An In Vitro Biomechanical Comparison of the Breaking Strength and Stiffness of Polydioxanone (Sizes 2, 7) and Polyglactin 910 (Sizes 3, 6) in the Equine Linea Alba

Fierheller, Erin E.; Wilson, David G.

doi:10.1111/j.1532-950x.2005.00004.x

Cited by 34 publications

(58 citation statements)

References 13 publications

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“…Several models have been used to test the strength of closures of the equine linea alba . The intact cadaver model used in this study was originally described by Magee et al Although it is impossible to simulate in vivo conditions in an ex vivo model, we chose this model because it allows application of 3‐dimensional forces to the incision, whereas in vitro models test only an isolated section of linea alba.…”

Section: Discussionmentioning

confidence: 99%

“…In ex vivo studies, closures performed with polyglactin 910 in a simple continuous suture pattern fail mainly at the surgeon's knot . According to in vitro tests, tied large gauge suture loops break at or adjacent to the knot 90%‐100% of the time . This mode of failure has been attributed to a deformation of the material's original structure due to the load, creating a stress point between the loop and the first throw of the knot .…”

Section: Introductionmentioning

confidence: 99%

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Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

et al. 2018

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Objective To compare the bursting strength and failure mode of ventral midline celiotomy closed with a simple continuous suture pattern with 1 of 2 knot combinations, a novel self‐locking knot combination of a forwarder start with an Aberdeen end knot (F‐A) and a traditional combination of a surgeon's start with a surgeon's end knot (S‐S). Study design Ex vivo experimental. Sample population Equine cadavers (n = 14). Methods A 20‐cm ventral midline celiotomy was created in 14 equine cadavers. Horses were assigned to celiotomy closure with an F‐A or S‐S knot combination. Prior to closure, a 200‐L inflatable bladder was placed in the abdomen and then insufflated until failure of the celiotomy closure. The horses’ signalment, weight, breed, and age, as well as knot combination type, mode of failure, closure time, and bursting strength (mm Hg) were recorded. Results The median bursting strength was significantly greater when incisions were closed with the F‐A knot combination (388 mm Hg) compared with the S‐S knot combination (290 mm Hg) (P = .035). Most incisions failed along the fascia when closed with F‐A combinations and at the knot when closed with S‐S combinations. Conclusion The bursting strength of ventral midline incisions in equine cadavers was increased by an average of 25% when closed with the self‐locking F‐A knot combination. Clinical significance Closing ventral midline celiotomies with an F‐A knot combination may provide a more secure closure than the traditional S‐S knot combination. Additional in vivo investigation is required prior to recommending this closure in clinical cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

et al. 2018

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“…Currently, polyester is rarely used to close the linea alba because it is nonabsorbable and has increased risk of suture sinus formation 49 . In a similar single cycle to failure model, #7 polydioxanone had the highest breaking strength (316.8 N), followed by #6 polyglycolic acid (281 N), #3 polyglycolic acid (229 N), and finally #2 polydioxanone (193 N) 50 . In a bursting strength ex vivo model, Anderson et al reported that linea alba incisions closed with #7 polydioxanone had greater mean bursting strength and incision failure occurred at the abdominal wall 51 .…”

Section: Introductionmentioning

confidence: 99%

Incisional infections associated with ventral midline celiotomy in horses

Shearer

Holcombe

Valberg

2020

J Vet Emergen Crit Care

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Objective To review the veterinary literature regarding healing and complications associated with equine celiotomy including anatomy and physiology, risk factors for incisional infection and hernia, and treatment. Etiology Celiotomy is the most common approach to treat horses with surgical colic. Incision through the linea alba provides exposure to most of the abdomen for exploration, exteriorization, and correction of surgical lesions. Incisional apposition relies on suture strength during anesthetic recovery and for the first 30 days postoperatively. Factors associated with the patient, surgical lesion and procedures, anesthesia, and recovery put the horse at risk for surgical site infection. Infection is the most important risk factor for incisional hernia formation. Diagnosis A presumptive diagnosis of surgical site infection is made based on the presence of fever and incisional swelling, pain, and discharge. Ultrasonography can be used to identify areas of fluid accumulation prior to the appearance of incisional drainage. Definitive diagnosis is based on positive bacteriologic culture of the incisional discharge. Incisional hernia is diagnosed by palpation of the incision, usually 30–60 days after surgery. Ultrasound of the incision may aide in early diagnosis of incisional hernia if gaps along the incision in the linea alba are apparent. Therapy No objective data exist to assess the efficacy of specific therapies for surgical site infections following celiotomy. Principles of treatment include the establishment of drainage, bandaging, antimicrobial therapy based on culture and sensitivity, and extended rest in an attempt to avoid incisional hernia or dehiscence. Treatment for incisional hernia includes prolonged circumferential bandaging, open or minimally invasive hernia repair, or no treatment. Prognosis Incisional complications are associated with prolonged convalescence and diminished prognosis for return to athleticism. Limiting risk factors for surgical site infections, prompt treatment, and incisional support may optimize celiotomy healing and timely return to function. Horses compete in many disciplines with incisional hernias.

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“…Studies of suture tensile strength include a wide variation in suture composition, sample configuration, and rate of tensile load application. Reported loading rates range from 5 to 3000 mm per minute on strands that are straight, looped, knotted, or used for actual tissue closure . In addition, degradation rates have been tested on sutures incubated in a variety of environments, including synthetic and biologic fluids, or implanted in animals …”

Section: Introductionmentioning

confidence: 99%

Tensile properties of synthetic, absorbable monofilament suture materials before and after incubation in phosphate‐buffered saline

et al. 2019

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Objective To compare tensile properties of synthetic, absorbable, monofilament suture material before and after incubation in phosphate‐buffered saline (PBS). Study design Two sizes (2‐0 and 3‐0) of Biosyn, Maxon, Monocryl, PDS II, Securocryl, and Securodox were tested. Sample population Ten suture loops per group. Methods Tensile strength, elongation, and modulus of suture loops were measured at baseline and after 7, 14, 21, or 28 days of incubation in PBS. Results Size, suture material, and size × suture material interaction influenced maximum breaking load, maximum elongation, and modulus of elasticity. At baseline, 2‐0 and 3‐0 Maxon had the highest breaking loads (111.67 N and 79.71 N, respectively) for their size, and 2‐0 PDSII and 3‐0 Securodox had the lowest (68.71 N and 48.73 N, respectively). Maxon 2‐0 and 3‐0 had the greatest elongations (9.68 mm and 8.45 mm, respectively) for their size, and 2‐0 Biosyn and 3‐0 Securocryl had the least (7.21 mm and 6.58 mm, respectively). Biosyn 2‐0 and 3‐0 had the highest modulus. With incubation, Maxon (2‐0), PDS II (2‐0, 3‐0), and Securodox (2‐0, 3‐0) maintained or gained strength over 4 weeks. Strengths of 2‐0 and 3‐0 Biosyn and 3‐0 Maxon were maintained for 2 weeks, while Monocryl and Securocryl lost 20% to 44% of baseline strength within 1 week and 60% to 72% within 2 weeks. Day 7 strengths of 2‐0 Biosyn and 2‐0 Monocryl were greater than baseline strength of 2‐0 PDS II. Strength of 3‐0 Biosyn at day 14 was greater than strength of Monocryl at days 7 and 14 and greater than strength of 3‐0 PDS II, 3‐0 Securodox, and 3‐0 Securocryl at baseline and days 7 and 14. Conclusion Suture tensile properties varied with suture size, composition, and brand. At baseline, Maxon suture had the greatest strength and elongation, and Biosyn had the greatest stiffness. Clinical significance Tensile strength retention, when reported as a percentage of original strength, provides insufficient information for comparison of suture tensile properties.

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An In Vitro Biomechanical Comparison of the Breaking Strength and Stiffness of Polydioxanone (Sizes 2, 7) and Polyglactin 910 (Sizes 3, 6) in the Equine Linea Alba

Abstract: Given its high initial breaking strength and its relatively longer in vivo strength retention, 7 PD seems an appropriate choice of suture material for closure of the equine linea alba when maximal short-term failure strength is desired.

Cited by 34 publications

References 13 publications

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

Incisional infections associated with ventral midline celiotomy in horses

Tensile properties of synthetic, absorbable monofilament suture materials before and after incubation in phosphate‐buffered saline

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