Regier Penny J, Smeak Daniel D, McGilvray Kirk C
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado.
Vet Surg. 2019 Nov;48(8):1399-1405. doi: 10.1111/vsu.13271. Epub 2019 Jul 4.
To evaluate the mechanical properties, strength, and quality of seal provided by continuous intradermal suture lines closed with barbed suture vs monofilament suture.
Experimental study.
Forty-eight full-thickness wounds in canine cadavers.
Four-centimeter-long parasagittal cutaneous wounds were created in canine cadavers. Each intradermal closure was closed with smooth monofilament suture and terminated with a 2 + 1 Aberdeen knot (n = 24) or a unidirectional barbed suture terminated with a single end pass (n = 24). Wounds (n = 12/group) were harvested, and a servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated; maximum load, displacement, stiffness, and mode of construct failure were recorded. Harvested wounds were placed in a watertight construct to measure the volume of fluid leaking over 3 minutes at 1.0 ± 0.1 psi.
Stiffness did not differ between constructs (P > .05). Incisions closed with monofilament sutures sustained higher maximum load (311.21 N ± 87.40) and displacement at failure (21.19 mm ± 4.51) compared with those with barbed sutures (116.38 N ± 42.82 and 15.03 mm ± 2.32, respectively, P < .05). Closures with monofilament sutures leaked more (4.38 mL ± 7.90) compared with those with barbed sutures (0.15 mL ± 0.43, P < .05).
Monofilament sutures resulted in stronger constructs, whereas barbed suture constructs provided a better watertight seal.
While unidirectional barbed sutures may improve watertight skin closure, surgeons should consider using conventional monofilament sutures when mechanical strength of the closure is of primary concern.
评估倒刺缝线与单丝缝线闭合连续皮内缝合线所提供的机械性能、强度及密封质量。
实验研究。
犬类尸体上的48处全层伤口。
在犬类尸体上制造4厘米长的矢状旁皮肤伤口。每个皮内缝合用光滑单丝缝线闭合，并以2 + 1阿伯丁结结束（n = 24），或以单向倒刺缝线单端穿过结束（n = 24）。收集伤口（每组n = 12），并使用伺服液压机对垂直于缝线长轴施加拉伸载荷。生成载荷 - 位移曲线；记录最大载荷、位移、刚度及结构破坏模式。将收集的伤口置于防水结构中，以测量在1.0 ± 0.1 psi压力下3分钟内泄漏的液体体积。
不同结构间刚度无差异（P >.05）。与倒刺缝线闭合的切口相比，单丝缝线闭合的切口承受更高的最大载荷（311.21 N ± 87.40）和破坏时的位移（21.19 mm ± 4.51）（分别为116.38 N ± 42.82和15.03 mm ± 2.32，P <.05）。单丝缝线闭合的切口渗漏更多（4.38 mL ± 7.90），而倒刺缝线闭合的切口渗漏较少（0.15 mL ± 0.43，P <.05）。
单丝缝线形成的结构更强，而倒刺缝线结构提供更好的防水密封。
虽然单向倒刺缝线可能改善皮肤防水闭合，但当闭合的机械强度是主要关注点时，外科医生应考虑使用传统单丝缝线。
