J Korean Soc Surg Hand.  2016 Dec;21(4):198-204. 10.12790/jkssh.2016.21.4.198.

Biomechanical Analysis of Resorbable Barbed Suture Tenorrhaphy

• Lee SH
• Kim SH
• Oh HY
• Park ES
• Shin HS
• Jung SG

• KMID: 2364210
• DOI: http://doi.org/10.12790/jkssh.2016.21.4.198

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.

Keyword

Barbed suture; Tenorrhaphy; Tensile strength

MeSH Terms

Adult
Cadaver
Humans
Methods
Polydioxanone
Polypropylenes
Rupture
Sutures*
Tendons
Tensile Strength
Polydioxanone
Polypropylenes

Figure

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  Fig. 1. Test machine for the (A) wire strength test and (B) suture strength test.

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  Fig. 2. Graph of break load and extension. PDS, polydioxanone.

• 

  Fig. 3. (A) 2-strand and (B) 4-strand barbed suture technique.

• 

  Fig. 4. Analysis of results. The panel shows (A) suture break, (B) knot rupture, and (C) pullout, respectively.

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  Fig. 5. Load of failure in 2-strand tenorrhaphy. NS, not significant; PDS, polydioxanone. A p<0.05 was considered significant.

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  Fig. 6. Load of failure in 4-strand tenorrhaphy. S, not significant; PDS, polydioxanone. A p<0.05 was considered significant.

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