Reina Rodriguez Fernando S, Buckley Conor T, Milgram Joshua, Kirby Barbara M
University College Dublin School of Veterinary Medicine, Dublin, Ireland.
Trinity College Dublin Centre for Bioengineering, Dublin, Ireland.
Vet Surg. 2018 Feb;47(2):193-203. doi: 10.1111/vsu.12751. Epub 2017 Nov 18.
To compare biomechanical properties and mechanism of failure of 3 regions of ventral abdominal wall in cats by using 2 suture materials, 2 suture bite-to-stitch intervals (SBSI), and full-thickness versus fascia-only closure.
Randomized, cadaveric, ex vivo mechanical testing.
16 adult cat cadavers, 3 samples per cat.
Three regions of ventral abdominal wall were mechanically tested (N = 48 samples). Preumbilical, umbilical (U), and postumbilical (POU) regions were harvested by using a template. The thickness of the linea alba was recorded. Six samples without celiotomy served as controls. Twenty-eight samples were randomized to SBSI (2 × 2 or 5 × 5 mm) and suture material (3-0 polyglactin 910 or 3-0 polydioxanone) for simple continuous celiotomy closure. Fourteen samples were randomized to full-thickness or fascia-only closure. Samples were tested by linear distraction; tensile strength and mechanism of failure were recorded. Effects of body weight, thickness of linea alba, anatomic region, SBSI, type of closure, and suture material were evaluated by mixed model linear analysis. Load to failure was compared between males and females, full-thickness and fascia-only closure by independent t test, with P < .05 considered statistically significant.
The POU region achieved lower loads to failure. Load to failure was greater in males compared with females. No difference was detected between full-thickness and fascia-only closure. Failure most commonly occurred by tearing of suture through tissues. Tissue failure with suture line loosening occurred mainly in the 5 × 5-mm SBSI group.
The POU region is biomechanically weak and may therefore be predisposed to incisional herniation.
通过使用2种缝合材料、2种缝线间距(SBSI)以及全层缝合与仅缝合筋膜,比较猫腹前壁3个区域的生物力学特性及失效机制。
随机、尸体、体外力学测试。
16只成年猫尸体,每只猫3个样本。
对腹前壁的3个区域进行力学测试(N = 48个样本)。使用模板获取脐前、脐部(U)和脐后(POU)区域。记录白线厚度。6个未行剖腹术的样本作为对照。28个样本随机分为SBSI(2×2或5×5 mm)和缝合材料(3-0聚乙醇酸910或3-0聚二氧六环酮)进行单纯连续剖腹术缝合。14个样本随机分为全层缝合或仅缝合筋膜。通过线性牵张对样本进行测试;记录拉伸强度和失效机制。通过混合模型线性分析评估体重、白线厚度、解剖区域、SBSI、缝合类型和缝合材料的影响。通过独立t检验比较雄性和雌性、全层缝合和仅缝合筋膜的失效负荷,P < 0.05认为具有统计学意义。
POU区域的失效负荷较低。雄性的失效负荷高于雌性。全层缝合和仅缝合筋膜之间未检测到差异。失效最常见的原因是缝线在组织中撕裂。缝线松动导致组织失效主要发生在5×5-mm SBSI组。
POU区域生物力学较弱,因此可能易发生切口疝。