Poly-4-hydroxybutyrate (P4HB): a new generation of resorbable medical devices for tissue repair and regeneration

Biomed Tech (Berl). 2013 Oct;58(5):439-52. doi: 10.1515/bmt-2013-0009.


Poly-4-hydroxybutyrate (P4HB) is a thermoplastic, linear polyester, produced by recombinant fermentation, that can be converted into a wide range of resorbable medical devices. P4HB fibers are exceptionally strong, and can be designed to provide prolonged strength retention in vivo. In 2007, the FDA cleared a monofilament suture made from P4HB for general soft tissue approximation and/or ligation. Subsequently, surgical mesh devices for hernia repair, tendon and ligament repair, and plastic and reconstructive surgery have been introduced for clinical use. This review describes the unique properties of P4HB, its clinical applications, and potential uses that are under development.

Publication types

  • Review

MeSH terms

  • Absorbable Implants*
  • Biocompatible Materials / chemical synthesis*
  • Guided Tissue Regeneration / instrumentation*
  • Polyesters / chemical synthesis*
  • Prosthesis Design
  • Tissue Engineering / instrumentation*
  • Tissue Scaffolds*


  • Biocompatible Materials
  • Polyesters
  • poly(4-hydroxybutanoate)