Plating tendons can be considered as an additional method that may improve tendon apposition and decrease gap formation.
Initial and maximum intraluminal leak pressures of four enterotomy closures were compared. Closure patterns included a modified Gambee, simple interrupted, simple continuous, and skin staple closure. Forty-eight 3-cm enterotomy constructs were created from jejunal segments harvested from 12 dogs. Twelve each were randomly assigned to the four closure methods. Time of closure, as well as initial and maximum leak pressures, were measured and compared. The modified Gambee closure was the slowest closure to perform, with skin staple closure being the fastest. All suture patterns tested had higher mean initial leak pressures than reported physiologic intestinal pressures during peristalsis, although the skin staple closures resulted in leakage below normal physiologic pressure in several samples. The modified Gambee closure was able to sustain a significantly higher initial leak pressure than skin staple closures. The modified Gambee suture pattern had the greatest maximum leak pressure of all enterotomy closure patterns tested. Use of the modified Gambee suture pattern should be considered in enterotomy closure, although in vivo studies are required to determine if these differences are clinically significant.
OBJECTIVE To compare suture placement time, tension at skin separation and suture line failure, and mode of failure among 4 suture patterns. DESIGN Randomized trial. SAMPLE 60 skin specimens from the pelvic limbs of 30 purpose-bred Beagles. PROCEDURES Skin specimens were harvested within 2 hours after euthanasia and tested within 6 hours after harvest. An 8-cm incision was made in each specimen and sutured with 1 of 4 randomly assigned suture patterns (simple interrupted, cruciate, intradermal, or subdermal). Suture placement time and percentage of skin apposition were evaluated. Specimens were mounted in a calibrated material testing machine and distracted until suture line failure. Tensile strength at skin-edge separation and suture-line failure and mode of failure were compared among the 4 patterns. RESULTS Mean suture placement time for the cruciate pattern was significantly less than that for other patterns. Percentage of skin apposition did not differ among the 4 patterns. Mean tensile strength at skin-edge separation and suture-line failure for the simple interrupted and cruciate patterns were significantly higher than those for the intradermal and subdermal patterns. Mean tensile strength at skin-edge separation and suture-line failure did not differ significantly between the intradermal and subdermal patterns or the simple interrupted and cruciate patterns. The primary mode of failure for the simple interrupted pattern was suture breakage, whereas that for the cruciate, intradermal, and subdermal patterns was tissue failure. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested external skin sutures may be preferred for closure of incisions under tension to reduce risk of dehiscence.
This paper details a passive, inductor–capacitor (LC) resonant sensor embedded in a commercial dressing for low-cost, contact-free monitoring of a wound; this would enable tracking of the healing process while keeping the site closed and sterile. Spiral LC resonators were fabricated from flexible, copper-coated polyimide and interrogated using external reader antennas connected to a two-port vector network analyzer; the forward transmission scattering parameter (S21) magnitude was collected, and the resonant frequency (MHz) and the peak-to-peak amplitude of the resonant feature were identified. These increase during the healing process as the permittivity and conductivity of the tissue change. The sensor was first tested on gelatin-based tissue-mimicking phantoms that simulate layers of muscle, blood, fat, and skin at varying phases of wound healing. Finite element modeling was also used to verify the empirical results based on the expected variations in dielectric properties of the tissue. The performance of the resonant sensors for in vivo applications was investigated by conducting animal studies using canine patients that presented with a natural wound as well as a controlled cohort of rat models with surgically administered wounds. Finally, transfer functions are presented that relate the resonant frequency to wound size using an exponential model (R 2 = 0.58–0.96). The next steps in sensor design and fabrication as well as the reading platform to achieve the goal of a universal calibration curve are then discussed.
Recent advances in hyperelastic materials and self-sensing sensor designs have enabled the creation of dense compliant sensor networks for the cost-effective monitoring of structures. The authors have proposed a sensing skin based on soft polymer composites by developing soft elastomeric capacitor (SEC) technology that transduces geometric variations into a measurable change in capacitance. A limitation of the technology is in its low gauge factor and lack of sensing directionality. In this paper, we propose a corrugated SEC through surface texture, which provides improvements in its performance by significantly decreasing its transverse Poisson’s ratio, and thus improving its sensing directionality and gauge factor. We investigate patterns inspired by auxetic structures for enhanced unidirectional strain monitoring. Numerical models are constructed and validated to evaluate the performance of textured SECs, and to study their performance at monitoring strain on animal skin. Results show that the auxetic patterns can yield a significant increase in the overall gauge factor and decrease the stress experienced by the animal skin, with the re-entrant hexagonal honeycomb pattern outperforming all of the other patterns.
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