Security and biomechanical strength of three end-pass configurations for the terminal end of intradermal closures performed with unidirectional barbed suture material in dogs (original) (raw)
Related papers
Journal of the American Veterinary Medical Association, 2016
Small Animals & Exotic M any suture patterns and materials have been described for routine incision closure. Considerations for selection of an appropriate suture pattern and material include inflammatory response, risk of surgical site infection, knot security, tensile strength, suture handling, cost, risk of dehiscence, and speed of application. 1 Each suture pattern has its unique advantages and disadvantages. Common interrupted external suture patterns in the skin include the simple interrupted and cruciate patterns. These patterns allow more precise approximation of the skin edges along with more security than continuous buried suture pat
Comparison of tensile strength of skin closure by simple interrupted, simple continuous, and staples
International Surgery Journal
Background: Objective of the study was to compare tensile strength and time taken for wound closure using simple interrupted sutures, simple continuous sutures, and staples sutures. Methods: Swine skin tissue was cut into pieces of 2×6 cm and were divided into 3 groups according to skin closure technique: simple interrupted sutures (Nylon 5-0), simple continuous sutures (Nylon 5-0), and staples suture. All sutures, three equal knots in one piece, were performed by a single surgeon. Time taken for the approximation of each sample was recorded in second (S). Tensile strength was measured in newton unit (N) by pulling apart until suture separation using a tensiometer. One-way analysis of variance (ANOVA) and subgroup analysis using Bonferroni correction was used to determine differences between groups. Results: Of 190 total pairs of skin tissue, the mean±SD times for skin approximation were 144.86±22.67 s for simple interrupted sutures, 96.19±17.64 s for simple continuous sutures, and ...
Comparing the Tolerability of a Novel Wound Closure Device Using a Porcine Wound Model
Advances in Wound Care, 2018
Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42. Wound strength was examined mechanically at days 10 and 42 on ex vivo wounds from euthanized pigs. Results: Histopathology in the suture entry/exit planes showed greater dermal inflammation with a simple interrupted nylon suture retained for 42 days compared with the SBD retained for 42 days (p < 0.03). While tensile wound strength in the device and suture groups were similar at day 10, wounds closed with the devices were nearly 8 times stronger at day 42 compared with day 10 (p < 0.001). Innovation: A novel SBD optimized for cutaneous wound closure that protects the skin surface from suture strands, forms a protective bridge over the healing wound edges, and knotlessly clamps sutures. Conclusion: This study suggests that the use of a SBD increases the tolerability of nylon sutures in porcine acute skin wound closures allowing for prolonged mechanical support of the wound. For slow healing wounds, this may prevent skin wound disruption, such as edge necrosis and dehiscence.
Assessment of knot security in continuous intradermal wound closures
Journal of Surgical Research, 2005
Background. The traditionally used square knot used for commencement and termination of continuous wound closures is bulky, requiring a minimum of four to six throws to form a secure knot with most suture materials and sizes. This study evaluates the security of self-locking knots, which are significantly smaller in volume than the traditionally applied square knot, for the intradermal closure of standardized wounds in porcine skin.
Aesthetic Surgery Journal, 2014
An estimated 50 million surgical procedures are performed each year in the United States. 1 Many of these procedures require closing a surgical incision that involves multiple layers of tissue, including muscle, fascia, and skin. The ideal closure for those incisions should be fast and easy to perform while providing optimal wound apposition with sufficient but not excessive tension, as well as a satisfactory cosmetic result. 2 Surgical sutures constitute the most common method of wound closure and continue to be the method of choice for most procedures. However, outcomes with sutures can vary depending on material composition and knot selection. 3,4 Complications associated with traditional sutures are often related to knots, including knot breakage and slippage, suture extrusion or splitting, and infection. 2 In addition, tightly approximated wounds and overly taut sutures can lead to ischemia at the wound edge, 519264A ESXXX10.1177/1090820X13519264Aesthetic Surgery JournalRubin et al research-article2014
Canadian journal of veterinary research = Revue canadienne de recherche vétérinaire, 2016
The influence of the type of material used, knot configuration, and use of an additional throw on the tensile force at failure, the elongation, and the mode of failure of different configurations of linear sutures and knotted suture loops was evaluated in this in-vitro mechanical study. We hypothesized that all types of knots would significantly influence the initial force and elongation of suture materials and would influence the force and elongation at which the knotted loops break, but not their mode of failure. A total of 432 samples of 4 types of size 3-0 suture material (polydioxanone, polyglecaprone 25, polyglactin 910, and nylon), representing 9 configurations, were tested in a tensiometer. The configurations were 1 linear suture without a knot and the following loops: square (SQ) knot; surgeon's (SU) knot; granny (GR) knot; and sliding half-hitch (SHH) knot using either 4 and 5 or 3 and 4 throws, depending on the material. For polydioxanone, SQ and SU knots did not decr...
Relative Strength of a New Suture Technique for Fascial Closure
Journal of Gynecologic Surgery, 1990
In an attempt to decrease the risk of fascial dehiscence, a new suture technique for fascial closure is proposed, referred to as the "secured" stitch. The secured interrupted stitch is performed by taking a double bite of fascia at each traditional site of fascial puncture. Relative strength of the secured interrupted stitch in comparison with the simple interrupted stitch is determined in samples of fresh bovine fascia. A significantly greater force is required to disrupt fascia repaired with the secured stitch compared with a simple interrupted repair. The secured stitch may afford a greater degree of protection from fascial dehiscence.
Introduction to the Barbed Sutures Supplement: The Expanding Applications of Barbed Sutures
Aesthetic Surgery Journal, 2013
In 1881, Alexander Graham Bell invented what arguably could be called the first metal detector. President James Garfield had been shot. His doctors needed to locate the bullet that was lodged in his chest, but the president already had lost a significant amount of blood. Doctors therefore were reluctant to perform manual exploration. Bell's invention seemed the best hope. What no one realized at the time was that the metal springs in the mattress upon which the president lay would render Bell's metal detector ineffective. Garfield ultimately died from his wounds. The metal detector endured. Through the work of later inventors, it evolved into a device serving a variety of important functions, most notably helping to ensure our safety in public places. 1 Many useful inventions originally intended for one purpose end up better serving another. In plastic surgery, such has been the evolution of barbed sutures. In the 1990s, lifting of the brows, midface, and neck using barbed sutures, usually applied subcutaneously with a threading technique, was widely promoted as a safer, quicker, and less invasive alternative to traditional surgical procedures. However, for many surgeons and their patients, both the short-and longer-term results were disappointing. Complications and other adverse events were common. Some problems were undoubtedly technique related, as practitioners with various backgrounds and little hands-on training with barbed sutures aggressively promoted themselves as experts and performed procedures without the requisite experience. Nevertheless, interest in these threading techniques for suspension of facial tissues waned considerably in the plastic surgery community. Subsequently, however, expanded applications for barbed suture technology have evolved. Sutures are essential in almost every procedure that we perform. The choice of suture depends on several variables, including the anatomic site, desired suture characteristics, and surgeon preference. In my practice, barbed sutures have come to play an important role in a growing number of procedures performed on a routine basis. Currently, I use them in conjunction with lateral browlifts, short-scar facelifts, breast lifts, breast reductions, and abdominoplasties. The following few paragraphs offer a brief summary of my current utilization of barbed sutures.