Coated Sutures

Beitzel, Knut; Voß, Andreas; McCarthy, Mary-Beth; Russell, Ryan P.; Apostolakos, John; Cote, Mark P.; Mazzocca, Augustus D.

doi:10.1097/jsa.0000000000000074

Cited by 5 publications

(3 citation statements)

References 53 publications

(91 reference statements)

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“…Additionally, suture material represents a foreign body, which is placed directly into a vulnerable area of decreased vascularity during repair. 22 Consequently, modifying the surface of the suture used for repair, to optimize adhesion and proliferation of cells involved in the healing process, may promote tissue recovery.…”

Section: Discussionmentioning

confidence: 99%

Augmenting Suture Tape Used in Rotator Cuff Surgery With Magnesium Increases in Vitro Cellular Adhesion of Human Subacromial Bursal Tissue

Muench

Kriscenski

Tamburini

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the effect of magnesium on cellular adhesion and proliferation of human subacromial bursal tissue (SBT), osteoblasts, and tenocytes on nonabsorbable suture tape commonly used in rotator cuff surgery. Methods Human SBT cells, primary human osteoblasts (HOBs), and primary human tenocytes were isolated from tissue samples and cultured in growth media. Commercially available collagen-coated nonabsorbable suture tape was cut into one-inch pieces, placed into 48-well culture dishes, sterilized under ultraviolet light, and treated with (+) or without (–) magnesium. For the (+) magnesium group, a one-time dose of 5 mM sterile magnesium chloride was added. Subsequently, cells were plated at a density of 20,000 cells/cm 2 . For each cell source (SBT, HOBs, tenocytes) cellular proliferation and adhesion assays on suture tape treated (+) or (–) magnesium were performed. Results SBT, HOBs, and tenocytes each demonstrated the ability to adhere and proliferate on suture tape. Augmenting suture tape with magnesium resulted in a significantly increased cellular adhesion of SBT compared with nonaugmented sutures ( P = .001), whereas no significant differences were observed for HOBs ( P = .081) and tenocytes ( P = .907). Augmentation with magnesium demonstrated no significant difference in cellular proliferation of SBT ( P = .856), HOBs ( P = .672), and tenocytes ( P = .251) compared with nonaugmented sutures. Conclusions SBT, osteoblasts, and tenocytes each demonstrated the ability to adhere and proliferate on suture tape. In addition, augmenting the suture with magnesium resulted in a significantly increased cellular adhesion of SBT compared with nonaugmented sutures, whereas no significant differences were observed for osteoblasts and tenocytes. Further, magnesium did not impair the proliferative activity of SBT, osteoblasts, and tenocytes on suture tape used in rotator cuff surgery. Clinical Relevance Modifying the surface of the suture used for repair with application of magnesium may be an inexpensive and technically feasible option to improve the use of SBT for biologic augmentation of rotator cuff repair.

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Section: Discussionmentioning

confidence: 99%

Augmenting Suture Tape Used in Rotator Cuff Surgery With Magnesium Increases in Vitro Cellular Adhesion of Human Subacromial Bursal Tissue

Muench

Kriscenski

Tamburini

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…15 Synthetic sutures are also coated to further reduce tissue reactivity, improve handling properties, and add antibacterial elements. 65 Most synthetic absorbable sutures feature good tensile strength and low tissue reactivity (Table 1). Polyamide (nylon) (Monosof; Covidien, Minneapolis, Minn.) (Ethilon; Ethicon Inc., Somerville, N.J.), polybutester (Novafil; Covidien, Minneapolis, Minn.), polyester (Ti-Cron; Covidien, Minneapolis, Minn.) (Fiberwire, Mersilene; Ethicon Inc., Somerville, N.J.), polypropylene (Surgipro; Covidien, Minneapolis, Minn.) (Prolene, Ethicon Inc., Somerville, N.J.), and steel sutures are nonabsorbable, strong, and induce less tissue reactivity.…”

Section: Overview Of Suture Materials and Propertiesmentioning

confidence: 99%

Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length

Bushong,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Knots are the weakest structural point in a suture line and inevitably weaken almost all suture materials. This practical review critically evaluates the factors, such as suture material properties, gauge, configuration, throw count, and tail length, that affect knot security. Methods: A PubMed search between the years 1934 and 2023 identified relevant studies that addressed factors relating to knot security. Studies that investigated knots and sutures solely used in laparoscopic and arthroscopic surgery were excluded. Knot configurations assessed were the Aberdeen, sliding, square, and surgeon’s. Results: Eighty-six articles were included in this review article and demonstrated that knot security varies greatly between suture materials and gauge. Knot security also varies by configuration, throw count, conditions, tail length, and stitch type. Throw count differs by knot configuration, with the Aberdeen knot being most secure with three throws and one to two turns compared with three to five throws for surgeon’s and square knots. The optimal tail length was 3 mm. Conclusions: This practical review demonstrates that there are significant differences in knot security based on a variety of factors. It is challenging to propose an ideal knot because most studies did not evaluate knot security using a broad variety of suture materials, gauges, and throws for each of the most common knots. Although this review article demonstrated several applicable findings, additional robust studies are needed to simplify proposals.

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“…2,30 Past studies have investigated incorporating exogenous factors into a suture coating to promote biological healing at a repair site. 4 A variety of different angiogenic promotors including butyric acid, platelet-derived growth factor, VEGF, and basic fibroblast growth factor mimetics have been incorporated in suture coatings and have been shown to promote tendon healing or vascularity in various animal models. 5,7,21,27 In addition, other studies have coated sutures with adhesion substrates to improve the biological acceptance of sutures and to promote healing.…”

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confidence: 99%

Deferoxamine-Soaked Suture Improves Angiogenesis and Repair Potential After Acute Injury of the Chicken Achilles Tendon

Efird

Fletcher

Draeger

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:A major obstacle to the treatment of soft tissue injuries is the hypovascular nature of the tissues. Deferoxamine (DFO) has been shown to stimulate angiogenesis by limiting the degradation of intracellular hypoxia-inducible factor 1–alpha.Hypothesis:DFO-saturated suture would induce angiogenesis and improve the markers of early healing in an Achilles tendon repair model.Study Design:Controlled laboratory study.Methods:Broiler hens were randomly assigned to the control (CTL) group or DFO group (n = 9 per group). The right Achilles tendon was partially transected at its middle third. The defect was surgically repaired using 3-0 Vicryl suture soaked in either sterile water (CTL group) or 324 mM DFO solution (DFO group). All animals were euthanized 2 weeks after the injury, and the tendon was harvested. Half of the tendon was used to evaluate angiogenesis via hemoglobin content and tissue repair via DNA content and proteoglycan (PG) content. The other half of the tendon was sectioned and stained with hematoxylin and eosin, safranin O, and lectin to evaluate vessel density.Results:Hemoglobin content (percentage of wet tissue weight) was significantly increased in the DFO group compared with the CTL group (0.081 ± 0.012 vs 0.063 ± 0.016, respectively; P = .046). DNA content (percentage of wet tissue weight) was also significantly increased in the DFO group compared with the CTL group (0.31 ± 0.05 vs 0.23 ± 0.03, respectively; P = .024). PG content (percentage of wet tissue weight) was significantly decreased in the DFO group compared with the CTL group (0.26 ± 0.02 vs 0.33 ± 0.08, respectively; P = .035). Total chondroid area (number of vessels per mm2 of tissue area evaluated) was significantly decreased in the DFO group compared with the CTL group (17.2 ± 6.6 vs 24.6 ± 5.1, respectively; P = .038). Articular zone vessel density (vessels/mm2) was significantly increased in the DFO group compared with the CTL group (7.1 ± 2.5 vs 2.1 ± 0.9, respectively; P = .026).Conclusion:The significant increase in hemoglobin content as well as articular zone vessel density in the DFO group compared with the CTL group is evidence of increased angiogenesis in the fibrocartilaginous region of the tendon exposed to DFO. The DFO group also displayed a significantly greater level of DNA and significantly lower level of PG, suggesting enhanced early healing by fibrous tissue formation.Clinical Relevance:Stimulating angiogenesis by DFO-saturated suture may be clinically useful to improve healing of poorly vascularized tissues.

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Coated Sutures

Cited by 5 publications

References 53 publications

Augmenting Suture Tape Used in Rotator Cuff Surgery With Magnesium Increases in Vitro Cellular Adhesion of Human Subacromial Bursal Tissue

Augmenting Suture Tape Used in Rotator Cuff Surgery With Magnesium Increases in Vitro Cellular Adhesion of Human Subacromial Bursal Tissue

Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length

Deferoxamine-Soaked Suture Improves Angiogenesis and Repair Potential After Acute Injury of the Chicken Achilles Tendon

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