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At least 109 records · Page 6Linked to original sources
PubMed2003

The effect of two nonresorbable suture types on the mechanical performance over a metal suture anchor eyelet.

An understanding of the mechanical properties of different suture materials is valuable when selecting the most appropriate suture and repair technique. Sutures should be strong, easy to handle and have high knot security. The introduction of suture anchors adds an additional variable regarding the effect of stress risers over the eyelet. Improving the mechanical properties of a suture may be a possible method to help avoid failure over stress risers such as the eyelet of suture anchor. This study examined the static and viscoelastic properties of a new polyethylene based non-resorbable suture (Fibrewire) over the eyelet of a standard anchor compared to braid polyester non-resorbable suture (Ethibond). Fibrewire had superior ultimate load properties compared to Ethibond (360.2 N+/-23.8 vs 191.9 N+/-17.3) as well as greater stiffness (61.3 N/mm+/-9.7 vs 8.1 N/mm+/-0.4) when tested in uniaxial tension through a metal anchor eyelet (Mitek) ( p<0.001). Fibrewire demonstrated greater stress relaxation than Ethibond ( p<0.05). Differences in the static and viscoelastic properties of suture may have implications in the post-operative period or during rehabilitation.

Equipment Failure Analysis↗
PubMed1980

[Experimental studies on the usefulness of Dexon (polyglycolic acid) and our own modified suture method for suturing after tendon severing].

The author had observed in experimental investigations the healing process that achillo-tenotomy in rabbits and a following suture with catgut or silk or DEXON. The suture after tenotomy was carried out with a circular suture of an own modification. Microscopic and macroscopic investigations showed a distinct bigger reaction of the connective tissue and more adhesions around the tenorrhaphy after catgut suture than after silk or DEXON suture. The mechanic investigations showed a clearly smaller tensile strength after a catgut suture than after silk or DEXON suture. Since DEXON sutures will completely resorb they are superior to the non-absorbable sutures.

Achilles Tendon↗
PubMed1995

Comparison of laser vascular welding, interrupted sutures, and continuous sutures in growing vascular anastomoses.

BACKGROUND AND OBJECTIVES: The argon laser-assisted vascular anastomosis may solve the problems of conventional sutured anastomosis, such as vascular stenosis and arrest of growth owing to a foreign-body reaction to suture material. STUDY DESIGN/MATERIALS AND METHODS: Twelve argon laser-assisted vascular anastomoses, seven conventional anastomoses with interrupted sutures, and five conventional anastomoses with continuous sutures were performed in 12 young mongrel dogs. RESULTS: Five months later, the external diameter at the anastomosis had increased 70.5% in the laser group, 67.0% in the interrupted suture group, and 22.9% in the continuous suture group. Histological examination of the laser-assisted anastomoses showed almost complete healing, with no granulomatous response around the anastomotic site. In the interrupted suture group, marked scaring and foreign body reactions were observed on the vessel wall at the site of the anastomosis. The continuous suture group showed more remarkable disorientation of the vascular layer and intimal hyperplasia than the interrupted suture group. CONCLUSION: Vascular anastomosis using the argon laser offers advantages over the conventional procedure in growing vessels.

Anastomosis, Surgical↗
PubMed1987

[Manual suture versus/or mechanical suture (from the Italian viewpoint)].

Mechanical suturing has become widespread in Italy in recent years, especially for anastomoses between the large intestines and the rectum and between the esophagus and the stomach or small intestine; many chest surgeons also use this type of suture. Basically, mechanical suturing is preferred for anastomoses for which the manual technique has proved difficult, for example those low in the pelvis or high up in the chest. Few surgeons use mechanical suturing at sites where it is easy to suture by hand. Overall, experience with mechanical suturing has been positive, mainly because the number of conservative resections performed for rectal carcinoma has increased while the frequency of the so-called Miles operation has declined in recent years. Our own experience with mechanical suturing has been collected in the construction of colorectal (235 with mechanical suturing out of a total of 592), ileorectal and ileoanal anastomoses (45 ileorectal and 12 ileoanal anastomoses with mechanical suturing out of a total of 155 surgical operations).

Gastrointestinal Diseases↗
PubMed2005

Capillary activity of surgical sutures and suture-dependent bacterial transport: a qualitative study.

OBJECTIVE: To evaluate the multitude of new synthetic absorbable sutures (both monofilament and multifilament) in comparison with older materials with regard to capillarity and bacterial transport. METHODS: Sutures of United States Pharmacopoeia (USP) 4-0 thickness were arranged in a three-chamber system under sterile conditions. Either a colorant (liquid transport evaluation) or bacteria (bacterial transport evaluation) were added to the contamination chamber, and movement of colorant or bacteria was evaluated for as long as 30 days. RESULTS: None of the monofilament sutures transported colorant or bacteria. Colorant transport was found on the pseudomonofilament and multifilament sutures between the first and the fifth day. Escherichia coli were transported on the majority of the multifilament sutures, although no transport was found on silk or polyester sutures. Bacterial transport was most often evident in tests using the motile Proteus mirabilis. CONCLUSIONS: All multifilament and pseudomonofilament suture designs allowed transport of colorants and bacteria to some degree. The movement of fluids and bacteria did not depend on the absorptive capacity of the sutures, coating, or the presence of an open suture end.

Capillary Action↗
PubMed1986

Enzymatic wound cleaning and absorbable sutures. An experimental study on Varidase and Dexon sutures.

The effect of an enzymatic preparation for wound cleaning (Varidase) on the mechanical properties of absorbable sutures (Dexon) was studied in vitro and in vivo in a rat model. In vitro the sutures demonstrated a significant decrease in strength (breaking strength and energy absorption) and extensibility after 12 days of incubation in saline. Incubation in Varidase, however, further decreased the mechanical properties significantly. The stiffness of the sutures was independent of treatment and time. In vivo changes of mechanical properties of the sutures resemble those of the in vitro study, except for a decrease in stiffness of the sutures. The sutures in a primary closed wound had the same strength (energy absorption) as the sutures of an open wound treated by saline, while the sutures of an open wound treated by Varidase tended to have a decreased strength (p = 0.08). This study supports the hypothesis that an enzymatic process may be involved in the degradation of Dexon. The continuous use of Varidase in Dexon-sutured wounds for a period longer than a few days is, therefore, questioned.

Animals↗
PubMed2005

Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques.

BACKGROUND: Interface contact pressure between the tendon and bone has been shown to influence healing. This study evaluates the interface pressure of the rotator cuff tendon to the greater tuberosity for different rotator cuff repair techniques. HYPOTHESIS: The transosseous tunnel rotator cuff repair technique provides larger pressure distributions over a defined insertion footprint than do suture anchor techniques. STUDY DESIGN: Controlled laboratory study. METHODS: Simulated rotator cuff tears over a 1 x 2-cm infraspinatus insertion footprint were created in 25 bovine shoulders. A transosseous tunnel simple suture technique (n = 8), suture anchor simple technique (n = 9), and suture anchor mattress technique (n = 8) were used for repair. Pressurized contact areas and mean pressures of the repaired tendon against the tuberosity were determined using pressure-sensitive film placed between the tendon and the tuberosity. RESULTS: The mean contact area between the tendon and tuberosity insertion footprint was significantly greater for the transosseous technique (67.7 +/- 5.8 mm(2)) compared with the suture anchor simple (34.1 +/- 9.4 mm(2)) and suture anchor mattress (26.0 +/- 5.3 mm(2)) techniques (P < .05). The mean interface pressure exerted over the footprint by the tendon was also greater for the transosseous technique (0.32 +/- 0.05 MPa) compared with the suture anchor simple (0.26 +/- 0.04 MPa) and suture anchor mattress (0.24 +/- 0.02 MPa) techniques (P < .05). CONCLUSION: The transosseous tunnel rotator cuff repair technique creates significantly more contact and greater overall pressure distribution over a defined footprint when compared with suture anchor techniques. CLINICAL RELEVANCE: Stronger and faster rotator cuff healing may be expected when beneficial pressure distributions exist between the repaired rotator cuff and its insertion footprint. Tendon-to-tuberosity pressure and contact characteristics should be considered in the development of improved open and arthroscopic rotator cuff repair techniques.

Animals↗
PubMed2005

Tendon-bone interface motion in transosseous suture and suture anchor rotator cuff repair techniques.

BACKGROUND: Although many studies involving rotator cuff repair fixation have focused on ultimate fixation strength and ability to restore the tendon's native footprint, no studies have characterized the stability of the repair with regard to motion between the tendon and repair site footprint. HYPOTHESIS: Suture anchor fixation for rotator cuff repair has greater interface motion between tendon and bone than does transosseous suture fixation. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve fresh-frozen human cadaveric shoulders were tested in a custom device to position the shoulder in internal and external rotations with simulated supraspinatus muscle loading. Tendon motion relative to the insertional footprint on the greater tuberosity was determined optically using a digital camera rigidly connected to the humerus, with the humerus positioned at 60 degrees of internal rotation and 60 degrees of external rotation. Testing was performed for the intact tendon, a complete supraspinatus tear, a suture anchor repair, and a transosseous tunnel repair. RESULTS: Difference in tendon-bone interface motion when compared with the intact tendon was 7.14 +/- 3.72 mm for the torn rotator cuff condition, 2.35 +/- 1.26 mm for the suture anchor repair, and 0.02 +/- 1.18 mm for the transosseous suture repair. The transosseous suture repair demonstrated significantly less motion when compared with the torn rotator cuff and suture anchor repair conditions (P < .05). CONCLUSION: Transosseous suture repair compared with suture anchor repair demonstrated superior tendon fixation with reduced motion at the tendon-to-tuberosity interface. CLINICAL RELEVANCE: Development of new fixation techniques for arthroscopic and open rotator cuff repairs should attempt to minimize interface motion of the tendon relative to the tuberosity.

Arthroscopy↗
PubMed2004

Nanomechanical properties of facial sutures and sutural mineralization front.

The mechanical properties of craniofacial sutures have rarely been investigated. Three facial sutures-the pre-maxillomaxillary (PMS), the nasofrontal (NFS), and the zygomaticotemporal (ZTS)-and their corresponding sutural mineralization fronts in 8 young New Zealand White rabbits were subjected to nano-indentation with atomic force microscopy as a test of the hypothesis that they have different mechanical properties. The average elastic modulus of the PMS was 1.46 +/- 0.24 MPa (mean +/- SD), significantly higher than both the ZTS (1.20 +/- 0.20) and NFS (1.16 +/- 0.18). The average elastic moduli of sutural mineralization fronts 30 micro m away were significantly higher than their corresponding sutures and had the same distribution pattern: the PMS (2.07 +/- 0.24 MPa) significantly higher than both the ZTS (1.56 +/- 0.29) and NFS (1.71 +/- 0.22). Analysis of these data suggests that facial sutures and their immediately adjacent sutural mineralization fronts have different capacities for mechanical deformation. The elastic properties of sutures and sutural mineralization fronts are potentially useful for improving our understanding of their roles in development.

Analysis of Variance↗
PubMed1991

Postkeratoplasty astigmatism control. Single continuous suture adjustment versus selective interrupted suture removal.

Two different suturing techniques performed during keratoplasty were retrospectively evaluated to compare postkeratoplasty astigmatism, number of suture manipulations, and time to optical stability. One group of patients (n = 31) received a combination of continuous 11.0 nylon suture and 12 or 16 interrupted 10.0 nylon sutures (CCIS), which were selectively removed post-operatively to reduce astigmatism. The second group of patients (n = 26) received a single continuous 10.0 nylon suture (SCS) that was adjusted postoperatively at the slit lamp to regulate corneal astigmatism. Compared with the CCIS technique, adjusting the single continuous suture resulted in less postoperative astigmatism (SCS, 1.5 +/- 1.1 diopters [D]; CCIS, 3.2 +/- 1.9 D), fewer suture manipulations per patient (SCS, 0.9 +/- 0.7; CCIS, 3.8 +/- 1.8), and earlier optical stability for visual rehabilitation (SCS, 2.6 +/- 1.5 months; CCIS, 9.6 +/- 4.7 months) (P less than 0.01). No continuous sutures were broken during adjustment. The adjustable single continuous suture may offer an improved method for early control of postkeratoplasty astigmatism.

Astigmatism↗
PubMed1998

Multiple suture synostosis and increased intracranial pressure following repair of single suture, nonsyndromal craniosynostosis.

OBJECTIVE: Increased intracranial pressure, frequently associated with closure of multiple cranial sutures, has been reported to occur in 36% of cases following correction of syndromal craniosynostosis. Although much less common, multiple suture closure may occur following repair of single suture, nonsyndromal craniosynostosis and we present cases that concern two such children. RESULTS: Two children with nonsyndromal craniosynostosis, one metopic and one left-coronal, underwent fronto-orbital advancement at age 3 months. At age 19 months and at age 5 years, respectively, both patients re-presented with headaches, decrease in head circumference percentile, and acceptable cosmetic outcome. Both had computerized tomographic evidence of multiple closed cranial sutures and increased intracranial pressure (ICP) (determined by monitoring). Both patients improved following a cranial expansion procedure. CONCLUSION: Delayed closure of multiple sutures and resultant increased ICP may occur following correction of nonsyndromal, single suture craniosynostosis. This may be more likely when the initial suture is contiguous with the facial sutures. Children should be followed for many years following craniosynostosis repair with cranial, neurologic, and possibly funduscopic examinations as well as head circumference measurements to detect delayed closure of cranial sutures.

Age Factors↗
PubMed2006

Biomechanical comparison of double-loaded suture anchors using arthroscopic Mason-Allen stitches versus traditional transosseous suture technique and modified Mason-Allen stitches for rotator cuff repair.

BACKGROUND: In recent studies objective evaluations have demonstrated that arthroscopic rotator cuff repairs can have higher failure rates than open repairs. Thus, there is a need for a stronger tissue-holding stitch for arthroscopical repair. The purpose of this study was to compare the biomechanical properties of traditional open transosseous suture technique and modified Mason-Allen stitches versus double-loaded suture anchors and arthroscopic Mason-Allen stitches in rotator cuff repair. METHODS: In 20 sheep shoulders the infraspinatus tendons were dissected from their insertion and were randomized to 2 repair groups: (1) repair with transosseous suture and modified Mason-Allen stitches, (2) repair with double loaded bioabsorbable suture anchors and arthroscopic Mason-Allen stitches: Both groups were coupled with braided, nonabsorbable polyester (Ethibond) suture sized USP No. 2. All repairs were cyclically loaded from 10 to 180N with the use of a materials testing machine. The number of cycles to gap formation of 5 and 10mm at the repair site and the mode of failure were recorded. RESULTS: The number of cycles to 5-mm gap was mean 634 (SD 106) for group 1 and mean 750 (SD 107) for group 2 (P<0.026). The corresponding values to 10-mm gap were mean 1573 (SD 161) for group 1, and mean 1789 (SD 183 cycles) for group 2 (P<0.012). In group 2 the mode of failure occurred by tissue pull-out, whereas in group 1 the failure occurred by a mixture of suture breakage and pull-out. CONCLUSIONS: This time-zero study demonstrates that the combination of bioabsorbable suture anchors and arthroscopic Mason-Allen stitches provides strength superior to that of the modified Mason-Allen transosseous suture technique under isometric cyclic loading conditions. However, additional evaluation is needed to examine the effects on the sustained strength of the repair throughout the healing process.

Absorbable Implants↗
PubMed2001

Arthroscopic suture tying: A comparison of knot types and suture materials.

PURPOSE: The purpose of this study was to determine the structural properties of 3 arthroscopically tied knots using 2 different suture materials: the French knot, the Duncan loop knot, and the original Revo knot. TYPE OF STUDY: Cohort analytic study. METHODS: The sutures used were No. 1 PDS II, an absorbent monofilament, and No. 1 Ethibond (Ethicon, Somerville, NJ), a braided nonabsorbent material. The resulting 6 suture-knot combinations were individually tested to failure in both open- and closed-loop configurations. RESULTS: The French knot showed the greatest strength compared with the Duncan loop and the Revo knot with both No. 1 Ethibond and No. 1 PDS II sutures (P <.05). The No. 1 Ethibond exhibited higher initial stiffness than the No. 1 PDS II for all 3 knot types (P <.05). Results were similar for both open and closed-loop configurations. Also, the French knot failed predominantly by suture breakage instead of knot slippage for both suture materials. CONCLUSIONS: The results of this study suggest that, among the suture and knot combinations investigated in this study, the arthroscopic repair of musculoskeletal injuries should be performed using the French knot and No. 1 Ethibond suture.

Arthroscopy↗
PubMedDate not supplied

Growth of tracheal sutures with absorbable sutures in primates.

Postoperative wound healing is studied after tracheal suturing in 5 primates operated on in two stages. First by double level hemisection comparing continuous and interrupted sutures with polydioxanone. In a second stage: comparison of continuous sutures after tracheal segmental resection. The tracheas were harvested sequentially to study the evolution of the sutured zone by measuring its diameter and by histopathologic examination. The reduction of the tracheal diameter observed was not statistically significant after hemisection using continuous (p = 0.7) or interrupted sutures (p = 0.6). But after tracheal resection the stenosis was significant with continuous sutures (p < 0.05). Histologic study revealed that polydioxanone is well tolerated and is absorbed within 26 weeks. The authors recommend the use of continuous sutures to repair simple wounds and of interrupted sutures after tracheal resection anastomosis.

Animals↗