Biomechanical Analysis of Resorbable Barbed Suture Tenorrhaphy

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the tensile strength and repair-site profile of a technique of resorbable barbed suture tenorrhaphy.
Methods: Forty-eight flexor digitorum profundus tendons were collected from the 8 adult cadavers. In the test group, the tendons were sutured using absorbent 2-0 barb knotless sutures in a 2-strand or 4-strand zig-zag pattern. In the control group, 2-0 Prolene and 3-0 polydioxanone (PDS) were used to suture the tendons using the 2-stand Modified Kessler method and the 4-strand cruciate suture method. Using a tensile force measurement machine, the breaking load (N) and the stiffness (N/mm) were measured. The types of rupture were categorized into suture breaking, knot rupture, and pullout.
Results: In the comparative analysis between the absorbent 2-0 Quill (Angiotech Pharmaceuticals, Canada) suture that used the 2-strand core suture and the 3-0 PDS and 2-0 Prolene sutures, the average breaking load for the 2-0 Quill suture was 26.83±7.47 N, and 21.96±6.78 N and 17.20±4.93 N for the 2-0 Prolene and 3-0 PDS sutures. In the comparison using the 4-strand core suture, the average breaking load for the 2-0 Quill suture was 62.50±13.34 N, and 22.35±5.72 N and 18.67±4.27 N for the 2-0 prolene and 3-0 PDS sutures. The most common type of rupture were knot rupture.
Conclusion: For flexor tendon sutures using the absorbent barb sutures, compared to the conventional 2-0 Prolene or 3-0 PDS sutures, absorbent barbed sutures have a higher tensile strength.

참고문헌 (Reference)

• 1 Momose T, "The effect of knot location, suture material, and suture size on the gliding resistance of flexor tendons" 53 : 806-811, 2000
• 2 Ketchum LD, "Suture materials and suture techniques used in tendon repair" 1 : 43-53, 1985
• 3 Amadio P, "IFSSH flexor tendon committee report" 30 : 100-116, 2005
• 4 Bunnell S, "Gig pull-out suture for tendons" 36 : 850-851, 1954
• 5 Silfverskiold KL, "Flexor tendon repair in zone II with a new suture technique and an early mobilization program combining passive and active flexion" 19 : 53-60, 1994
• 6 Sirotakova M, "Early active mobilization of primary repairs of the flexor pollicis longus tendon with two Kessler two-strand core sutures and a strengthened circumferential suture" 29 : 531-535, 2004
• 7 Strickland JW, "Development of flexor tendon surgery : twenty-five years of progress" 25 : 214-235, 2000
• 8 Aoki M, "Biomechanical and histologic characteristics of canine flexor tendon repair using early postoperative mobilization" 22 : 107-114, 1997
• 9 Clemente A, "Barbed suture vs conventional tenorrhaphy : biomechanical analysis in an animal model" 16 : 251-257, 2015
• 10 Parikh PM, "Barbed suture tenorrhaphy : an ex vivo biomechanical analysis" 124 : 1551-1558, 2009
• 11 McKenzie AR, "An experimental multiple barbed suture for the long flexor tendons of the palm and fingers : preliminary report" 49 : 440-447, 1967
• 12 Trail IA, "An evaluation of suture materials used in tendon surgery" 14 : 422-427, 1989
• 13 Jennings ER, "A new technique in primary tendon repair" 95 : 597-600, 1952
• 14 Bainbridge LC, "A comparison of post-operative mobilization of flexor tendon repairs with"passive flexion-active extension"and"controlled active motion"techniques" 19 : 517-521, 1994