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I can understand that when you encounter a suture breaking while closing the subcutaneous layer this can be frustrating. I’d like to introduce you to a solution designed to address these exact challenges—STRATAFIX™ Spiral PDS™ Plus Knotless Tissue Control Device. It offers superior strength, reliability, and efficiency, making it an ideal choice for closing the subcuticular layer in robotic procedures. STRATAFIX™ Spiral PDS™ Plus Knotless Tissue Control Device combines the right balance of polymer, barb geometry, and barbing pattern to deliver optimal system strength. While suture strength is important, you mentioned the challenges that post operative infections pose for you, your patient, and the hospital and that these complex thoracic procedures can raise the risk of an SSI. The STRATAFIX™ Spiral PDS Plus includes antibacterial technology and is the only barbed suture with triclosan which has been shown to help address known risk factors for surgical site infection. 1,2* STRATAFIX™ has been shown to exhibit 99.9% fewer bacteria than non-triclosan-coated sutures such as V-LOC™.3,4† This technology aligns with the CDC, ACS/Surgical Infection Society, and NICE guidelines, which recommend triclosan-coated sutures to reduce the risk of SSIs.¶#,5-9 In fact, a meta-analysis of 21 randomized controlled trials showed a 28% reduction in SSI risk with the use of triclosan-coated sutures.10** You also mentioned efficiency is important. The STRATAFIX™ Spiral PDS Plus sutures support an efficient traditional unidirectional continuous technique or a bidirectional technique, enabling two clinicians to close with a single device with the ability to complete duel or multi-layer closures. The barbed suture with multiple fixation points supports increases efficiency by eliminating the need for knot-tying and the related complications. This has been demonstrated in two clinical trials across spine and gynecology surgery to result in shorter OR time and lower costs.11,12 Would you be willing to trial STRATAFIX™ Spiral PDS™ Plus in your next few robotic cases to see the results for yourself?

References

*Refers to STRATAFIX Symmetric PDS Plus Device, STRATAFIX Spiral PDS Plus Device, and STRATAFIX Spiral MONOCRYL Plus Device only.1. Ethicon Wound Closure Manual 2012. Ethicon, Inc.

†In vitro studies comparing STRATAFIX™ Spiral MONOCRYL™ Plus vs QULL™ MONODERM™ and STRATAFIX™ Spiral MONOCRYL™ Plus vs V-Loc™ 90 using 24-hour incubation with high concentrations of S. aureus.

¶These guidelines on reducing the risk of surgical site infections are general to triclosan-coated sutures and are not speci‹c to any one brand.

# 2021 NICE MedTech guidelines recommend the use of Ethicon Plus Antibacterial Sutures as part of a bundle of care for preventing surgical site infection.33

** In a meta-analysis that included 21 RCTs, 6462 patients, 95% CI: (14, 40%), P<0.001.

1. Antibacterial Suture (poligelcaprone 25 with triclosan). Surg Infect (Larchmt). 2007;8(2):201-207. 3. Ming X, Rothenburger S, Nichols MM. In vivo and in

2. Vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008;9(4):451-457.

3. Bhende S, Burkley D, Nawrocki J. In vivo and in vitro anti-bacterial efficacy of absorbable barbed polydioxanone monofilament tissue control device with triclosan. Surg Infect (Larchmt). 2018;19(4):430-437.

4. Bhende S. Study Report: Comparative evaluation of bacterial colonization on STRATAFIX Spiral MONOCRYL Plus Knotless Would Closure Device vs V-LOC 90 Absorbable Wound Closure Device and MONOCRYL knots using an in vitro attachment assay and scanning electron microscopy. October 12, 2018. Ethicon, Inc.

5. Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008;9(4):451-457.

6. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. doi:10.1001/jamasurg.2017.0904.

7. Global guidelines on the prevention of surgical site infection. World Health Organization website. http://www.who.int/gpsc/ssi-prevention-guidelines/en/. Accessed October 5, 2018.

8. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2016;224:59-74.

9. National Institute for Health and Care Excellence (NICE) Guideline. Surgical site infections: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#closuremethods. Accessed February 14, 2022.

10. de Jonge SW, Atema JJ, Solomkin JS, Boermeester MA. Meta-analysis andtrial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg. 2017;104(2):e118-e133.

11. Johnston SS, Chen BP, Tommaselli GA, Jain S, Pracyk JB: Barbed and conventional sutures in spinal surgery patients: an economic and clinical outcomes comparison. J Wound Care 2020, 29(Sup5a):S9-s20.

12. Peleg D, Ahmad RS, Warsof SL, et al. A randomized clinical trial of knotless barbed suture vs conventional suture for closure of the uterine incision at cesarean deliver.Am J Obstet Gynecol. 2018;218(3):343.e1-343.e7.

CONFIDENTIAL. FOR INTERNAL USE ONLY. NOT FOR USE WITH ANY CUSTOMER OR FOR EXTERNAL DISTRIBUTION.

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