Affecting factors for abdominal incisional tension in surgery of dogs and cats

Li, Shuai; Zhao, Xingkai; Deng, Yifeng; Zhao, Yangsheng; Liu, Yongwang; Wang, Donglu; Guo, Yizhe; Xu, Xuanrong; Zhou, Zhenlei

doi:10.1016/j.rvsc.2022.11.014

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Due to the uncertainty regarding the tension requirements at the suture site, many surgeons tend to use larger gauge sutures with high tensile strength for wound closure. However, a previous study on the tension of the canine abdominal wall in 59 clinical surgeries revealed that the median tension at the midpoint of muscle incisions was only 1.51 N, with a maximum tension of only 4.23 N, while the median tension for skin incisions was only 0.67 N (27). These findings indicate that the actual tension required by the tissues during surgical suturing may be significantly lower than anticipated by surgeons.…”

Section: Discussionmentioning

confidence: 72%

“…Surgeons typically select sutures based on their experience, but research indicates that in most cases, surgeons may overestimate the tension requirements of the tissues to be sutured, resulting in the use of larger-sized suture needles and threads (26,27). Studies have shown that the clinical use of USP 2-0 sutures can provide sufficient stability, resulting in a 0% incidence of incisional hernia in 356 human cases of midline abdominal closure (28).…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical and tissue reaction: the effects of varying sutures size on canine abdominal wall stitching

Li,

Guo,

Zhao

et al. 2023

Front. Vet. Sci.

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ObjectiveLarger diameter sutures can provide sufficient tensile strength to surgical incisions but may exacerbate the inflammatory response caused by the amount of implanted foreign material. This experiment aims to investigate the differences in biomechanical stability and tissue reactivity after suturing canine midline abdominal incisions with different suture sizes.MethodAssessing the biomechanical differences between USP 2-0, 3-0, and 4-0 PGA sutures using uniaxial tensile testing on ex vivo canine midline skin and fascial muscle tissues using either a simple continuous or simple interrupted technique. mRNA and protein expression levels of inflammatory factors were measured through RT-PCR and ELISA. Tissue reactivity was evaluated using a semi-quantitative scoring system.ResultFor strains below 30% in skin and below 50% in muscle, there were no significant differences among groups. The results of skin biomechanical testing showed that the USP 4-0 PGA suture group demonstrated significantly lower maximum tensile strength compared to the USP 2-0 PGA or USP 3-0 PGA suture groups. However, it remained capable of providing at least 56.3 N (1.03 MPa) tensile strength for canine skin incisions, matching the tensile strength requirements of general canine abdominal wall surgical incisions. In addition, there were no statistically significant differences observed in the maximum tensile strength among different size of sutures according to the data of biomechanical testing in muscle. Larger diameter sutures led to increased levels of inflammatory factors (IL-1β, IL-6, TNF-ɑ) and tissue reactivity. Simple interrupted sutures caused higher levels of inflammatory factors in muscular tissue compared to simple continuous sutures.ConclusionUSP 4-0 PGA sutures provide sufficient biomechanical stability for suturing canine abdominal skin and linea alba. Suture size significantly influences tissue reactivity after suturing, with smaller gauge sutures reducing early tissue inflammatory response. Thus, USP 4-0 PGA suture has more advantages to suturing canine abdominal surgical incisions.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Biomechanical and tissue reaction: the effects of varying sutures size on canine abdominal wall stitching

Li,

Guo,

Zhao

et al. 2023

Front. Vet. Sci.

Self Cite

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Safety and aesthetic outcomes of double purse-string suture nipple reconstruction in early breast cancer patients undergoing nipple resection and endoscopic skin-sparing mastectomy with breast reconstruction

Dai,

Chung,

Liang

et al. 2024

Front. Oncol.

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BackgroundThe current surgical methods for managing incisions after nipple excision in breast reconstruction patients are limited. However, double purse-string suture (DPS) shows promise in the treatment of nipple excision. This study aimed to investigate the safety and aesthetic outcomes of DPS nipple reconstruction in early breast cancer patients who underwent endoscopic skin-sparing mastectomy (E-SSM) and breast reconstruction.MethodsWe retrospectively analyzed the clinical data of 87 early breast cancer patients with nipple excision who underwent E-SSM with breast reconstruction. According to the suture methods of nipple incision, all patients were divided into the spindle suture (SS) group, single purse-string suture (SPS) group, and DPS group, with SS and SPS groups combined as the traditional suture (TS) group. Then, we compared the groups’ differences in aesthetic outcomes, surgical safety, and oncological safety.ResultsA total of 87 patients with 88 breasts were enrolled in this study (SS n=17, SPS n=21, DPS n=50). Patients in the DPS group had significantly better nipple reconstruction satisfaction, Harris scale and any complications incidence than the TS group (all p <0.05). For nipple reconstruction satisfaction and any complication, the adjusted OR (95%CI) of the DPS group were 6.314(1.095-36.415) (p=0.039) and 0.124(0.018-0.863) (p=0.035) compared with the SS group. One patient in the SS group had vertebral metastases, and no recurrence, metastasis, or death has been observed in the other two groups during the follow-up period.ConclusionsDPS is an effective and safe nipple reconstruction procedure for patients undergoing E-SSM with breast reconstruction, delivering excellent aesthetic outcomes.

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Affecting factors for abdominal incisional tension in surgery of dogs and cats

Cited by 2 publications

References 18 publications

Biomechanical and tissue reaction: the effects of varying sutures size on canine abdominal wall stitching

Biomechanical and tissue reaction: the effects of varying sutures size on canine abdominal wall stitching

Safety and aesthetic outcomes of double purse-string suture nipple reconstruction in early breast cancer patients undergoing nipple resection and endoscopic skin-sparing mastectomy with breast reconstruction

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