Bürger Henry V, Alexander Jahnke, Torben Harz, Fonseca-Ulloa Carlos A, Rickert Markus, Stolz Dirk
Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-Universität Gießen, Klinikstraße 29, 35392, Gießen, Germany.
Department of Orthopaedics and Orthopaedic Surgery, Universitätsklinik Gießen Marburg (UKGM), Klinikstraße 33, 35392, Gießen, Germany.
J Orthop. 2025 Mar 10;69:30-36. doi: 10.1016/j.jor.2025.03.003. eCollection 2025 Nov.
It is not possible to add an infinite amount of suture material to tendon plasties and repairs in vivo. Each additional knot can reduce the tensile strength by up to 50 %. Therefore, barbed sutures, as a knotless suturing system, should be investigated as a potential alternative to traditional sutures to minimize knot-related weakening.
Superficial porcine flexors were randomized into five groups. A non-contact measurement was utilized. The Z-plasty and the turndown flap according to Silfverskiöld were used. The Stratafix barbed knotless suture was compared to regular smooth polydioxanone. The biomechanical protocol included a creep test, a cyclic test, and a tear-off test.
The Z-plasty with Stratafix showed significantly improved maximum force compared to the Z-plasty with Polydioxanon (PDS 108.5 ± 22.2N, Stratafix 142.3 ± 23.5N, p < .01). The Z-plasty was significantly superior to the turndown flap in maximum Force (turndownflap with Stratafix 52.4 ± 14.6N, Z-plasty with Stratafix 108.5 ± 22.2N, p < .001).
The Stratafix barbed suture can significantly improve the Z-plasty in maximum tension by up to 32 % when compared to regular PDS. To formulate a more precise indication, biological factors must be further investigated.
在体内进行肌腱整形和修复时，不可能添加无限量的缝合材料。每增加一个结，拉伸强度最多可降低50%。因此，倒刺缝线作为一种无结缝合系统，应作为传统缝线的潜在替代品进行研究，以尽量减少与结相关的强度削弱。
将猪的浅屈肌随机分为五组。采用非接触式测量。使用了Z成形术和根据西尔弗斯基öld法设计的翻转皮瓣。将Stratafix倒刺无结缝线与普通光滑的聚二氧六环酮缝线进行比较。生物力学实验方案包括蠕变试验、循环试验和撕裂试验。
与使用聚二氧六环酮（PDS 108.5±22.2N，Stratafix 142.3±23.5N，p<0.01）的Z成形术相比，使用Stratafix的Z成形术最大力显著提高。在最大力方面，Z成形术明显优于翻转皮瓣（使用Stratafix的翻转皮瓣为52.4±14.6N，使用Stratafix的Z成形术为108.5±22.2N，p<0.001）。
与普通PDS相比，Stratafix倒刺缝线可使Z成形术的最大张力显著提高多达32%。为了制定更精确的适应症，必须进一步研究生物学因素。
