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American Journal of Veterinary Research Apr 2021To evaluate the effect of a continuous locking novel epitendinous suture (nES) pattern with and without a core locking-loop (LL) suture on the biomechanical properties...
Evaluation of a continuous locking novel epitendinous suture pattern with and without a core locking-loop suture on the biomechanical properties of tenorrhaphy constructs in an ex vivo model of canine superficial digital flexor tendon laceration.
OBJECTIVE
To evaluate the effect of a continuous locking novel epitendinous suture (nES) pattern with and without a core locking-loop (LL) suture on the biomechanical properties of ex vivo canine superficial digital flexor tendon (SDFT) tenorrhaphy constructs.
SAMPLE
54 cadaveric forelimb SDFTs from 27 musculoskeletally normal adult dogs.
PROCEDURES
Tendons were assigned to 3 groups (18 SDFTs/group): sharply transected and repaired with a core LL suture alone (group 1), an nES pattern alone (group 2), or a combination of a core LL suture and nES pattern (group 3). All constructs underwent a single load-to-failure test. Yield, peak, and failure loads; gap formation incidence; and mode of failure were compared among the 3 groups.
RESULTS
Mean yield, peak, and failure loads differed significantly among the 3 groups and were greatest for group 3 and lowest for group 1. Mean yield, peak, and failure loads for group 3 constructs were greater than those for group 1 constructs by 50%, 47%, and 44%, respectively. None of the group 3 constructs developed 3-mm gaps. The most common mode of failure was suture pulling through the tendon for groups 1 (12/18) and 2 (12/18) and suture breakage for group 3 (13/18).
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested augmentation of a core LL suture with an nES pattern significantly increased the strength of and prevented 3-mm gap formation at the tenorrhaphy site in ex vivo canine SDFTs. In vivo studies are necessary to assess the effectiveness and practicality of the nES pattern for SDFT repair in dogs.
Topics: Animals; Biomechanical Phenomena; Cadaver; Dog Diseases; Dogs; Lacerations; Suture Techniques; Sutures; Tendon Injuries; Tendons; Tensile Strength
PubMed: 33764835
DOI: 10.2460/ajvr.82.4.302 -
Journal of Biomedical Materials... Oct 2022In this research, a novel bioabsorbable suture that is, monofilament and capable of localized drug delivery, was developed from a combination of natural biopolymers that...
In this research, a novel bioabsorbable suture that is, monofilament and capable of localized drug delivery, was developed from a combination of natural biopolymers that where not previously applied for this purpose. The optimized suture formulation comprised of sodium alginate (6% wt/vol), pectin (0.1% wt/vol), and gelatin (3% wt/vol), in the presence of glycerol (4% vol/vol) which served as a plasticizer. The monofilament bioabsorbable sutures where synthesized via in situ ionic crosslinking in a barium chloride solution (2% wt/vol). The resulting suture was characterized in terms of mechanical properties, morphology, swelling, degradation, drug release, and biocompatibility, in addition to Fourier-transform infrared (FTIR) spectroscopy, Powder X-ray Diffraction (PXRD) and Differential Scanning Calorimetry (DSC) analysis. The drug loaded and non-drug loaded sutures had a maximum breaking strength of 4.18 and 4.08 N, in the straight configuration and 2.44 N and 2.59 N in the knot configuration, respectively. FTIR spectrum of crosslinked sutures depicted Δ9 cm downward shift for the carboxyl stretching band which was indicative of ionic interactions between barium ions and sodium alginate. In vitro analysis revealed continued drug release for 7 days and gradual degradation by means of surface erosion, which was completed by day 28. Biocompatibility studies revealed excellent hemocompatibility and no cytotoxicity. These results suggest that the newly developed bioabsorbable suture meets the basic requirements of a suture material and provides a viable alternative to the synthetic polymer sutures that are currently on the market.
Topics: Absorbable Implants; Alginates; Polymers; Suture Techniques; Sutures; Tensile Strength
PubMed: 35373911
DOI: 10.1002/jbm.b.35069 -
Veterinary Surgery : VS Oct 2022To assess the effect of repeated freezing and thawing on the suture pull-out strength in arytenoid and cricoid cartilages subjected to the laryngoplasty (LP) procedure.
OBJECTIVE
To assess the effect of repeated freezing and thawing on the suture pull-out strength in arytenoid and cricoid cartilages subjected to the laryngoplasty (LP) procedure.
STUDY DESIGN
Ex vivo experimental study.
SAMPLE POPULATION
Ten grossly normal equine cadaveric larynges.
METHODS
Bilateral LP constructs were created using a standard LP technique. One hemilarynx was randomly allocated to the single freeze and thaw group and the other allocated to the repeated freeze and thaw (3 complete cycles) group. The suture ends of each LP construct were attached to a load frame and subjected to monotonic loading until construct failure. Mean load (N) and displacement (mm) at LP construct failure were compared between groups.
RESULTS
All LP constructs failed by suture pull through the arytenoid cartilage. The mean load at failure was similar between groups (118.9 ± 25.5 N in the single freeze and thaw group and 113.4 ± 20.5 N in the repeated freeze and thaw group, P = .62). The mean displacement at failure was similar between groups (54.4 ± 15.1 mm in the single freeze and thaw group and 54.4 ± 15.4 mm in the repeated freeze and thaw group, P = .99).
CONCLUSION
Repeated freezing and thawing did not affect the suture pullout strength of the arytenoid and cricoid cartilages.
CLINICAL SIGNIFICANCE
Laryngeal specimens that have been subjected to repeated freezing and thawing can be utilized in the experimental evaluation of LP procedures because there is no alteration of the suture pull-out strength of the relevant cartilages.
Topics: Animals; Arytenoid Cartilage; Cadaver; Cricoid Cartilage; Freezing; Horses; Laryngoplasty; Sutures
PubMed: 35815735
DOI: 10.1111/vsu.13855 -
Journal of Vascular Surgery Nov 2014
Topics: Antisepsis; Catgut; Equipment Design; History, 19th Century; Humans; Ligation; Surgical Wound Infection; Suture Techniques; Sutures; Vascular Surgical Procedures
PubMed: 24833248
DOI: 10.1016/j.jvs.2014.04.005 -
Translational Vision Science &... Aug 2022This study investigated the feasibility and potential advantage of using a new microsurgical teleoperated robot, Symani Surgical System, in the ophthalmology field. In...
PURPOSE
This study investigated the feasibility and potential advantage of using a new microsurgical teleoperated robot, Symani Surgical System, in the ophthalmology field. In particular, considering the extreme precision of the system and the dexterity of the instrument, possible use of the Symani Surgical System has been explored for suturing in corneal graft surgery.
METHODS
Manual and robot-assisted suturing of partial corneal transplants was performed on the porcine eye model by an ophthalmologist with experience with the porcine model. Suturing execution time, suture placement, and tomographic parameters were analyzed to assess the regularity and distribution of corneal sutures for both manual and robotic treatment.
RESULTS
The two robot-assisted procedures were properly completed on the porcine model, confirming the ease of use of the system and its capabilities, as well as the dexterity of the microinstruments. Manual and robotic treatments were found to be equivalent in terms of distance and angular precision of suture placement and corneal surface regularity (Gaussian anterior curvature). The robotic procedure required longer suturing execution times compared with the manual procedure.
CONCLUSIONS
The technical and clinical feasibility of robot-assisted suturing of partial corneal graft using the Symani Surgical System has been confirmed for the first time, to our knowledge, using an ex vivo porcine model. Robotic suturing required longer time to complete but was equivalent to the manual procedure with regard to the imaging data collected.
TRANSLATIONAL RELEVANCE
This study evaluated the use of the Symani Surgical System in the ophthalmology field. Future investigations could further identify the advantages offered by the stability, dexterity, and motion precision of the system for corneal surgeries, paving the way for clinical use in both adult and even more challenging pediatric therapy.
Topics: Animals; Feasibility Studies; Humans; Ophthalmology; Robotics; Suture Techniques; Sutures; Swine
PubMed: 35976656
DOI: 10.1167/tvst.11.8.13 -
American Journal of Veterinary Research May 2022To compare biomechanical strength of 4.75- and 5.5-mm suture anchors when pulled at 45° or 90° angles using 1 versus 2 strands of suture.
OBJECTIVE
To compare biomechanical strength of 4.75- and 5.5-mm suture anchors when pulled at 45° or 90° angles using 1 versus 2 strands of suture.
SAMPLE
48 synthetic bone block samples.
PROCEDURES
Anchors were inserted into synthetic bone blocks and tested for pullout in 4 configurations (1 suture strand vs 2 strands and 45° vs 90° insertion angle) for a total of 8 groups with 6 samples each. A 3-way ANOVA was used to compare effect of anchor size, strand amount, and angle of pull.
RESULTS
All constructs failed via anchor pullout. Anchor configurations with 2 strands of suture and 4.75-mm anchor (mean, 286 ± 24 N) or 5.5-mm anchor (mean, 300 ± 15 N) had greater pullout strength than configurations with only 1 strand of suture and 4.75-mm anchor (mean, 202 ± 12 N) or 5.5-mm anchor (mean, 286 ± 13.6 N). The 5.5-mm anchors had a higher maximum load to failure under axial pull at 45° (mean, 300 ± 15 N) and 90° (mean, 295 ± 24 N), compared with 4.75-mm anchors at 45° (mean, 202 ± 12 N) and 90° (mean, 208 ± 15 N). There was a higher maximum load to failure for the double-stranded constructs, regardless of anchor size, at both angles of insertion. Anchors inserted at 45° had a higher maximum load to failure than those inserted at 90°. Constructs with 2 strands of suture had a greater pullout strength regardless of the direction of pull.
CLINICAL RELEVANCE
The strength of the anchor construct is likely increased with the use of double-loaded anchors inserted at 45°. Clinicians should consider using 2 strands in clinical cases.
Topics: Animals; Biomechanical Phenomena; Cadaver; Suture Anchors; Suture Techniques; Sutures; Tensile Strength
PubMed: 35930779
DOI: 10.2460/ajvr.21.05.0065 -
BMC Oral Health Nov 2022The type of suture used in periodontal surgery can affect post-surgical complications. This study aimed to compare simple with cross-mattress sutures for nondisplaced... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The type of suture used in periodontal surgery can affect post-surgical complications. This study aimed to compare simple with cross-mattress sutures for nondisplaced flaps of the maxillary molar region.
METHODS
This randomized controlled trial included 32 candidates of nondisplaced flap surgery of the maxillary molar region referred to the private office of a periodontist in Bandar Abbas, Iran from January 21 to May 4, 2020. First, the patients' age, sex, and plaque index were recorded. Then, they were randomized into two equal groups. In the first group, the interdental suturing was done using simple sutures with 4-0 vicryl threads, and in the second group, interdental suturing was performed using cross-mattress sutures with the same threads. The primary outcome was suture time, including the duration of the first suture and the total duration of all sutures. The secondary outcomes were bleeding on probing and the requirement of supplementary sutures immediately after the surgery, as well as the gingival index (at suture removal and one month after surgery).
RESULTS
The two groups were comparable regarding age, sex, and plaque index. The first suture duration was significantly longer in the simple group compared to the cross-mattress group (P < 0.001); however, the total suture time did not differ between groups. Moreover, a significantly higher number of patients in the simple group required supplementary sutures (50% vs. 6.3%, P = 0.006). There was no significant difference between groups regarding bleeding on probing and gingival index (at suture removal and one month after surgery).
CONCLUSIONS
Cross-mattress sutures were superior to simple sutures in terms of supplementary suture requirement for nondisplaced flaps of the maxillary molar region, while the two suturing techniques were alike regarding total suture time, gingival index, and probing on bleeding.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT), IRCT20191224045882N1. Registered 08/02/2020. Registered while recruiting, https://www.irct.ir/trial/44754 .
Topics: Humans; Iran; Sutures; Suture Techniques; Surgical Flaps; Molar
PubMed: 36384543
DOI: 10.1186/s12903-022-02551-1 -
International Wound Journal Nov 2022Open wounds are usually closed with suture. However, young patients often do not cooperate and prevent proper suture placement. Young patients are often terrified of... (Randomized Controlled Trial)
Randomized Controlled Trial
Open wounds are usually closed with suture. However, young patients often do not cooperate and prevent proper suture placement. Young patients are often terrified of mild pain and wholly uncooperative, which is why we introduce this timesaving, less painful, more aesthetic technique of placing and removing stitches. 104 patients with facial lacerations aged 5 to 15 years were treated at a single center from May 2019 to March 2021. Patients were randomly assigned equally to a simple interrupted suture group (the SI group) or a continuous locking with Steri-Strip group (the CS group). Suture times, times for stitch removal, pain scores at stitch removal and mature scar scores were evaluated. Suture and stitch removal times were significantly shorter, and pain scores at stitch removal and observer scar assessment scale scores were lower in the CS group. Patient scar assessment scale score was non-significantly lower in the SI group. This study shows that the novel continuous locking with the Steri-Strip technique is easier and quicker to perform, causes less pain when removing stitches, provides better aesthetic results than the simple interrupted suture technique and suggests the continuous locking with Steri-Strip technique would be very useful for uncooperative young patients.
Topics: Humans; Cicatrix; Adhesives; Suture Techniques; Sutures; Pain
PubMed: 35293122
DOI: 10.1111/iwj.13787 -
Injury Dec 2020The biomechanical properties of small vessels and microvascular anastomoses have not been studied completely yet. However, in case of vascular injury and various...
INTRODUCTION
The biomechanical properties of small vessels and microvascular anastomoses have not been studied completely yet. However, in case of vascular injury and various microsurgical reconstructive procedures a safe anastomosis is essential. Quick and reliable tests are needed to test various anastomoses in research and in teaching courses as well for quality control and proper feedback. We aimed to compare selected biomechanical properties of the simple interrupted, the continuous suture and the modified Lauritzen's sleeve-technique.
MATERIALS AND METHODS
Sixty femoral arteries from chicken thigh biopreparates and 12 abdominal aortas from rats were used in this study. In case of the pressure resistance test the groups were: the simple interrupted, the continuous suture and the modified Lauritzen's sleeve-technique. The tensile-strength, elongation and elasticity measurement groups were the simple interrupted and continuous sutures with 8 and 12 stitches. Furthermore the suture materials in various conditions (simple thread, knotted threads, stitch with intact and damaged threads) were also compared. The tensile-strength and the pressure probe devices were custom made in cooperation with the Faculty of Informatics.
RESULTS
The average diameter of the chicken femoral arteries was 3.25±0.38 mm. The sleeve-technique showed the biggest pressure drop (56±16.41 mmHg), however, it was the fastest method. The tensile-strength of simple interrupted suture was 4.55±0.7 Newton (N), being lower than of the intact vessel (6.8 ± 1.4 N). The tensile-strength did not differ significantly between the 12-stitch simple interrupted and continuous sutures, however, the latter was stronger. The anastomoses made on thread model were significantly stronger than the ones on vessels.
CONCLUSION
The main variables were the number of stitches and the strength of the vessel. The pressure drop was not correlated with the stitch number. One incorrect stitch can dramatically increase the leakage. Although the sleeve-technique is quick to be performed, it cannot withstand high pressure. The suture material itself is far stronger then the vessel. The vessel tensile strength was decreased in the anastomoses. For the given vessel diameter more than 8 stitches should be used.
Topics: Anastomosis, Surgical; Animals; Microsurgery; Rats; Suture Techniques; Sutures; Tensile Strength
PubMed: 32147145
DOI: 10.1016/j.injury.2020.02.104 -
Clinics (Sao Paulo, Brazil) Oct 2017In this work, we attempted to develop a modified single-knot Kessler-loop lock suture technique and compare the biomechanical properties associated with this single-knot... (Comparative Study)
Comparative Study
OBJECTIVE
In this work, we attempted to develop a modified single-knot Kessler-loop lock suture technique and compare the biomechanical properties associated with this single-knot suture technique with those associated with the conventional modified Kessler and interlock suture techniques.
METHODS
In this experiment, a total of 18 porcine flexor digitorum profundus tendons were harvested and randomly divided into three groups. The tendons were transected and then repaired using three different techniques, including modified Kessler suture with peritendinous suture, interlock suture with peritendinous suture, and modified Kessler-loop lock suture with peritendinous suture. Times required for suturing were recorded and compared among groups. The groups were also compared with respect to 2-mm gap load, ultimate failure load, and gap at failure.
RESULTS
For tendon repair, compared with the conventional modified Kessler suture technique, the interlock and modified Kessler-loop lock suture techniques resulted in significantly improved biomechanical properties. However, there were no significant differences between the interlock and modified Kessler-loop lock techniques with respect to biomechanical properties, gap at failure, and time required.
CONCLUSIONS
The interlock and modified Kessler-loop lock techniques for flexor tendon sutures produce similar mechanical characteristics in vitro.
Topics: Animals; Biomechanical Phenomena; Models, Animal; Random Allocation; Reference Values; Reproducibility of Results; Suture Techniques; Sutures; Swine; Tendon Injuries; Tendons; Tensile Strength; Treatment Outcome; Weight-Bearing; Wound Healing
PubMed: 29069263
DOI: 10.6061/clinics/2017(09)10