Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis
Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2019-05-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00962 |
| _version_ | 1798005779893059584 |
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| author | Özlem Çolak Yüksel Kankaya Nezih Sungur Kadri Özer Koray Gürsoy Kemal Şerbetçi Uğur Koçer |
| author_facet | Özlem Çolak Yüksel Kankaya Nezih Sungur Kadri Özer Koray Gürsoy Kemal Şerbetçi Uğur Koçer |
| author_sort | Özlem Çolak |
| collection | DOAJ |
| description | Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model.
Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded.
Results The maximum tensile strength until failure was 44.6±4.3 N in group 1, 35.7±5.2 N in group 2, and 56.7±17.3 N in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05).
Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options. |
| first_indexed | 2024-04-11T12:45:25Z |
| format | Article |
| id | doaj.art-b7a4e47a8aaf4612b78ce96feeaf13d8 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-11T12:45:25Z |
| publishDate | 2019-05-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-b7a4e47a8aaf4612b78ce96feeaf13d82022-12-22T04:23:23ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712019-05-01460322823410.5999/aps.2018.009623614Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysisÖzlem Çolak0Yüksel Kankaya1Nezih Sungur2Kadri Özer3Koray Gürsoy4Kemal Şerbetçi5Uğur Koçer6Department of Plastic, Reconstructive and Aesthetic Surgery, Okmeydani Training and Research Hospital, İstanbul, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Aydın State Hospital, Aydın, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara, TurkeyDepartment of Biomedical Engineering, İzmir Democracy University, İzmir, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara, TurkeyBackground The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was 44.6±4.3 N in group 1, 35.7±5.2 N in group 2, and 56.7±17.3 N in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00962suture techniquesinstrumentationtendon injuriessurgery |
| spellingShingle | Özlem Çolak Yüksel Kankaya Nezih Sungur Kadri Özer Koray Gürsoy Kemal Şerbetçi Uğur Koçer Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis Archives of Plastic Surgery suture techniques instrumentation tendon injuries surgery |
| title | Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis |
| title_full | Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis |
| title_fullStr | Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis |
| title_full_unstemmed | Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis |
| title_short | Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis |
| title_sort | barbed sutures versus conventional tenorrhaphy in flexor tendon repair an ex vivo biomechanical analysis |
| topic | suture techniques instrumentation tendon injuries surgery |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00962 |
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