From the School of Aerospace and Mechanical Engineering.
Plastic and Reconstructive Surgery, Department of Surgery, University of Oklahoma Health Sciences Center.
Plast Reconstr Surg. 2023 Nov 1;152(5):862e-866e. doi: 10.1097/PRS.0000000000010391. Epub 2023 Mar 14.
Wound dehiscence, with an estimated occurrence rate greater than 4% in plastic surgery, is generally underreported, and can be an indicator of increased mortality and remission rates. The authors developed the lasso suture as a stronger alternative to the current standard patterns. The lasso suture takes less time to perform than the standard high-tension wound repair method. The authors dissected caprine skin specimens to create full-thickness wounds for suture repair using simple interrupted, vertical mattress, horizontal mattress, and deep dermal with running intradermal (DDR) sutures ( n = 10) and lasso sutures ( n = 9). They then conducted uniaxial failure testing to quantify the suture rupture stresses and strains. They also measured the suture operating time with medical students and residents (PGY or MS programs) performing wound repair (10-cm wide, 2-cm deep, 2-0 polydioxanone sutures) on soft-fixed human cadaver skin. The lasso stitch had a greater first-suture rupture stress compared with all other patterns ( P < 0.001): 2.46 ± 0.27 MPa for lasso versus 0.69 ± 0.14 MPa for simple interrupted, 0.68 ± 0.13 MPa for vertical mattress, 0.50 ± 0.10 MPa for horizontal mattress, and 1.17 ± 0.28 MPa for DDR sutures. Performing the lasso suture was 28% faster than performing standard DDR (264 ± 21 versus 349 ± 25 seconds; P = 0.027). In summary, the authors showed that the lasso has superior mechanical properties compared with the studied traditional sutures, and that the new technique can be performed more quickly than the current standard (DDR stitch) for high-tension wounds. Future animal and in-clinic studies will be helpful to confirm the authors' findings in this proof-of-concept study.
The authors propose the lasso suture, a new suturing method with improved tensile performance compared with traditional techniques and a faster operative time than the deep dermal stitch typically used for high-tension wounds in reconstructive surgery to prevent wound dehiscence.
在整形手术中，伤口裂开的发生率估计超过 4%，但通常报道较少，可能是死亡率和缓解率增加的指标。作者开发了套索缝线作为当前标准模式的更强替代方案。与标准的高张力伤口修复方法相比，套索缝线的操作时间更短。作者解剖山羊皮肤标本，用简单间断、垂直褥式、水平褥式和深部真皮连续皮内（DDR）缝线（n=10）和套索缝线（n=9）进行全层伤口缝合修复。然后进行单轴失效测试，以量化缝线断裂应力和应变。他们还让医学生和住院医师（PGY 或 MS 项目）在固定在软支撑上的人体尸体皮肤上进行伤口修复（10cm 宽、2cm 深、2-0 聚二氧杂环已酮缝线），测量缝线操作时间。与所有其他缝线类型相比，套索缝线的首次缝线断裂应力更大（P＜0.001）：套索缝线为 2.46±0.27 MPa，简单间断缝线为 0.69±0.14 MPa，垂直褥式缝线为 0.68±0.13 MPa，水平褥式缝线为 0.50±0.10 MPa，DDR 缝线为 1.17±0.28 MPa。与标准的 DDR 缝线相比，套索缝线的操作速度快 28%（264±21 秒与 349±25 秒；P=0.027）。总之，作者表明，与研究中的传统缝线相比，套索具有更好的力学性能，并且与当前用于重建手术中高张力伤口的标准缝线（DDR 缝线）相比，新技术的操作速度更快。未来的动物和临床研究将有助于证实作者在这项概念验证研究中的发现。
作者提出了套索缝线，这是一种新的缝合方法，与传统技术相比，拉伸性能得到改善，与深部真皮缝线（通常用于重建手术中的高张力伤口）相比，操作时间更快，可预防伤口裂开。
