly moving tissue, e.g., near the heart, may open in immobile tissue, e.g., nodules connecting the wound within plaster light.

U.S. Patent No. 2,734,502 describes the use of a polyalkyl methacrylate for coating silk sutures and the use of a hot coating mold process.

U.S. Pat. No. 3,297,033 describes synthetic surgical polyglycolic acid sutures in which the fibrous surfaces can be coated with, for example, silicone or beeswax to alter the rate of treatment and absorption rate.

Coating, staining, and finishing of surgical sutures with polymeric materials is well known. Silicones, wax, polytetrafluoroethylene and other polymers have been used. We are constantly striving to find unique coating materials with unique advantages for improving surgical sutures.

The surgical suture yarn of the invention comprising a polymeric multifilament yarn is characterized in that it is coated with a thin lubricating coating consisting of a lubricating, bioabsorbable copolymer of CH 2 H 2 O wherein either R 1 or is methyl and the other is hydrogen and n and m are large enough for the compound to be pasty or solid at 25 ° C, R is a residue of a relatively small molecule reactive hydrogen compound having 2-6 reactive hydrogen atoms and up to 6 carbon atoms, and c is the number of reactive hydrogen atoms of the R-forming compound having a molecular weight of the bioabsorbable copolymer of 3000-16250 and in which the lubricating bioabsorbable copolymer is absorbed from the suture within a few days.

3,71666

In another embodiment, the polymeric fiber is comprised of a tissue-absorbable polymer that degrades hydrolytically non-toxic, tissue-compatible, absorbable components. This polymer has glycolic acid ester bonds. In another embodiment, the tissue absorbable in the tissue is polyglycolic acid.

In another embodiment, the polymeric fiber is silk, cotton, nylon, non-absorbable polyester, polypropylene, or polyethylene.

The slip coating comprises about 0.1 to 25% by weight based on the amount of uncoated yarn forming the suture yarn, thereby reducing both node slip stress variations and friction sufficiently to allow the sailor knot to be moved along the suture yarn and the wound edge to be controlled.

DE-A-2 600 174 relates to a surgical suture yarn, characterized in that it is coated with an absorbable composition which in combination provides (1) an absorbable film-forming polymer, an absorbable lubricant and (3) an absorbable hydrophobic material. The suture yarn according to the publication is thus coated with a coating composition containing three components, which is a very important and clear difference compared to the suture yarn according to the invention. In the specification, it is mentioned that the lubricant of the three-component coating composition may be a polyalkylene glycol, which may comprise copolymers of ethylene oxide and propylene oxide. It is further mentioned that polyethylene glycol is a preferred lubricant, and all embodiments use three-component coating compositions using polyethylene glycol having a molecular weight of 20,000 as the lubricant. the polymer acts as a binder between the lubricant and the hydrophobic agent, and the hydrophobic agent prevents the coating from overwetting. In addition, it is noted that three separate substances are generally required for these functions, but that it is possible that a single ingredient may perform one or more functions, in which case the 4,71666 absorbable compositions could contain less than three of said components. Replacing the three components with a single one is not mentioned. A very essential difference between the suture coating according to the invention and the coating of DE-A-2600174 is that the coating used according to the invention is rapidly absorbed after introduction of the suture into the body, i.e. within a few days, while the coating composition used in the present publication absorbs much more slowly.

Absorbable polyglycolic acid sutures are described in the aforementioned U.S. Patent 3,297,033. Other synthetic, absorbable surgical sutures that are absorbed into living tissue can be coated with improved results. In currently approved, absorbable sutures, degradation or absorption into tissue occurs by hydrolytic cleavage of glycolic acid ester bonds. The present invention can be used with other synthetic absorbable surgical sutures described and developed in the art. In the case of synthetic, absorbent sutures, the coating problem to improve knot placement is complicated by the non-toxicity and absorbency required of the coating.

Unabsorbed sutures do not biodegrade in living mammalian tissue and remain in the tissue as a foreign object if they are not surgically removed (e.g., skin sutures) or if they do not protrude. Non-absorbable sutures reinforce longer-lived living mammalian tissue, often the lifespan of the subject. The non-absorbable sutures used to occlude the skin, with nodules on the skin, are removed by the surgeon at an appropriate stage of healing. In non-absorbable sutures whose nodes are immersed in the living tissue in which they remain, the lubricant to be treated is absorbed from the non-absorbable suture in less than about 48 hours. In this case, the sliding effect ceases and the knot is strengthened.

Typically, non-absorbable sutures are silk, cotton, nylon, non-absorbable polyester (Dacron®), polypropylene, polyethylene, or linen. Metals such as stainless steel as monofilament or braid, tannal or platinum have also been used.

5,71666 In the context of a coating, the terms "absorbable" or "bioabsorbable" refer to a coating which, when hydrolytically or enzymatically degraded or by its inherent properties, has a molecular weight such that it is absorbed from the surface of the suture and removed by the subject either unchanged or hydrolyzed.

The slip coating improves the position of the knot and also increases the smoothness and flexibility of the sutures, making them easier to pull through the skin and other tissues when sewing. This reduction in friction is called reduced resistance in the tissue. A coating that reduces resistance in the fabric and lubricates the formation of the knot also improves the slip of the knot.

Another surprising and unexpected advantage of the present lubricating coating is that the lubricating copolymers are absorbed from the suture within a few days, whereby the node strengthens as the wound heals.

The absorbent coating belongs to one or more groups of compounds, the compound structure consisting of polyoxyethylene and polyoxypropylene groups. For simplicity and to facilitate description, these compounds are described, represented by formulas, and treated to have only two or three groups in their chain. However, it is clear that the polyoxyethylene group may contain an insignificant amount of polyoxypropylene and the polyoxypropylene group may contain small amounts of polyoxyethylene. It appears from the manufacturing methods that small amounts of such ceramic alloys can and probably are present in the chain. Commercial grades are acceptable and their toxicity has been found to be low and insignificant.

The present lubricants are of the formula R (CH 2 CHO) n (CH 2 CHO) m H 70 R 1 R 2 wherein either R 1 is or is methyl and the other is hydrogen and n and m are so large that the compound is pasty or solid at 25 ° C, R is a residue of a relatively low molecular weight, reactive hydrogen compound having 2 to 6 reactive hydrogen atoms 6,771,666 and up to six carbon atoms, and c is the number of reactive hydrogen atoms in the compound forming R. Compounds that are at least pasty at 25 ° C are preferred because they adhere better to the synthetic, absorbable polyfilament suture. There is no clear limit, but as the ingredients become more pasty or firmer, their effectiveness usually improves.

Often, these lubricating, bioabsorbable copolymers are classified as surfactants because the polyoxyethylene groups are predominantly hydrophilic and the polyoxypropylene groups predominantly hydrophobic. The materials are sold by Wyandotte Chemical Company, Michigan, U.S.A. under the trade name Plunorics ^ with the formula H (OCHoCH.) (OCHCH) (OCHnCH.) OH 2 2x. t 2. y 2 2 z ch3 <K) where x, y and z are integers, with the Reverse Pluronics formula

H (OCHCH_) (OCHoCH_) (OCHCH) OH, 2 n 2 2 m, 2 O

CH3 ch3 <6 \ where n, m and o are integers, and Tetronics ^ where the formula is / R1 ch2n ri / - R1 CH2N \ R1 where R is - (CH.CHO) (CH_CH.O) H 1 3, q 2 2 n ch3 In the present invention, the values x, y, z, n, m, o, q and r of the synthetic, absorbable suture lubricants are such that the lubricants are pasty or solid at 25 ° C.

7 71666

The pastes are opaque, semi-solids having a melting point above room temperature, preferably above about 40 ° C.

Particularly useful in the present invention are (g) Pluronics compounds.

The approximate compositions of some commercial products are shown in Table I.

Since all compositions are mixtures, all values are approximate and slightly rounded.

8 71666

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Plunorics compounds with a molecular weight of about 4750-16,250 are generally solid waxes. The polyoxypropylene moiety has a molecular weight of 950-4000 and the polyoxyethylene moiety is about 60-80%.

The pastes generally have a total molecular weight of 3500-5700, with a polyoxypropylene molecular weight of 1750-6500 and a polyoxyethylene content of 30-50%. The transition from wax to paste and from it to liquid is not clear.

The low toxicity of the polyoxyethylene-polyoxypropylene compounds of the present invention is shown in the table below.

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The suture thread has been used as a basis for determining the amount of material applied to a synthetic, absorbable polymeric thread to make an absorbable surgical suture.

The amount of lubricating, bioabsorbable copolymer is about 0.1-25% by weight of the uncoated fiber, based on the weight of the uncoated fiber forming the suture. It is not necessary for the coating to be continuous because the non-continuous coating on the surface reduces friction and adhesion. A higher amount can be used if the lubricating, bioabsorbable copolymer penetrates the fiber, whereby the individual filaments are also partially or completely coated.

The wide range of coating weights makes it possible to apply the sutures in question to a wide range of applications. Because the surface roughness of the thread to be coated can be varied greatly depending on the mechanical structure, e.g., braid or thread, as well as depending on the filaments, which are less than two denier to more than six denier per filament, finer filament sizes can give a smoother surface, and after fabrication or heat treatment, the surface roughness can in principle vary. Smoother surfaces require a less lubricating, bioabsorbable copolymer to achieve the same lubricity.

The surgical methods used involve achieving the desired degree of Liu immersion. With a certain type of node, the in the method, a larger amount of lubricant than usual improves the position of the node and likewise increases the recovery or sliding of the node, which is called the safety of the node. In some surgical methods, it is highly desirable for the knot to run very easily into place, even if it slips more easily.

The nodal surgeon has to consider the interaction between ringing and easy sliding. If the suture is relatively well slipped, the surgeon may use a sailor knot that easily goes into place. The node can be secured with additional sea-male battles. On the other hand, if the suture slip is poor, the surgeon may use a double closed or other type of knot that moves more easily to place the knot in place, after which a double closed knot may be made with a sailor knot or additional closed knots to secure the knot. Thus, the surgeon can either adapt his or her method of concluding the according to the suture or use sutures whose surface slip is best suited to the method the surgeon wishes to use. In general, the methods are interchangeable. The surgeon strives to obtain an suture whose properties satisfy him, then applying his method of tying to the sutures at hand. Some surgeons very successfully tie a stainless steel thread using a tie method suitable for such a thread. In this case, the node goes very badly in place. Others prefer a well-slipped stitch that makes the knot go much more easily into place.

Because the easy placement of a node and its durability are somewhat opposite characteristics, the surgeon must use additional rounds or such nodes that can withstand the specific conditions of the chosen surgical procedure. By varying the amount of lubricating, bioabsorbable copolymer, node displacement can be adjusted to meet the requirements of the working surgeon.

The operating time of the nodes can be varied.

As the lubricating, bioabsorbable copolymer in question is removed from the suture in living tissues, the knot strength increases after this removal and after about 48 hours the knot strength is significantly improved.

The requirements of the surgery vary very widely and different coating weights allow the sutures to be applied according to the conditions. If the surgeon wants a more slippery suture, more lubricating, bioabsorbable copolymer is generally used, and on the other hand, as the surgeon accepts slightly lower knot placement and resistance properties in the tissue for better knot strength, the amount of coating is reduced to achieve this particular compromise.

By using 2-8% of a lubricating, bioabsorbable copolymer, a useful compromise between easy knot placement and knot strength is usually achieved.

By using about 5% by weight of Pluronic F-68, the recommended compromise between knot placement and knot strength of 14 71 666 is achieved for braided polyglycolic acid sutures of 2-6 denier / filament.

The following examples demonstrate the effect of certain coatings and their amounts under specified conditions.

Example 1

Node displacement and entanglement test

Series 2/0 USP XIX (maximum diameter 0.339 mm) polyglycolic acid sutures braided from 2 denier / filament extrudate were coated with seven different amounts of Pluronic F-68 and this series and a "blind" or uncoated suture were used for the seaman's knot.

In this experiment, the suture was tied with a sailor knot around a cylinder 10.2 cm in circumference. The loop thus formed was removed from the cylinder and placed in the jaws of a testing machine.

The knot was allowed to run into place by initially pulling from the free end on a testing machine that registers the pull on the paper as the knot travels down the stitch. In this case, there is a certain entanglement or variation in the node's position in the tension, which is recorded graphically. The part of the series of bets performed with different amounts of coating was reported where the maximum force of the node's displacement falls on the enclosures indicated in the table. All knots in the coated sutures went into place without breaking along the entire length of the suture. The tensile strength of the knitted braid was 3.2-3.6 kg. The knot in the uncoated braid was locked and the stitch was broken in nine out of ten tests.

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i 16 71 66 6 To make these coatings, the braid was drawn through a chloroform solution of Pluronic F-68 at a concentration about twice the percentage concentration of the suture coating.

When using other braid structures and sizes, the relative ease of node positioning may be greater or less with the same amount of coating, and alternatively, the amount of coating may be adjusted to achieve the desired node deployment values.

The amount of Pluronic in the solvent may vary and solvents other than chloroform may be used.

Organic solvents such as methyl alcohol, ethyl alcohol, isopropyl alcohol, methylene chloride, warm xylene (about 60 ° C), tetrahydrofuran, acetone, dimethylformamide, dimethyl sulfoxide, mixtures thereof, and the like can be used as the lubricant solvent for the coating. Another useful method is to drain the solution onto a moving strand, after which the excess is allowed to drip off.

A small amount of water increases the solubility of the lubricants and facilitates coating, but the contact sheet between water and the suture must be kept as short as possible and, when the coating system is moist, the sutures must be dried immediately and kept dry.

In general, it is more convenient to use a solvent coating method when the adhesive amount is less than 10% and a heated mold when the adhesive amount is more than about 10%.

Example 2

A series of experiments were performed using two commercial grades of Pluronic F-68 and F-127 size 2/0 sutures coated with 6 denier / filament absorbable polyglycolic acid sutures as a coating.

The coatings were applied as a chloroform solution of Pluronic. The concentration of Pluronic used in the coating in the solution was approximately twice as high as in the braid. A solution of about 2.8 5 Pluronic F-68 in chloroform gave approx.

1.4% Pluronic F-68 in the braid. The concentration can be adjusted to 17 71 666 to obtain the desired amount. The strand to be coated was braided into a 2/0 size suture using a 6 denier / filament polyglycolic acid extrudate. Uncoated sutures taken from the same batch were used as controls. A standard type ATLAB Yarn Friction Tester was used. model CS-151-026, Custom Scientific Instruments, Inc., Whippany, New Jersey 07981, equipped with a Hewlett Packard model 321 dual channel amplifier recorder to record the tension in the filament fed to and from the tester. The coefficient of adhesion is the ratio of the maximum draw (T ^) to the supply stress (T ^) minus the ratio of the minimum draw (T2) to the supply stress, ie T3 to T2

T T

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At friction values, sliding begins.

Of particular interest are the ratio values and percentage reduction. With other types of test equipment, the numerical values may change, but the relative ratios as a measure of improvement are the same.

An unbroken thread coated as described was used in this experiment. For use as a suture, such a strand is cut to length, provided with a needle, packaged and sterilized by conventional methods. Friction and adhesion are more easily measured with continuous strands.

The reductions in static friction, adhesion, and coefficient of friction of typical coatings and sutures are shown in Table IV.

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In a representative and typical test to determine knot strength, a series of experiments were performed using 2/0 size polyglycolic acid sutures, 2 denier / filament, coated with 4.79% Pluronic® F-68, and various knots. The force (kg) to slide or break the nodes without slipping was: 20 71666 N ^ S S S s s

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A series of experiments were performed, including a blank, including chloroform solutions of Pluronic® R bioabsorbable, lubricating copolymers using the methods of Example 2. Table V below shows the improvement in adhesion and friction achieved with a range of polymers and concentrations.

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A braided strand of polyglycolic acid forming a 2/0 size USP suture was dipped in 10% chloroform solution of Pluronic F-68 and dried. About 5% by weight of the polymer adhered to the weight of the strand itself.

The dried and coated filament was cut into 137.2 cm blocks, fitted with needles, packaged, sterilized, and dried by conventional methods.

Sutures thus prepared were used in surgical procedures. When used to approximate wound tissues, the suture is placed in a suitable location and tied with a sailor knot. The sailor knot easily went into place, pulling the wound edges together with the tightness desired by the surgeon. The suture resistance in the tissue was low and the knot position was excellent. Once the node was at the desired final location, it was secured with three additional mermaid nodes. In the nodules immersed in the tissue, the slippery, bioabsorbable copolymer was removed from the suture surface in 48 hours, which increased the strength of the nodes. The actual suture retained its strength in the tissue for at least 15 days and was almost completely absorbed in 90 days.

Although the examples and experiments relate to sailor cells, ease of knot placement and reduced tissue resistance are valid for most suture insertions and knot retention. The amount of coating and the relative values of node overgrowth and reduced tissue resistance will vary according to the needs of the particular surgical situation.

The needles, packaging and sterilization of coated sutures are carried out by conventional methods.

Example 5

Friction and adhesion tests

Series 2/0 USP XIX (maximum diameter 0.339 mm) braided silk sutures were coated with five different amounts of Pluronic F-68 and twelve different amounts of Pluronic F-127.

For comparison, four blank experiments were performed with an uncoated, braided suture from the same batch, and the average of these was used as a reference.

25 71 6 6 6

For comparison, five experiments were also performed with a commercial silicone-coated silk suture, cf. the aforementioned U.S. Patent 3,187,752.

The coating was performed by passing the braid through a chloroform solution of Pluronic at a concentration about twice the desired percentage concentration by suture and air drying.

A standard type ATLAB Yarn Friction Tester, Model CS-151-026, Custom Scientific Instruments, Inc., Whippany, New Jersey 07981 was used with a Hewlett Packard Model 321 two-channel amplifier recorder to record the tension in the filament fed to and from the tester. The coefficient of adhesion is the ratio of the maximum tensile (T ^) to the supply stress (T ^) minus the ratio of the minimum tensile (T £) to the supply stress.

At the friction value T ^ the sliding begins. T?

Of particular interest are the ratio values and percentage reduction. With other types of test equipment, the numerical values may change, but the relative ratios as a measure of improvement are the same.

An unbroken thread coated as described was used in this experiment. For use as a suture, such a thread is cut to length, provided with a needle, packaged and sterilized by conventional methods. Friction and adhesion are more easily measured with continuous strands.

The reductions in static friction, adhesion and coefficient of friction are shown in Table III.

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n <28 7 1 6 6 6 When using other braiding structures and sizes, the relative ease of node positioning may be greater or lesser with the same amount of coating, or alternatively the amount of coating may be adjusted to achieve the desired node positioning values.

The amount of Pluronic in the solvent may vary and solvents other than chloroform may be used.

Organic solvents such as methyl alcohol, ethyl alcohol, isopropyl alcohol, methylene chloride, warm xylene (about 60 ° C), tetrahydrofuran, acetone, dimethylformamide, dimethyl sulfoxide, mixtures thereof and the like can be used as the lubricant solvent for the coating. Another useful method is to drain the solution onto a moving strand, after which the excess is allowed to drip off.

A small amount of water increases the solubility of the lubricants and facilitates coating.

In general, it is more convenient to use a solvent coating method when the adhesive amount is less than 10% and a heated mold when the adhesive amount is more than about 10%.

Example 6 2/0 Braided Nylon Stitches Using the method described in Example 1, experiments were performed with a nylon braid, stitch size 2/0. The reduction in friction and adhesion is shown in Table IV. For comparison, both uncoated braids made from the same batch and commercial silicone coated nylon were used.

In particular, the reduction in entanglement is excellent.

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Example 7 2/0 Dacron® Braided Sutures Using the method described in Example 1, experiments were performed with a polyester braid (Dacron®}, suture size 2/0. The reduction in friction and entanglement is shown in Table V.

For comparison, both uncoated braid made from the same batch and silicone coated braid were used.

The average of the uncoated braid experiments was used as a basis to show improvement.

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The values in the example are illustrative. Lower friction and entanglement was achieved with sutures of all sizes. With other materials and structures, results may vary.

The amount of coating and ease of node placement can be varied as desired by surgeons.

For absorbent or non-absorbable sutures which have a problem with porosity, a coating of phosphatide, preferably purified lecithin, as described e.g. U.S. Patent No. 2,576,576 to reduce porosity and friction using the coating in question as an additional friction reducer. In some circumstances, lecithin may irritate the tissue, especially when impure.

Example 8

The braided silk suture, suture size 2/0 USP, was dipped in 10% chloroform solution of Pluronic F-68 and dried. About 5% by weight of the polymer adhered to the weight of the strand itself.

The dried and coated filament was cut into 137.2 cm blocks, fitted with needles, packaged, sterilized, and dried by conventional methods.

The silk sutures thus prepared were used in surgical procedures. When used to approximate wound tissues, the suture is placed in a suitable location and tied with a sailor knot. The Marine-male knot easily went into place, pulling the wound edges together with the tightness desired by the surgeon. The resistance of the suture in the fabric is low and the knot position is excellent. Once the node was at the desired final location, it was secured with three additional sailor nodes. In knots immersed in the tissue, the slippery, bioabsorbable copolymer was removed from the suture surface in 48 h, which increased the strength of the knot.

When removed from the experimental animals after 48 hours, the sailor knot without additional rounds had a significantly higher knot strength than immediately after placement.

In human tissue, knot strength is improved insofar as observations can be made when the bioabsorbable slip coating is absorbed into the tissue.

Although the examples and experiments relate to sailor knots, the ease with which the knot is located and the reduced resistance in the fabric 34 7 1 6 6 6 apply to most sutures and knot retention. The amount of coating and the relative values of node placement and reduced tissue resistance will vary according to the needs of the particular surgical situation.

The needles, packaging and sterilization of coated sutures are carried out by conventional methods.

Claims (5)

35 71 666 A surgical suture comprising a polymeric multifilament yarn, characterized in that it is coated with a thin lubricating coating consisting of a lubricating, bioabsorbable copolymer comprising polyoxyethylene units and polyoxypropylene units (OCH) and having the formula: «7 2 fn 21 mc R 1 R 2 wherein either or R 1 is methyl and the other is hydrogen and n and m are large enough that the compound is pasty or solid at 25 ° C, R is a residue of a relatively small molecule reactive hydrogen compound , having 2 to 6 reactive hydrogen atoms and up to 6 carbon atoms, and c is the number of reactive hydrogen atoms of the R-forming compound having a molecular weight of a bioabsorbable copolymer of 3000 to 16250 and a slippery bioabsorbable copolymer absorbed from the suture within a few days. Suture yarn according to claim 1, characterized in that the polymer yarn consists of a tissue-absorbable polymer with glycolic acid ester bonds. Suture yarn according to claim 2, characterized in that the polymer absorbed in the tissue is polyglycolic acid. Suture yarn according to Claim 1, characterized in that the polymer yarn is silk, cotton, nylon, non-absorbable polyester, polypropylene or polyethylene. Suture yarn according to claim 1, characterized in that the slip coating comprises about 0.1 to 25% by weight based on the amount of uncoated yarn forming the suture yarn, wherein both the node slip stress variations and friction are sufficiently reduced to move the sailor knot along the suture yarn and wound edge.