Catgut sutures are made from sheep intestine but have fallen out of favor due to disease transmission risks. Several countries banned catgut in the 1990s-2000s due to concerns over BSE and the potential for catgut to transmit diseases like Creutzfeldt-Jakob disease to humans. Modern synthetic absorbable sutures like Monosyn and Monosyn Quick are preferable alternatives as they have equal or better performance and eliminate disease transmission risks.

1. Catgut sutures
A Timeless Classic or A Thing Of The Past?
NO-More Catgut
PRESENTED BY
ASMA -UL -HUSNA
M.PHIL ,DU
PRODUCTSSPECIALIST
Nazmul Huda
Aesculap suture Divisional In charge BD

2. CATGUT Production
Sheep intestine (Submucosa)

Cut into ribbons

Washed and bleached (remove impurities)

(Chroming process: washed, buffered, dyed)

Ribbons spun together

Drying, polishing  Twisted

3. INTRODUCTION
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1990 the number of animals affected by BSE had been increasing in Europe
1996 France banned the use of Catgut in its hospitals
2000-2002 Austria, Japan, Germany, UK, Jordan and the Kuwait banned Catgut.
Jordan was the first Middle East country to ban Catgut,
EU banned catgut in all of Europe. This includes distribution and
manufacture.

4. CATGUT: REASONS WHY NOT
1. Unpredictible behaviour. Breakdown of catgut is accelerated in
infected tissue . in addition, the loss of strength of the catgut
suture can even vary from site to site in the human body.
2. Inflamatory response. Catgut contains collagen, as biologically active
molecules not belonging to the human body. The human body
strives to remove all proteins and fragments of proteins that could
have A foreign biological function as this could harm the human
metabolism, therefore causing inflammation
3. Disease transmission. Due to the organic bovine origin of catgut, the
issue of safety can be raised in the form of (tses). Put patients at
risk of certain diseases that catgut can.
4
SOURCE:
1. http://ec.europa.eu/health/scientific_committees/emerging/opinions/scmpmd/scmp_out05_en.htm
2. Kruger, T.F, et al. Clinical Gynaecology. Third Edition, 2007 Juta & Co. Ltd. Page 554
3. Wallace WR, Maxwell GR, Cavalaris CJ. Comparison of polyglycolic-polyactic acid suture to black silk, chromic and plain Catgut in human oral tissues. J Oral Surg 1970; 28; 739-746
4. Gilstrap, L, Cunningham, F, VanDorsten, J. Operative Obstetrics. Second Edition 2002, The McGraw-Hill Companies, Inc. Page 57..
5 Main Reasons Why Not To Use Catgut Any More:

5. CATGUT: REASONS WHY NOT
4. RECOMMENDATIONS.
– Biosecurity Australia, an agency within the Australian Department of
Agriculture Fisheries and Forestry, identifies Catgut as a “high TSE risk
product”
– Catgut was confirmed a poor choice for use in contaminated wounds
by the Scientific Committee on Medicinal Products and Medical
Devices (SCMPMD)6
5. IT IS NOT NEEDED!!. Modern absorbable sutures have improved tensile
strength and prolonged knot-retaining capabilities compared to Catgut. In
fact, SCMPMD report concluded that comparable synthetic absorbable
sutures, which can be substituted for Catgut sutures, have been found to
provide equal, or increased clinical performance than Catgut sutures
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SOURCE:
5. Department of Agriculture Fisheries and Forestry Australia, ‘Measures to address additional TSE concerns with veterinary vaccines and other high risk biologicals’,
November 2001
6. http://ec.europa.eu/health/scientific_committees/emerging/opinions/scmpmd/scmp_out05_en.htm

6. What are TSEs and BSE?
• Transmissible spongiform encephalopathy’s (tses) are a
family of diseases occurring in man and animals and are
characterized by a degeneration of brain tissue giving a
sponge-like appearance leading to death.
• The commonly accepted cause of the tse disease is a
transmissible agent called prion (prpres), which is an
abnormal form of a protein.
• The family includes diseases such as --creutzfeldt jakob
disease (cjd) and kuru in humans, bovine spongiform
encephalopathy (bse) in cattle, scrape in small ruminants
(sheep and goats), chronic wasting disease (cwd) in cervids
and transmissible mink encephalopathy (tme) in minks
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7. Can any alternative of catgut chromic/plain ?
Yes !
Modern Synthetic Absorbable Monofilaments suture
Monosyn & Monosyn quick
Can be a perfect alternative of catgut chromic/plan
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8. Catgut® plain is an absorbable
natural suture, made of collagen
catgut® plain is a twisted suture
with a micro polish treatment that
converts the surface into
monofilament
• Catgut ® is treated with
glycerol containing solution. The
suture material retains its original
pliability and softness on removal
from the packaging
Monosyn and Monosyn Quick® are
an excellent absorbable
synthetic monofilament suture
made of Glyconate (Glyconate, a
terpolymer made of: 72 % glycolide,14 % TM C,14 % ε-
caprolactone )
• Exclusively engineered by B. Braun
for the suturing of soft tissues
• Monosyn and Monosyn Quick
remain its original pliability and
softness before depredation in
addition elastic properties ensure
knot security
8 V/s
CATGUT V/s MONOSYN & MONOSYN QUICK