Current Pharmaceutical Biotechnology, 2003, 4, 331-337

331

Non-Degradable Biocompatible Polymers in Medicine: Past, Present and

Future
V. Prasad Shastri*
School of Medicine and Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia,
PA 19104, USA
Abstract: Polymers have a long history in medicine. Their uses to date range from traditional applications such as
catheters, syringes, blood contacting extra corporeal devices to matrices for drug delivery, cell encapsulation and tissue
regeneration. Polymers can be broadly classified on the basis of the reactivity of their chemical backbone (or
susceptibility of the backbone to breakdown upon exposure to water, i.e., hydrolysis) as non-degradable and degradable.
In this review, the polymers that exhibit no to very low degradation in aqueous and biological environments will be
covered. The applications of various polymers both in traditional and emerging medical areas is discussed in the context
of its chemical structure to better enable material selection for biomedical research.

INTRODUCTION
Synthetic polymers have found extensive applications in
the biomedical arena. The spectrum of applications includes
but are not limited to:

.
.
.
.
.
.
.
.

Coatings on
compatibility)

devices

(e.g.,

to

improve

blood

Devices (e.g., implantable drug delivery systems,

artificial heart)
Implants (e.g., bone pins and screws, articulating surface
in artificial joints)
Catheters and dialysis tubing
Vascular graft
Membranes for oxygenation and detoxification
Injectable drug delivery and imaging systems
Membrane and porous scaffolds for tissue regenerative
applications.

Injectable drug delivery systems and tissue engineering,

which have emerged in the past two decades, constitute some
of the recent applications for synthetic polymers.
Due to the vast body of literature in the biomedical uses
of synthetic polymers, detailed treatment of each system is
beyond the scope of this review. Instead, the focus will be on
presenting a broad perspective of the past, present and future
of the role of an important sub-class of synthetic polymers
namely the non-degradable systems. Whenever possible
important clinical findings are highlighted and good recent
reviews have been referred to. The purpose of this review
article is to provide a brief overview of some of the major
polymers in medicine and not to serve as a substitute for
original research articles and more exhaustive reviews of
specific families of polymers or their uses. The central theme
in this review is the exploitation of a specific material
*Address correspondence to this author at the 3231 Walnut Street,
Philadelphia, PA 19104, USA; E-mail: shastriv@seas.upenn.edu
1389-2010/03 $41.00+.00

property vis--vis a clinical or biological problem. Table 1

provides a list of some of the most commonly used synthetic
polymers in medicine, their chemical structure, trade names,
key properties, and uses.
PAST AND PRESENT USES
One of the major driving forces in use of polymers in
medicine has been the need to find functional replacements
for failing body parts. Skeletal reconstruction has by far seen
the most polymer use to date. The choice of the polymer is
based on several considerations such as mechanical strength,
ease of processing, inertness in a biological environment,
abrasive resistance, wear-tear characteristics, bloodcompatibility, tissue adhesivity and permeability to oxygen
among others. Which property will dominate the selection
criteria is dictated by the interplay between the above
mentioned variables in the context of a particular application.
For example, in choosing a material for vascular grafting
anti-coagulative characteristics would be a dominating factor
along with compliance. Likewise, in facial reconstruction
applications moldability and inertness will be dominating
considerations.
The property of polymers is dictated by the nature of the
chemical bonds that make up the polymer backbone, which
is a function of the chemistry of the building blocks, namely
the monomer unit and the linkages between the monomers
[1]. In general a carbon-carbon bond is chemically and
biological quite inert. The inert nature of the C-C bond can
be modulated by oxidation of the carbon backbone.
Therefore, an ester and urethane bond is more likely to
degrade than a ketone or a sulfone bond; which is more
likely to degrade than an ether bond [2]. Furthermore, with
respect to processibility and mechanical properties,
increasing the oxidation of the carbon backbone improves
melt processing due to diminished crystallinity which also
favors solution based processing due to improved solubility
in common organic solvents. Order in a polymer backbone
can be affected to increase crystallinity by substitution of the
carbon backbone. Substitution of hydrogen atoms in a
polyethylene (PE) backbone with fluorine and methyl group
2003 Bentham Science Publishers Ltd.

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Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

Table 1.

V. Prasad Shastri

Chemical Composition Structure, Key Properties and Traditional Applications of Most Commonly Used Non-Degradable
Polymers in Biomedical Applications

Chemical name & Trade name

Chemical Structure

Key Property

Traditional Applications

Strength and lubricity

Orthopaedic implants and

catheters

Chemical inertness and

rigidity

Drug delivery, meshes and

sutures

Chemical and biological

inertness and lubricity

Hollow fibers for enzyme

immobilization, vascular graft,
guided tissue regeneration and
barrier membrane in the
prevention of tissue adhesions

Hard material, excellent

optical transparency

Bone cement, ocular lens

Elasticity, film forming

properties

Implantable drug delivery

devices

Ease of processing, biological

inertness, excellent oxygen
permeability, excellent optical
transparency

Implantable drug delivery

devices, device coatings, gas
exchange membranes, ocular
lens, orbital implants

Same as above

Gel-like characteristics

Filler in Silicone breast

implants

Blood compatibility and

rubber-like elasticity

Vascular grafts, heart valves,

blood contacting devices,
coatings

Fiber forming properties and

slow in vivo degradation

Knitted Dacron vascular grafts,

coatings on degradable sutures,
meshes in abdominal surgery

Chemical inertness, creep

resistant

Hollow fibers and membranes

for immobilization of
biomolecules in extra-corporeal
devices

Negligible protein adsorption

and hydrogel forming
characteristics

Passsivation of devices toward

protein adsorption and cell
encapsulation

Poly(ethylene) (PE) (HDPE,

UHMWPE)

H2
C
C
H2
n

Poly(propylene) (PP)

CH3
CH
C
H2

Poly(tetrafluroethylene) (PTFE)
(Teflon), extended-PTFE (GoreTex)

F2
C
C
F2
n

Poly(methymethacrylate)
(Palacos)

CH3
C C
H2
CO2CH3

Ethylene-co-vinylacetate (EVA)
(Elvax)

C
H2

C
H2

C
H2

H3
C
y
OH

Poly(dimethylsiloxane) (PDMS)
(Silastic, silicone rubber)

CH3
Si

CH3
Low MW poly(dimethylsiloxane)
(Silicone oil)
Poly(ether-urethanes) (PU)
(Tecoflex, Tecothane,
BioSpan)

Aromatic N

(Polyther)
n

Poly(ethylene terphthalate) (PET)

(Dacron)

(CH2) 2 O
n

Poly(sulphone) (PS)
O
Aromatic Ether

S
O

Poly(ethyleneoxide)
(PEO, PEG)

H2
C

C
H2

O
n

Non-Degradable Biocompatible Polymers in Medicine

Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

333

(Table 1) contd.

Chemical name & Trade name

Poly(ethyleneoxide-copropyleneoxide) (PEO-PPO),
(Pluronics)

Chemical Structure
CH3
C C O
H2 H2

C
H

C O
H2

Poly(vinylalcohol)
H2
C

CH
OH

Key Property

Traditional Applications

Ampiphilicity and gel

forming properties

Emulsifier

Surfactant and gel-forming

properties

Emulsifier in drug
encapsulation processes and
matrix for sustained drug
delivery

MW = Molecular weight, HD = High density, UHMW = Ultra high molecular weightTable 1

such as in Teflon and poly(propylene) (PP), respectively,

results in polymers that are highly crystalline and hence only
processible at high temperatures and yield less pliable
objects. Knowing these general trends will help in
rationalizing the choice of polymers in various biomedical
applications, which is discussed below.
In skeletal tissue replacement, excellent mechanical and
structural characteristics are a prerequisite. Furthermore, in
joint reconstruction such as total hip and knee replacement,
synthetic polymers are used to fabricate the articulating
surface, which also has a load bearing function. An artificial
replacement therefore has to satisfy these two requirements.
Since high density polyethylene (HDPE) and ultra high,
molecular weight PE exhibit both good flexural and
compressive modulus and a nominal coefficient of friction,
they have seen extensive use in orthopaedic devices [3].
Since PE can be processed by injection molding, it allows
for the easy fabrication of complex contoured objects such as
joints. Although the wear-and-tear, characteristics are
acceptable, local and systemic accumulation of PE particulate
debris due to frictional erosion of the articulating surface can
pose a potential long-term health risk [4]. Delrin (DuPont),
which is polyacetal derived from poly(oxymethylene) has
also been explored as an alloplastic material in the
reconstruction of mandibular joint [5] and in the fabrication
of acetabular cups prosthesis [3]. Analysis on retrieved
implants has shown that while the tissue response to PE and
Delrin are similar, changes to implant surface properties
were markedly different [6]. It was observed that in general,
friction in recovered Delrin sockets was twice as that on PE
sockets and the dimensional change was four times greater in
the Delrin implants leading to a greater incidence of aseptic
loosening of the implant [3]. Delrin is also used in the
fabrication of heart valve occluders [7]. Extensive
mechanical and structural analysis of Delrin heart valve and
acetabular explants have found no evidence to support any in
vivo degradation of the implant, which is indicative of good
biostability [8].
Poly(propylene) (PP), a methylated variant of PE has also
seen use in several medical areas. Although its mechanical
characteristics are not suitable for load bearing applications
it has excellent fiber forming properties. PP meshes have
been used as a prosthetic in the repair of abdominal defects
(ventral incisional hernia) with superior clinical outcomes
[9-11]. Recently, PP fibers have been explored in the

delivery of tetracycline, an antimicrobial agent, to the root

canal [12]. The Actisite delivery system is currently
approved by the US FDA for clinical use and represents the
first periodontal drug delivery system. PP is also currently
being used in malar and mandibular reconstruction [13].
Fluorinated aliphatic polymers such as Teflon possess
certain unique properties as the result of the highly polarized
C-F bond along the backbone. Besides imparting very high
crystallinity to the polymer, it also makes the surface very
hydrophobic and lipophobic. This translates into a surface
that is very resistant to fouling and truly neutral with respect
to promoting or preventing biologically adverse interactions.
When extruded under conditions of anisotropic loading, the
micro architecture of Teflon exhibits pores that are axially
aligned along the direction of stretching, resulting in a
unique material with a microporous architecture. ExtendedPTFE (e-PTFE) (Gore-Tex) has very good permeability to
oxygen and has found utility in several tissue-contacting
applications. Gore-Tex meshes have been used as barriers in
abdominal surgery to prevent unnatural adhesions [14,15]. ePTFE alloplasts have been used as barrier membranes in
directing re-growth of bone in supraalveolar periodontal sites
with moderate to good success [16-18]. Gore-Tex meshes
have also been explored in the tension-free repair of ventral
and incisional hernia [19]. Due its inert nature and tissue
adhesivity, Teflon and e-PTFE are being used in orbital
reconstruction [20], facial reconstruction [21,22] and
rhinoplasty [23-25]. Teflon particles formulated as an
injectable paste (STING, subureteric Teflon injection) are
currently being used for the treatment of vesicoureteric
reflux (VUR) in children with promising results [26]. GoreTex patches have been successfully employed to treat
urinary incontinence due to urethral hypermobility in woman
[27]. Teflon has also been explored in the development of
artificial meniscus with a less than promising outcome [28].
Gore-Tex (e-PTFE) grafts have been used in graft-vein
anastomosis with satisfactory clinical outcomes [29], and are
currently used in the fabrication of large diameter aortic and
carotid vascular grafts. Dacron-a polyester derived from
aromatic diacid and ethylene glycol (poly(ethylene
terphthalate), (PET), is a slow degrading polymer that has
become the material of choice for the fabrication of large
diameter grafts. Knitted Dacron vascular grafts, has
revolutionized cardiovascular surgery by offering a viable
synthetic alternative to autologous transplantation and has

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Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

been successfully used around the world for the past 15-20
years [30]. Like e-PTFE, Dacron meshes are also being used
in abdominal wall reconstruction following a hernia
procedure [9]. It is important to note that slow degrading
polyamides, nylons, have also been successfully explored as
meshes and are commonly used in the fabrication of sutures.
Poly(methylmethacrylate), PMMA which is derived from
a photo- and chemically-curable monomer methylmethacrylate, has been used as a bone cement (sold under the trade
name Palacos) in the fixation and anchoring of artificial
joints [31,32]. PMMA has also been successfully explored in
cranial reconstruction (cranioplasty) as a bone substitute
[33]. One significant advantage of PMMA bone cement
formulations over other synthetic bone substitutes
is that its composition can be altered by the addition of
bone promoting agents such as hydroxyapatite and other
tri-calcium salts [34]. Although there are toxicity issues
associated with long-term exposure to unreacted
methacrylate monomer, the benefits conferred by its
cementing properties far outweigh any risks [31]. The
adverse effects of unreacted methacrylate monomer can be
significantly diminished by using appropriate photoinitiators
that promote 'dark curing', which is continued curing
post-exposure to light radiation. In the past decade and a
half, Palacos bone cement has also been explored as a
vehicle for the localized drug delivery of gentamicin
(PalamedG), bacteriostatic agent for the treatment of
osteomylitis [35,36].
Due to the lack of degradability, synthetic polymers can
provide a diffusional barrier to small and large molecules.
This property is a function of bulk polymer properties such
as the glass transition temperature (Tg). Polymers that have
Tg below or close to room temperature exhibit rubber like
characteristics. The flexible nature of these polymers makes
them ideally suited for implantable applications. Elvax and
Silastic are two such polymers with an impressive history in
drug delivery [37].
Poly(dimethylsiloxane) (PDMS, silicone oil), and its
cross-linked variants silicone rubber (without filler) and
Silastic (with silicon dioxide filler) have a long history in
the medical field. The most successful drug delivery device
to date, the Norplant system, an implantable polymeric rod
for the delivery of contraceptives (Levonorgestrel), is based
on the barrier properties of Silastic membrane [38,39]. A
single implant is capable of delivering the contraceptive
agent at a steady rate for over three years. In this device, the
Silastic serves as both the matrix for drug dispersion and the
rate limiting barrier membrane. Besides drug delivery
applications, Silastic has been extensively used in facial
reconstructive surgery [40] and as orbital implant [20].
Silicone hydrogels have excellent optical and tissue
contacting properties and are favored over PMMA as
intraocular lenses [41,42]. Due to its inertness in biological
environments, Silastic tubing is used as the drain in the
Ahmed drainage implant or (Ahmed Glaucoma valve), a
FDA approved intraocular device for relieving intraocular
pressure due to Glaucoma [43,44]. In spite of the
controversy surrounding the Silicone breast implants, the
safety profile of this polymer is one of the best among all
polymers in use today in medicine [37].

V. Prasad Shastri

Table 2.

Polymer and Product Tradename and Manufacturers

Polymer Tradename

Manufacturer

Dacron, Delrin, Teflon

DuPont

Palacos, Palamed, Copal,

Osteopal

Merck

Slilastic, Silicone Oil

Dow Chemicals

Elvax

DuPont

Tecoflex, Tecothane

Thermedcis

BioSpan

Polymer Technology Group, Inc.

Pluronic

BASF

Actisite

Procter & Gamble

Gore-Tex

W. L. Gore & Associates

Palacos, Palamed, Copal,

Osteopal

Merck

Norplant

Wyeth-Ayerst

Ahmed Drainage Implant

New World Medical

Implanon, Nuvaring

NV Organon

Ocusert

Alza

Elvax (EVA), a copolymer of ethylene and vinyl

acetate, has excellent film forming properties and due to its
low Tg is very flexible at room temperature and has a good
in vitro and in vivo safety profile [37]. EVA membranes are
ideally suited as permeation barriers since by varying the
monomer ratios in the co-polymer, the diffusion of small
molecules can be altered. Implanon, which is an
implantable rod of EVA for the delivery of etonogestrel, is
currently approved for clinical use in Europe and Canada and
is awaiting approval in the United States, which is expected
by 2004. EVA (Elvax) is also used as the rate limiting
membrane in OCUSERT, which is an ocular insert for the
sustained release of Pilocarpine directly to the conjunctiva
surface for the treatment of Glaucoma [45]. A variant of the
Norplant system is the Nuvaring, for the delivery of
etonogestrel/ethinyl estradiol, which is a vaginal ring
fabricated with Elvax for the delivery of contraceptives and
is currently approved by the US FDA [46].
Polymers that possess low Tg exhibit rubber like
elasticity and are well suited for vascular applications
wherein distensibility (elastic deformation) in a material is
important to withstand the rigors and pressure variations of
arterial circulation. Polyurethane (PU), which is derived by
the copolymerization of a aromatic diisocyanate with a
poly(alcohol), has a Tg below room temperature and hence is
elastic in nature. PUs are slow degrading polymers that
exhibit excellent blood compatibility due to their phaseseparated microstructure [47]. Since PTFE and Dacron
surfaces are thrombogenic and relatively rigid, they are not
suitable for the fabrication of small diameter vascular grafts

Non-Degradable Biocompatible Polymers in Medicine

[48]. PU has been proposed as a viable alternative as it is

both haemocompatible and elastic [49,50]. As improvements
in PU stability are made, PU is being explored as coatings
for biliary stents [51] and in hear valve prosthesis [52].
Poly(ethyleneoxide) (PEO) (poly(ethyleneglycol), PEG),
which belong to the class of aliphatic polyethers have been
extensively explored as surface coatings for passivation of
surfaces towards protein adsorption. The origins of protein
inhibitory potential of PEG lie in steric exclusion effects due
to the hydration and organization of water molecules around
PEG chains [53]. This unique property of PEG has been
exploited in improving protein stability, which is achieved
by PEGylation of amino acid residues on proteins to
preserve native protein conformation by inhibiting
hydrophobic effects that lead to protein unfolding [54].
Poly(vinyl alcohol) (PVA), a aliphatic polyol and
Pluronics, which are block co-polymers of PEO and
poly(propyleneoxide), are routinely used as emulsion
stabilizers in the formulation of pharmaceuticals and
particulate polymeric drug delivery systems such as
nanoparticles and microspheres [55]. Their hydrogel forming
properties is just beginning to be explored in the emerging
areas of drug delivery and tissue engineering and is
discussed in the following section.
EMERGING AND FUTURE USES
Although the erosion of PE surface upon cyclic loading is
a concern, PE implants will continue to be used in the
orthopaedic setting due to their excellent clinical
performance. Creative solutions are being proposed to alter
the mechanical properties of UHMWPE so as to reduce
frictional wear. Merrill and co-workers have devised a novel
approach to improve the wear resistance of UHMWPE by
introducing a gradient of cross-linking in PE by exposing a
PE melt to e-beam radiation [56]. This next generation
implants have shown significantly improved performance in
laboratory trails.
Both in dental and facial reconstruction, one can expect
to see an increase in the use of e-PTFE in guided tissue
regeneration as new biomolecules that are capable of
directing specific tissue ingrowth are being identified. The
bio-inertness of Teflon will continue to propel its use in
tissue contacting applications such as meshes for abdominal
surgery, biliary stents [57], patches for aortoplasty in the
treatment of coarctation of the aorta in children [58], and the
treatment of urinary incontinence [27]. In the coming years
one can expect to see a exponential use of e-PTFE in
emerging disciplines such as tissue engineering, where
inertness of scaffold can prove vital in the presentation of
information for cellular manipulation.
In addition, to its traditional uses, PMMA bone cement is
increasing being used as a bone substitute in reconstructive
procedures. Improved formulations with better curing
characteristics (Copal, Osteopal) and loaded with
bioactives (PalamedG, Refobacin-Palacos) are already
on the market. Some of the novel applications that have
emerged in the recent past include cranioplasty and more
recently vertebroplasty [59-61]. Vertebroplasty is a
minimally invasive interventional therapy to alleviate pain

Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

335

associated with compression fracture. It involves injection of

PMMA bone (OsteopalV) cement to support the vertebral
body and restore its height after osteoporotic compression
fracture. In this setting, the bone cement behaves like a filler
between two spinal processes, thereby stabilizing the
fractured segments and alleviating the extreme pain
associated with spinal compression fractures. Since the
outcomes have been favorable, this procedure is fast gaining
clinical acceptance. Nevertheless, toxicity associated with
long-term exposure to unreacted methacrylate monomer will
continue to be an issue of concern.
The prognosis for polymers such as Silastic and EVA
(Elvax) in drug delivery applications is good. They will
continue to be used as matrices in the long-term delivery of
contraceptives, vaccines and other high-potency drugs that
require controlled long-term delivery regimens. Surface
modification
approaches
to
improve
long-term
biocompatibility of these polymers will be key in realizing
this potential. Silastic and Elvax may find uses in microelectro mechanical systems (MEMS) based drug delivery
system as matrices for drug dispersion, wherein a single
implantable device is capable of delivering a multitude of
drugs in a preprogrammed fashion.
Beside its traditional use as a non-ionic surfactant in
emulsification of polymer solutions in the fabrication of
particulate delivery systems, PVA and Pluronics will
continue to be explored for both topical and injectable
applications. However, before that happens long-term safety
of these polymers in an in vivo setting has to be established.
These polymers offer a major advantage over Silastic and
Elvax in that they are water-soluble and hence can be
excreted from the body obviating the need for a retrieval
procedure, as is the case with the Norplant system.
Although traditionally its has been assumed and
suggested that degradability in a scaffold is of paramount
importance in engineering of tissue replacement, this may
not hold true for many tissue components where mechanical
performance is an overriding factor. Examples of such tissue
include skeletal components such as cartilage, tendon,
ligaments and bone, and vascular prostheses. As tissue
engineering matures into a discipline, with a focus more on
'functional tissue engineering', there is a compelling
argument for the evaluation of hybrid tissue replacements. In
a hybrid tissue equivalent (HTE), the permanent synthetic
scaffold is designed to provide specific structural and
mechanical characteristics to augment the evolving cellular
component. In such a system, the role of cellular architecture
will be to enhance the biocompatibility of the hybrid implant
and ensure its integration with the host. In this context,
synthetic non-degradable polymers such Teflon, PU, Silastic
and PET will see an increased use as scaffolds in the ex-vivo
engineering of tissue equivalents due to their specific
mechanical characteristics. For example, poly(ethersulfones), which are traditionally used as hollow fibers for
immobilization of enzymes in extra-corporeal devices
[62,63], is being explored as guidance channels in peripheral
nerve regeneration [64]. In the case of PU, any improvement
in its long-term in vivo stability will significantly encourage
its use in long-term implants such as small diameter vascular
grafts. Similarly, gels derived from non-degradable soft-

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Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

polymers such as PEG, PEO, Pluronic and PVA will be

increasingly explored in the context of engineering of HTE.
Currently, photocurable gels derived from PEO and PVA are
being explored in the in vivo morphogenesis of cartilaginous
tissue [65].

V. Prasad Shastri
[20]
[21]
[22]
[23]

CONCLUSIONS
Biodegradable polymers have an illustrious past in
advancing the frontiers of medical science. Some of the
greatest surgical advances would have been impossible
without the non-degradable synthetic polymers. As we move
into the 21st century, emerging disciplines such as drug
delivery and tissue engineering will play an increasingly
central role in defining clinical treatment options. Nondegradable polymers, by virtue of their long association with
the medical sciences, will continue to influence and shape
these emerging fields. As we improve the tools for
manipulating surfaces more precisely, biomolecular cues to
control and dictate cellular behavior can be presented in a
more meaningful fashion. In this context, the inertness of
these polymers will be a vital asset in the evolution of the
next generation of biomimetic drug delivery systems,
implants and scaffolds.
ACKNOWLEDGEMENTS
This work was supported in part by a grant from the
National Institutes of Health (R24-AI47739-03). The author
wishes to thank Dr. Ulrike Varlemann-Shastri for helpful
discussions.

[24]
[25]
[26]
[27]
[28]
[29]
[30]
[31]
[32]
[33]
[34]
[35]
[36]
[37]
[38]
[39]
[40]
[41]
[42]

REFERENCES

[43]

[1]

[44]

[2]

[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
[14]
[15]
[16]
[17]
[18]
[19]

Odian, G. (1991) Principles of Polymerization, Third Edition,

Wiley-Interscience, New York, NY.
March, J. (1986) Advanced Organic Chemistry: Reactions,
Mechanisms, and Structure, Third Edition, John Wiley & Sons,
New York.
Mathiesen, E.B.; Lindgren, U.; Reinholt, F. P. and sudmann, E.
(1986) Acat Orthop. Scand., 57(3), 193-196.
Maruyama, M.; Capello, W.n.; DAntonio, J.A.; Jaffe, W.I. and
Bierbaum, B.E. (2000) Clin. Orthop., 370, 183-191.
MacAfee, K.A. and Quinn, P.D. (1992) Craniofac. Surg., 3(3),
160-169.
Mathiesen, E.B.; Lindgren, U.; Reinholt, F. P. and Sudmann, E.
(1987) J. Biomed. Mat. Res., 21(4), 459-466.
Wieting, D.W. (1996) J. Heart Valve Dis., 5(Suppl 2), S157-S168.
McKellop, H.A.; Milligan, H.L. and Rostlund, T. (1996) J. Heart
Valve Dis., 5(Suppl 2), S238-S242.
Anwar, S. (2003) Hospt. Med., 64(1), 34-35.
San Pio, J.R.; Damsgaard, T.E.; Momsen, O.; Villadsen, I. and
Larsen, J. (2003) Scand. J. Plast. Reconstr. Surg. Hand Surg.,
37(2), 102-106
Steele, S.R.; Lee, P.; Martin, M.J.; Mullenix, P.S. and Suliivan,
E.S. (2003) Am. J. Surg., 185(5), 436-440.
Goodson, M. (1996) Technol. Health Care, 4(3), 269-282.
Cox (III), A.J. and Wang, T.D. (1999) Facial Plast. Surg., 15(1), 312
Tulandi, T. (1997) Curr. Opin. Gynecol., 9(4), 239-243.
Morris-Stiff, G.J. and Highes, L.E. (1998) J. Am. Coll. Surg.,
186(3), 352-367.
Becker, W. and Becker, B.E. (1993) Periodontol. 2000, 1, 46-53.
Singurdsson, T.J.; Tatakis, D.N.; Lee, N.B. and Wikesjo, U.M.
(1995) J. Periodontol., 66(6), 511-521.
Wolfff, L.F. (2000) Northwest. Dent., 79(6), 23-28.
Aura, T.; Habib, E.; Mekkaoui, M.; Brassier, D. and Elhadad, A.
(2002) J. Laproendosc. Adv. Surg. Tech. A, 12(4), 263-267.

[45]
[46]
[47]
[48]
[49]
[50]
[51]

[52]
[53]
[54]
[55]
[56]
[57]
[58]
[59]
[60]
[61]

Meyer, D.R. (1995) Curr. Opin. Opthalmol., 6(5), 43-52.

Singh, S. and Baker, Jr., J.L. (2000) Clin. Plast. Surg. , 27(4), 579593.
Lewis, R.P.; Schweitzer, J.; Odum, B.C.; Lara, W.C.; Edlich, R.F.
and Gampper, T.J. (1998) J. Long Term Eff. Med. Implants, 8(1),
19-42.
Godin, M.S.; Waldman, S.R. and Johnson, Jr., C.M. (1995) Arch.
Otolaryngol. Head Neck. Surg., 121(10), 1131-1136.
Conrad, K. and Giullman, G. (1998) Plast. Reconstr. Surg., 101(6),
1675-1683.
Vuyk, H.D. and Adamson, P.A. (1998) Clin. Otolaryngol., 23(3),
209-217.
Puri, P.; Ninan, G.K. and Surana, R. (1995) Eur. Urol., 27(1), 7175.
Choe, J.M. and Staskin, D.R. (1999) Urology, 54(4), 641-646.
Messner, K. (1994) Biomaterials, 15(4), 243-250.
Berard, X.; Baste, J.C.; Sassoust, G.; Du Bourguet, L.; Combe, C.;
De Precigout, V. and Midy, D. (2003) J. Mal. Vasc., 28(2), 73-78.
Mili, S.; Mori, A.; Sakata, H. and Kawazoe, N. (1998) J. Am. Coll.
Surg., 186(5), 581-588.
DiMaio, F.R. (2002) Orthopedics, 25(12), 1399-1407.
Breusch, S.J. and Kuhn, K.D. (2003) Orthopade, 32(1), 41-50.
Moreira-Gonzalez, A.; Jackson, I.T.; Miyawaki, T.; Barakat, K.
and DiNick, V. (2003) J. Craniofac. Surg., 1492), 144-153.
Heini, P.F. and Berlemann, U. (2001) Eur. Spine J., 10(Suppl 2),
S205-S213.
Kanellakopoulou, K. and Giamerellos-Bourboulis, E.J. (2000)
Drugs, 59(6), 1223-1232.
Walenkamp, G.H. (2001) J. Chemother., 13, Spec. 1(1), 66-72.
Shastri, P.V. (2002) Contraception, 65(1), 9-13.
Teluja, S. (1970) J. Obstet. Gynec., 954-957.
Gu, S.; Sivin, I. and Du, M. (1995) Contraception, 52, 99-103.
Bonding, P. and Jensen, J.H. (1986) J. Laryngol. Otol., 100(1), 914.
Chehande, M. and Elder, M.J. (1997) Aust. N. Z. Opthhalmol.,
25(4), 255-263.
Doan, K.T.; Olson, R.J. and Mamalis, N. (2002) Curr. Opin.
Opthalmol., 13(1), 24-29.
Taglia, D.P.; Perkins, T.W.; Gangnon, R.; Heatley, G.A. and
Kaufmann, P.L. (2002) J. Glaucoma, 11(4), 347-353.
Morad, Y.; Donaldson, C.E.; Kim, Y.M.; Abdolell, M. and Levin,
A.V. (2003) Am. J. Opthalmol., 135(6), 821-829.
Pollack, I.P.; Quigley, H.A. and Harbin, T.S. (1976) South Med. J.,
69(10), 1296-1298.
Roumen, F.J.; Dieben, T.O. (1999) Contraception, 59, 59-62.
Zdrahala, R.J. and Zdrahala, I.J. (1999) J. Biomater. Appl., 14(1),
67-90.
Bos, G.W.; Poot A.A.; Beugeling, T.; van Aken, W.G. and Feijen,
J. (1998) Arch. Physiol. Biochem., 106(2), 100-15
Zdrahala, R.J. (1996) J. Biomater. Appl., 11(1), 37-61.
Tiwari, A.; Salacinski, H.; Seifalian, A.M. and Hamilton, G. (2002)
Cardiovasc. Surg., 10(3), 191-197.
Severini, A.; Mantero, S.; Tanzi, M.C.; Cigada, A.; Addis, F.;
Cozzi, G.; Salvetti, M. andreola, S.; Motta, A.; Regalia, E.;
Pulvirenti, A.; De Pedri, E. and Doci, R. (1999) Cardiovasc.
Intervent. Radiol., 22(6), 510-514.
Mackay, T.G.; Wheatley, D.J.; Bernacca, G.M.; Fisher, A.C. and
Hindle, C.S. (1996) Biomaterials, 17(19), 1857-1863.
Leckband, D.; Sheth, S. and Halperin, A. (1999) J. Biomater. Sci.
Polym. Ed., 10(10), 1125-1147.
Sato, H. (2002) Adv. Drug Deliv. Rev., 54(4), 487-504.
Jain, R.A. (2000) Biomaterials, 21(23), 2475-2490.
Muratoglu, O.K.; Oconnor, D.O.; Bragdon, C.R.; Delaney, J.;
Jasty, M.; Harris, W.H.; Merrill, E. and Venugopalan, P. (2002)
Biomaterials, 23(3), 717-724.
Tibble, J.A. and Cairns, S.R. (2001) J. Hepatobiliary Pancreat.
Surg., 8(2), 118-123.
Backer, C.L.; Paape, K.; Zales, V.R.; weigel, T.J. and Mavroudis,
C. (1995) Circulation, 92, 9 Suppl(II), 132-136.
Wenger, M.; Braun, M. and Markwalder, T.M. (2002) Rev. Med.
Suisse Romande, 122(11), 557-560.
Peters, K.R.; Guiot, B.H.; Martin, P.A. and Fessler, R.G. (2002)
Neurosurgery, 51(Suppl 5), 96-103.
Eck, J.C.; Hodges, S.D. and Humphreys, S.C. (2002) Am. J.
Orthop., 31(3), 123-127.

Non-Degradable Biocompatible Polymers in Medicine

[62]
[63]

Kuragano, T.; Kuno, T.; Takahashi, Y.; Yamamoto, C. Nagura, Y,

Takahashi, S. and Kanmatsuse, K. (2003) Blood Purif., 21(2), 176182.
Bhardwaj, V.; Macintosh, A.; Sharpe, I.D.; Gordeyev, S.A.;
Shilton, S.J. (2003) Ann. N.Y. Acad. Sci., 984, 318-328.

Current Pharmaceutical Biotechnology, 2003, Vol. 4, No. 5

[64]
[65]

337

Yu, X. and Bellamkonda, R.V. (2003) Tissue Eng., 9(3), 421-430.

Martens, P.J.; Bryant, S.J. and Anseth, K.S. (2003)
Biomacromolecules, 4(2), 283-292.