Yes, PDS (polydioxanone) is an absorbable suture. It is a synthetic, monofilament suture that the body breaks down gradually through a natural process called hydrolysis, where water molecules slowly split the suture material apart over a period of roughly six months. This makes it one of the longer-lasting absorbable sutures available.
How PDS Breaks Down in the Body
PDS dissolves through hydrolysis, meaning your body’s water content does the work rather than enzymes or immune cells attacking the material. The breakdown happens in two stages. First, water breaks apart the loosely organized portions of the suture fiber. Then, over the following weeks and months, it works through the more tightly packed crystalline portions of the material. This gradual process is what gives PDS its characteristically long absorption window.
The suture retains meaningful strength for several weeks after placement. It holds roughly 70% of its original tensile strength at two weeks and about 25% at six weeks. Full absorption of the suture mass takes approximately 180 to 210 days (around six to seven months). This slow, predictable timeline is one of the main reasons surgeons choose it over faster-absorbing alternatives.
What Makes PDS Different From Other Absorbable Sutures
PDS is a monofilament suture, meaning it is a single smooth strand rather than multiple fibers braided together. This matters for two reasons. First, monofilament sutures pass through tissue more smoothly, causing less friction and drag. Second, because there are no tiny gaps between braided fibers, bacteria have fewer places to harbor, which can reduce infection risk in certain wounds.
Compared to other common absorbable sutures like polyglactin (a braided suture that loses strength within two to three weeks), PDS provides support for a much longer period. This trade-off comes with slightly different handling: monofilament sutures have more “memory,” meaning they tend to spring back to their packaged shape, which can make knot tying a bit more demanding. The updated version, PDS II, was specifically developed to improve these handling characteristics while maintaining the same absorption profile.
Tissue Reaction and Inflammation
One of PDS’s notable advantages is how little inflammation it triggers. In a 2013 study comparing tissue reactions to several suture types in muscle, PDS produced the least inflammatory response at 48 hours, less than nylon, catgut, and braided polyglactin. At one week, the difference was even more pronounced: catgut showed increased immune cell activity, nylon maintained a persistent inflammatory component, and PDS continued to elicit minimal reaction. The researchers concluded PDS was the most desirable material tested, based on its combination of low tissue reactivity and handling qualities.
This low inflammatory profile makes PDS particularly useful in tissues where excess scarring or swelling could cause problems, or in patients where a prolonged immune response is undesirable.
Common Surgical Uses
PDS is favored in situations where tissues heal slowly and need extended support. Its FDA-cleared indications include soft tissue approximation, ophthalmic surgery, and pediatric cardiovascular surgery where tissue growth is expected after the procedure. In practice, surgeons commonly reach for PDS when closing fascia (the tough connective tissue layer of the abdominal wall), repairing tendons, and closing deep tissue layers that bear mechanical stress during healing.
It also sees frequent use in obstetric and gynecologic procedures. For example, it has been studied in the repair of anal sphincter injuries during childbirth, where its monofilament structure and long-lasting strength offer advantages over braided alternatives. Orthopedic, urologic, and plastic surgery teams use it as well, particularly when they need an absorbable option that won’t lose strength before the tissue has healed enough to support itself.
PDS vs. Non-Absorbable Sutures
The key distinction is simple: PDS disappears on its own, while non-absorbable sutures like nylon or polypropylene remain in the body permanently unless physically removed. For internal closures, this is a significant advantage because it eliminates the need for a second procedure and avoids leaving a permanent foreign body in the tissue. For external skin closures, PDS is less commonly chosen because its monofilament structure and slow absorption don’t align well with the short healing times of skin, where sutures are typically removed within one to two weeks anyway.
If you’re preparing for surgery and your surgeon mentions PDS, the practical takeaway is that this suture will hold your tissue together for weeks, then quietly dissolve over the following months without requiring removal.