在张力下，单丝和多丝缝线的扭转会降低缝线强度，并增加缝线断裂的风险。

Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture.

机构信息

Department of General and Colorectal Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.

出版信息

J Mech Behav Biomed Mater. 2012 Aug;12:168-73. doi: 10.1016/j.jmbbm.2012.02.001. Epub 2012 Feb 23.

DOI:10.1016/j.jmbbm.2012.02.001

PMID:22762905

Abstract

BACKGROUND

A continuous running suture is the preferential method for abdominal closure. In this technique the suture is secured with an initial knot and successive tissue bites are taken. At each tissue bite, the needle is rotated through the tissue; in doing so, the suture can twist around the knot which acts as an anchor.

OBJECTIVE

To determine the effect of axial torsional forces on sutures used in abdominal closure.

METHODS

The effect of axial twisting on polydioxanone (PDS*II), polyglactin (Vicryl), polypropylene (Prolene) and nylon (Ethilon) sutures was investigated using a uniaxial testing device.

RESULTS

The maximum tensile force withstood for untwisted sutures was determined: polydioxanone failed at a tensile force of 116.4±0.84 N, polyglactin failed at 113.9±2.4 N, polypropylene failed at 71.1±1.5 N and nylon failed at 61.8±0.5 N. Twisting decreased the maximum tensile force of all sutures; one complete twist per 10 mm (i.e., 15 twists) decreased the tensile strength of polydioxanone by 21%, polyglactin by 23%, polypropylene by 16% and nylon by 13%, p<0.001. Excessive twisting caused a nonlinear decrease in suture strength, with one twist per 75 mm (i.e., 20 twists) of polydioxanone decreasing strength by 39%, P<0.001.

CONCLUSION

The effect of excessive twisting on the mechanical properties of sutures is a previously unrecognised phenomenon. Surgeons should be aware that this can result in a decrease in suture strength and reduce the elasticity of the material, and therefore need to adapt their practice to reduce the torsional force placed on sutures.

摘要

背景

连续缝合是腹部缝合的首选方法。在这种技术中，缝线用初始结固定，然后连续缝合组织。在每次缝合组织时，针穿过组织旋转；这样，缝线可以围绕作为锚的结扭曲。

目的

确定腹部缝合中使用的缝线承受轴向扭转力的效果。

方法

使用单轴测试装置研究了聚二氧杂环己酮（PDS*II）、聚甘醇酸（Vicryl）、聚丙烯（Prolene）和尼龙（Ethilon）缝线的轴向扭转对缝线的影响。

结果

确定了未扭曲缝线承受的最大拉伸力：聚二氧杂环己酮在 116.4±0.84 N 的拉伸力下失效，聚甘醇酸在 113.9±2.4 N 的拉伸力下失效，聚丙烯在 71.1±1.5 N 的拉伸力下失效，尼龙在 61.8±0.5 N 的拉伸力下失效。扭转降低了所有缝线的最大拉伸力；每 10 毫米（即 15 个扭结）扭转一次，聚二氧杂环己酮的拉伸强度降低 21%，聚甘醇酸降低 23%，聚丙烯降低 16%，尼龙降低 13%，p<0.001。过度扭转会导致缝线强度呈非线性下降，每 75 毫米（即 20 个扭结）扭转一次，聚二氧杂环己酮的强度降低 39%，p<0.001。