A compressible adjunct is used with a surgical instrument including a staple cartridge deck. The compressible adjunct includes a first biocompatible material, a second biocompatible material with a lower melting temperature than the first biocompatible material, and a body including a face positionable against a length of the staple cartridge deck. The face includes a plurality of attachment regions spaced apart from one another, wherein the plurality of attachment regions include the second biocompatible material, wherein the face is selectively attachable to the staple cartridge deck at said plurality of attachment regions, and a plurality of non-attachment regions extending between the plurality of attachment regions, wherein the second biocompatible material is selectively disposed outside said non-attachment regions.

An antimicrobial suture comprising a filament and taurolidine.

Compositions of P4HB with high purity have been developed. The compositions are prepared by washing P4HB biomass prior to solvent extraction, and precipitating P4HB from solution. The same solvent is preferably used to wash the P4HB biomass, and as a non-solvent to precipitate the polymer from a P4HB solvent solution. The highly pure P4HB compositions are suitable for preparing implants. The implants may be used for the repair of soft and hard tissues.

Compositions of P4HB with high purity have been developed. The compositions are prepared by washing P4HB biomass prior to solvent extraction, and precipitating P4HB from solution. The same solvent is preferably used to wash the P4HB biomass, and as a non-solvent to precipitate the polymer from a P4HB solvent solution. The highly pure P4HB compositions are suitable for preparing implants. The implants may be used for the repair of soft and hard tissues.

A braided structure that includes a core and a sheath is provided. The core includes a yarn formed at least in part from an aromatic polymer (e.g., an aromatic polyester/liquid crystalline polymer or an aramid polymer), and the sheath, which includes a plurality of ultra high molecular weight polyolefin yarns, is braided around the core. The sheath has an overall diameter ranging from about 60 micrometers to about 650 micrometers. Despite its small diameter, the braided structure can be creep resistant and abrasion resistant while at the same time exhibiting low elongation, a high load at break, and high stiffness. The braided structure can be used in medical applications such as sutures, load bearing orthopedic applications, artificial tendons/ligaments, fixation devices, actuation cables, components for tissue repair, etc.

A braided structure that includes a core and a sheath is provided. The core includes a yarn formed at least in part from an aromatic polymer (e.g., an aromatic polyester/liquid crystalline polymer or an aramid polymer), and the sheath, which includes a plurality of ultra high molecular weight polyolefin yarns, is braided around the core. The sheath has an overall diameter ranging from about 60 micrometers to about 650 micrometers. Despite its small diameter, the braided structure can be creep resistant and abrasion resistant while at the same time exhibiting low elongation, a high load at break, and high stiffness. The braided structure can be used in medical applications such as sutures, load bearing orthopedic applications, artificial tendons/ligaments, fixation devices, actuation cables, components for tissue repair, etc.

A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Resorbable multifilament yarns and monofilament fibers including poly-4-hydroxybutyrate and copolymers thereof with high tenacity or high tensile strength have been developed. The yarns and fibers are produced by cold drawirg the multifilament, yarns and monofilament fibers before hot drawing the yarns and fibers under tension at temperatures above the melt temperature of the polymer or copolymer. These yarns and fibers have prolonged strength retention in vivo making them suitable for soft tissue repairs where high strength and strength retention is required. The multifilament yarns have tenacities higher than 8.1 grams per denier, and in vivo, retain at least 65% of their initial strength at 2 weeks. The monofilament fibers retain at least 50% of their initial strength at 4 weeks in vivo. The monofilament fibers have tensile strengths higher than 500 MPa. These yarns and fibers may be used to make various medical devices for various applications.

A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Absorbable monofilament fibers and self-retaining sutures with high tensile strengths have been developed. The straight pull tensile strengths of the absorbable self-retaining sutures closely approximate, equal or exceed the average minimum knot-pull tensile standards set by the United States Pharmacopeia (USP). These higher strength absorbable self-retaining sutures can therefore be used either without needing to oversize the suture for a given procedure, or by oversizing the self-retaining suture by no more than 0.1 mm in diameter. In one embodiment, the absorbable self-retaining sutures are made from poly-4-hydroxybutyrate or copolymers thereof.