Hochtaunuskliniken Bad Homburg, Department of General and Visceral Surgery, Zeppelinstrasse 20, D-61352 Bad Homburg, Germany.
Fachhochschule Bielefeld, Campus Minden, Fachbereich Technik, Artilleriestrasse 9, D-32427 Minden, Germany.
Sensors (Basel). 2018 May 28;18(6):1729. doi: 10.3390/s18061729.
Failure of laparotomy closure develops after up to 20% of abdominal operations. Suture tension has an influence on the quality of tissue regeneration. No sensors are available to register suture tension dynamics in vivo.
In a series of animal experiments, the effect of suture tension on the ultrastructure of the healing incision was examined. Surgeons' ability to suture with target tension was tested. An implantable sensor and data logger were developed and tested experimentally in sutures closing midline laparotomies in pigs both under normal and elevated intra-abdominal pressure.
High suture tension has a negative influence on the regeneration of laparotomy incisions. Running sutures for laparotomy closure lose 45% of their initial tension over periods of 23 h. Intermittent elevation of intra-abdominal pressure to 30 mm Hg leads to a near total loss of suture tension after 23 h.
Surgeons are not able to control and reproduce suture tension. Suture tension dynamics can be measured in vivo by the sensor developed. Further research is needed to define a tissue-specific suture tension optimum to reduce the incidence of complications after laparotomy. Techniques for laparotomy closure need to be modified.
高达 20%的腹部手术后会出现剖腹手术缝合失败。缝线张力会影响组织再生的质量。目前还没有传感器可以在体内记录缝线张力的动态。
在一系列动物实验中，研究了缝线张力对愈合切口超微结构的影响。测试了外科医生以目标张力进行缝合的能力。开发了一种可植入式传感器和数据记录器，并在猪的正中剖腹手术缝线闭合中进行了实验测试，包括正常和升高的腹腔内压力两种情况。
高缝线张力会对剖腹切口的再生产生负面影响。在 23 小时的时间内，连续缝线用于剖腹手术缝合时会损失初始张力的 45%。间歇性将腹腔内压力升高至 30mmHg 会导致 23 小时后缝线张力几乎完全丧失。
外科医生无法控制和重现缝线张力。通过开发的传感器可以在体内测量缝线张力动态。需要进一步研究以确定特定组织的缝线张力最佳值，以减少剖腹手术后并发症的发生。需要修改剖腹手术缝合技术。
