Forces on sutures when closing excisional wounds using the rule of halves

Lear, William; Roybal, Lacey L.; Kruzic, Jamie J.

doi:10.1016/j.clinbiomech.2019.12.018

Cited by 8 publications

(11 citation statements)

References 17 publications

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“…They did not apply NPWT to the incisional wounds in their study. 55 Our calculated baseline suture force levels (for the no suNPWT simulations) were 0.12 N and 0.09 N for the LSD and SSD suture densities, respectively, which resembles the empirical force levels reported in the Lear study. The minor differences can be explained by the fact that the mean force level in the sutures decreases non-linearly with each added suture 55 ; however, Lear et al used only three sutures for closing the wounds they had treated.…”

Section: Discussionsupporting

confidence: 81%

“…Using a commercial, calibrated force gauge, they measured a mean force of 0.52 N on the (individual) last suture, which translates to approximately 0.52/3 = 0.17 N per suture. They did not apply NPWT to the incisional wounds in their study 55 . Our calculated baseline suture force levels (for the no suNPWT simulations) were 0.12 N and 0.09 N for the LSD and SSD suture densities, respectively, which resembles the empirical force levels reported in the Lear study.…”

Section: Discussionsupporting

confidence: 66%

“…Specifically, Lear and colleagues measured suture forces in incisions of 11 male and 7 female patients aged 46 to 91 years, who presented for removal of skin cancers, following which the incision was closed by three sutures. 55 Using a commercial, calibrated force gauge, they measured a mean force of 0.52 N on the (individual) last suture, which translates to approximately 0.52/3 = 0.17 N per suture. They did not apply NPWT to the incisional wounds in their study.…”

Section: Discussionmentioning

confidence: 99%

“…Validation of the computational results reported here was possible with respect to experimentally reported tensional suture forces. Specifically, Lear and colleagues measured suture forces in incisions of 11 male and 7 female patients aged 46 to 91 years, who presented for removal of skin cancers, following which the incision was closed by three sutures 55 . Using a commercial, calibrated force gauge, they measured a mean force of 0.52 N on the (individual) last suture, which translates to approximately 0.52/3 = 0.17 N per suture.…”

Section: Discussionmentioning

confidence: 99%

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The potential of a canister‐based single‐use negative‐pressure wound therapy system delivering a greater and continuous absolute pressure level to facilitate better surgical wound care

Orlov

Gefen

2022

International Wound Journal

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Two types of single-use negative-pressure wound therapy systems are currently available to treat surgical wounds: Canister-based and canisterless. This work was aimed to evaluate the performance of a canister-based vs a canisterless system, each with a different negative-pressure setting and technology for fluid management. Continuous delivery of a specified level of negative pressure to the wound bed is hypothesised to be important for promoting surgical wound healing, by achieving continuous reduction of lateral tension in the wound, particularly through decrease of skin stress concentrations around suture insertion sites. To test the above hypothesis, we developed a computational modelling framework, a laboratory bench-test for simulated clinical use and had further conducted a pre-clinical study in a porcine model for closed incision. We specifically focussed on the impact of effective fluid management for continuous delivery of a stable, consistent negative pressure and the consequences of potential losses of the pressure level over the therapy period. We found that a greater (absolute) negative-pressure level and its continuous, consistent delivery through controlled fluid management technology, by removing excess fluid from the dressing, provides far superior biomechanical performances. These conditions are more likely to result in better quality of the repaired tissues.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The potential of a canister‐based single‐use negative‐pressure wound therapy system delivering a greater and continuous absolute pressure level to facilitate better surgical wound care

Orlov

Gefen

2022

International Wound Journal

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“…The value of 25 N represents the upper end of typical wound closure forces based on in vivo human data. [19][20][21][22] Additionally, the skin displacement out of the plane was constrained to be 1 mm in the z-direction to represent the realistic situation of the skin minimally pulling away from the site of a clinical wound closure (Figure 1d). The ARSD was modeled based on the same commercially available device that is used in our perfusion study (HEMIGARD ARS device, SUTUREGARD Medical Inc., Portland, Oregon).…”

Section: Finite Element Modelmentioning

confidence: 99%

Enhanced perfusion of elliptical wound closures using a novel adhesive suture retention device

Stoecker¹,

Lear²,

Johnson³

et al. 2021

Health Science Reports

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Background and Aims: The purpose of this investigation was to test the hypothesis that a novel adhesive retention suture device (ARSD) can increase perfusion at elliptical wound closures by distributing stress away from the suture site.Methods: Stress in the skin around a suture both with and without support from an ARSD was evaluated using a finite element model. A single-center, randomized splitscar comparison trial using laser speckle contrast analysis was used to quantify the perfusion at elliptical wound closures in human patients both with and without an ARSD. Results:The finite element model revealed that the ARSD promoted load transfer to the skin over a larger area, thus reducing the local stress and deformation in the skin around the suture site. Results from the split-scar study showed a mean improvement of 25% perfusion units with the ARSD, and the improvement was statistically significant (p = 0.002). Conclusion:The reduction in local stress and enhanced perfusion around the suture site reveals the potential benefit of using an ARSD to enable more efficient healing by avoiding complications associated with both low perfusion and skin tearing, such as dehiscence, infection, and cheese wiring.

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Analysis of Suture Force Simulations for Optimal Orientation of Rhomboid Skin Flaps

Guo,

Trusty,

Davies

et al. 2023

Lecture Notes in Computer Science

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Forces on sutures when closing excisional wounds using the rule of halves

Cited by 8 publications

References 17 publications

The potential of a canister‐based single‐use negative‐pressure wound therapy system delivering a greater and continuous absolute pressure level to facilitate better surgical wound care

The potential of a canister‐based single‐use negative‐pressure wound therapy system delivering a greater and continuous absolute pressure level to facilitate better surgical wound care

Enhanced perfusion of elliptical wound closures using a novel adhesive suture retention device

Analysis of Suture Force Simulations for Optimal Orientation of Rhomboid Skin Flaps

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