Montel Joshua S, Duffy Daniel J, Weng Hsin-Yi, Freeman Lynetta J
Department of Veterinary Clinical Sciences and Comparative Pathobiology, Purdue University Veterinary Teaching Hospital, West Lafayette, Indiana.
Vet Surg. 2017 May;46(4):580-586. doi: 10.1111/vsu.12644.
To determine which of 2 suture materials would be superior in terms of closure time and leakage pressure in open single-layer cystotomy closure.
Experimental study.
Twenty-four freshly harvested porcine urinary bladders.
A cystotomy was performed and the incision closed with a single layer simple continuous suture pattern with barbed (n = 12) or smooth (n = 12) suture. Time required for closure was measured. Each bladder was connected to a system for monitoring intraluminal pressure while inflated with saline until leakage occurred. Intraluminal pressure at time of initial leakage and leakage site were recorded. Two-sample t tests were used to compare maximum leakage pressure and closure time between the 2 groups. P < .05 was considered significant.
All bladders were sutured successfully with no difference in mean closure time (barbed suture 296 ± 46 seconds; smooth suture 293 ± 26 seconds) (P = .821). There was no difference in mean leakage pressure of porcine urinary bladder incisions closed in a single layer with barbed suture (28.8 ± 10.4 mm Hg) compared with smooth suture (30.6 ± 8.8 mm Hg) (P = .642).
Barbed suture provides comparable cystotomy repair to smooth suture, and no benefit to its use was identified in an open procedure. Barbed suture closure should be evaluated for adequate tensile strength in the presence of urine, satisfactory in vivo healing of cystotomies, and lack of long-term urolith formation in dogs and cats.
确定在开放性单层膀胱切开术缝合中,两种缝合材料在缝合时间和漏尿压力方面哪种更具优势。
实验研究。
24个刚摘取的猪膀胱。
进行膀胱切开术,切口用带倒刺缝线(n = 12)或光滑缝线(n = 12)以单层单纯连续缝合法缝合。测量缝合所需时间。每个膀胱连接到一个监测腔内压力的系统,同时用盐水充盈直至漏尿发生。记录初次漏尿时的腔内压力和漏尿部位。采用两样本t检验比较两组之间的最大漏尿压力和缝合时间。P < 0.05被认为具有统计学意义。
所有膀胱均成功缝合,平均缝合时间无差异(带倒刺缝线296 ± 46秒;光滑缝线293 ± 26秒)(P = 0.821)。单层使用带倒刺缝线缝合的猪膀胱切口平均漏尿压力(28.8 ± 10.4 mmHg)与光滑缝线(30.6 ± 8.8 mmHg)相比无差异(P = 0.642)。
带倒刺缝线与光滑缝线在膀胱切开术修复方面效果相当,在开放性手术中未发现使用带倒刺缝线的益处。应评估带倒刺缝线在尿液存在时的足够抗张强度、膀胱切开术在体内的满意愈合情况以及犬猫长期尿路结石形成情况。