The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: Long‐term clinical and ultrasonographic evaluation

Frame, K.; Ben‐Amotz, Oded; Simpler, Renee; Zuckerman, Josh; Ben‐Amotz, Ron

doi:10.1002/ccr3.2287

Cited by 5 publications

(7 citation statements)

References 56 publications

(134 reference statements)

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“…Previous veterinary studies evaluating barbed suture use for tendon repair using 3LP and modified Bunnell‐Mayer patterns found barbed sutures to be inferior, leading to suture breakage and lower failure loads compared to smooth sutures of an equivalent size 25 . In a recent case report, Fame et al used a modified knotless barbed Kessler technique to successfully repair a canine common calcanean tendon in vivo 26 . To the authors' knowledge, use of core barbed sutures augmented with an ES for canine tenorrhaphy has not been described or biomechanically evaluated.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model

et al. 2021

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Objective To determine the effect of a novel barbed suture pattern (NBSP) compared to a three‐loop‐pulley (3LP) with and without epitendinous suture (ES) augmentation on the biomechanical strength and gap formation of repaired canine tendons. Study Design Ex vivo, cadaveric, randomized, experimental study. Sample Population Forty, adult superficial digital flexor tendons (SDFT). Methods SDFT were randomly assigned to one of four groups (n = 10/group). Sharp tenotomy was performed and repaired with 3LP, NBSP, 3LP + ES, and NBSP + ES. Constructs were tested to failure while evaluating yield, peak, and failure loads, loads at 1 and 3 mm gap formation, and failure mode. Results Constructs augmented with ES sustained 80% greater yield (p < .001), peak (p < .001), and failure (p < .001) loads, with no difference between 3LP + ES and NBSP + ES constructs regarding peak (p = .614), and failure forces (p = .865). Loads resulting in 1 and 3 mm gap formation were greater when constructs were augmented with an ES (p ≤ .003). Failure mode differed between groups (p < .001), occurring predominantly due to suture pull‐through in 3LP and NBSP groups compared to tissue failure distant to the repair site in ES augmented constructs. Conclusion Tendons repaired with the NBSP used in this study resisted similar forces as those repaired with 3LP. Augmentation with an ES improved the biomechanical properties of repaired constructs, including resistance to gap formation. Clinical Relevance The NBSP repair tested here may be advantageous over monofilament suture repair as it uses a similar‐sized barbed core suture but eliminates the requirement for knot tying.

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Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model

et al. 2021

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“…Ultrasonography is considered to be an adequate method to subjectively evaluate the degree of inflammation in muscles and tendons [11][12][13] . In this study, the thickness values of the muscles that form the linea alba and the subcutaneous tissue did not differ significantly between the groups.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of barbed suture for celiorrhaphy and subcutaneous closure in bitches with pyometra submitted to ovariohysterectomy

et al. 2021

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Purpose: To evaluate the use of barbed sutures over the surgical time, the leukogram, the tissue thickness in which the sutures were employed (ultrasonography), the costs, and the possible complications in bitches with pyometra submitted to ovariohysterectomy (OH). Methods: Convectional 2.0 polyglyconate suture was used in the control group (CG n = 10) and 2.0 barbed polyglyconate suture in the barbed group (BG n = 10) to perform celiorrhaphy (simple continuous pattern) and subcutaneous closure (continuous intradermal pattern). Data were assessed using paired (leukogram between 24 and 48 h within the same group) and unpaired (leukogram, surgical time, tissue thickness, and costs) Student's t-test. The Fisher exact test was used to assess the occurrence of seroma between groups (p < 0.05). Results are shown as mean ± standard error of mean. Results: The time spent to perform the celiorrhaphy (195.30 ± 17.37 s vs. 204 ± 16.00 s), subcutaneous closure (174.0 ± 15.86 s vs. 198.0 ± 15.62 s), and the total surgical time (24.30 ± 1.44 min vs. 23.00 ± 1.30 min) did not differ between BG and CG, respectively (p > 0.05). Leukogram at 48 h post-surgery did not differ between groups (p = 0.20). No differences were observed in the subcutaneous and the abdominal wall thickness (cm) assessed by ultrasonography at 48 h in BG (0.31 ± 0.04, 0.80 ± 0.05) and CG (0.34 ± 0.03, 0.72 ± 0.06), respectively. Similarly, 15 days post-surgery the same structures did not differ between BG (0.26 ± 0.02, 0.74 ± 0.08) and CG (0.26 ± 0.03, 0.64 ± 0.05) (p > 0.05). In one bitch from each group, a mild seroma was observed on one side of the surgical wound 48 h after surgery (p = 1.00). The procedures in which barbed sutures were used had an average additional cost of R$ 200.00 ± 11.66 (p < 0.0001). Conclusions: Barbed suture has proven to be efficient and safe for abdominal and subcutaneous closure. However, considering its current high cost in addition that the surgical time of bitches with pyometra undergone OH was not reduced, no advantages were observed with the use of barbed sutures for this type of surgery.

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“…Suture sizes 2-0 and 3-0 are commonly used for human flexor tendon repairs, and these sizes of barbed sutures were used in previous cadaver and animal in vivo repair studies. 11,18,19,[23][24][25] Manufacturers report that the mechanical properties of barbed sutures are similar to those of non-barbed sutures of one size smaller. 26 Therefore, size 2-0 (non-barbed and barbed) and 3-0 (barbed) sutures were examined in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Ex vivo studies have investigated using size 2–0 and 3–0 PP barbed sutures for flexor digitorum profundus tendon repair in pigs and cadavers, and barbed sutures made from different materials were also used to evaluate their possible use for tendon repair in several animal and human models 10–17 . Two in vivo animal studies have examined the use of barbed sutures for tendon repair, one in 2015 using 3–0 Quill SRS PDS bidirectional barbed sutures in chickens to repair the flexor digitorum profundus tendon, and one in 2019 using 2–0 PP bidirectional barbed sutures in a canine case study to repair a complete common calcanean tendon rupture 18,19 . However, barbed sutures have not yet been used for human clinical tendon repair.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13][14][15][16][17] Two in vivo animal studies have examined the use of barbed sutures for tendon repair, one in 2015 using 3-0 Quill SRS PDS bidirectional barbed sutures in chickens to repair the flexor digitorum profundus tendon, and one in 2019 using 2-0 PP bidirectional barbed sutures in a canine case study to repair a complete common calcanean tendon rupture. 18,19 However, barbed sutures have not yet been used for human clinical tendon repair.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the mechanical properties and anchoring performance of polyvinylidene fluoride and polypropylene barbed sutures for tendon repair

et al. 2022

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Polyvinylidene fluoride (PVDF) has been considered as an alternative suture material to replace polypropylene (PP) due to its superior biocompatibility and mechanical properties, but it has never been examined for use in barbed sutures, particularly for tendon repair. This study fabricated size 2-0 PVDF and PP bidirectional barbed sutures and compared their mechanical properties and anchoring performance in patellar tendons. The mechanical properties were evaluated via tensile testing, and the anchoring performance of the barbed sutures was assessed by a tendon suture pullout test. Sixty porcine patellar tendons were harvested, transected to mimic a full-thickness injury, and repaired using a cross-locked cruciate suturing technique. The ultimate tensile force was 60% higher for the PVDF barbed sutures (22.4 ± 2.1 N) than for the PP barbed sutures (14.0 ± 1.7 N). The maximum pullout force was 35% higher for PVDF barbed sutures (70.8 ± 7.8 N) than for PP barbed sutures (52.4 ± 5.8 N). The force needed to form a 2-mm gap, indicative of repair failure, was similar between the PVDF (29.2 ± 5.0 N) and PP (25.6 ± 3.1 N) barbed sutures, but both were greater than the 2-mm-gap forces for non-barbed sutures of the same size. In this study, PVDF barbed sutures provided better mechanical properties and improved tissue anchoring performance compared to the barbed PP sutures for porcine patellar tendon repair, demonstrating that PVDF monofilament sutures can be barbed and used effectively for tendon repair.

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The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: Long‐term clinical and ultrasonographic evaluation

Abstract: The canine common calcanean tendon can be repaired successfully using a modified Kessler knotless barbed technique. A long‐term ultrasound follow‐up showed improved and increased normal tendon fibrillar echotexture and homogeneity.

Cited by 5 publications

References 56 publications

Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model

Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model

Evaluation of barbed suture for celiorrhaphy and subcutaneous closure in bitches with pyometra submitted to ovariohysterectomy

Comparison of the mechanical properties and anchoring performance of polyvinylidene fluoride and polypropylene barbed sutures for tendon repair

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