Biomechanics in Knot Tying

Brzóska, Roman; Laprus, Hubert; Michniowski, Piotr; Ranosz, Paweł

doi:10.1007/978-3-662-56108-9_4

Cited by 1 publication

(1 citation statement)

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“…In an analysis of suture fracture morphology, Karaca and Hockenberber found that the polymer type, size of suture, and knot security played important roles in the breaking process ( 30 ). The reliability and security of knots have been repeatedly shown to affect the geometry and tensile strength of sutures ( 31 ). Aanning and colleagues found that Prolene® sutures anchored with square knots retained only 75% of their strength compared with half hitches ( 32 ), while running 3–0 monofilament and multifilament sutures anchored with square knots retained only 50% to 84% of the strength of identical sutures secured with half hitches ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

BioGlue® is not associated with polypropylene suture breakage after aortic surgery

Pacini

Murana

Hollinworth³

et al. 2022

Front. Surg.

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ObjectiveWe have encountered broken or damaged polypropylene sutures (Prolene®) at the anastomotic sites during aortic reoperations. Because a surgical sealant, bovine serum albumin-glutaraldehyde (BioGlue®), was used in previous aortic surgery in some of these cases, we undertook this in vitro study to evaluate whether the use of BioGlue® was associated with breakage of polypropylene sutures at the aortic anastomosis.Materials and methodsThe broken polypropylene sutures, anastomotic sites and aortic tissue at the location of suture breakage were visually inspected and evaluated intraoperatively. Six human cadaveric aortic samples were incised circumferentially and anastomosed proximally to a valved conduit with running 4–0 polypropylene sutures (Prolene®). In the test group (n = 3), BioGlue® was applied directly to the Prolene® sutures at the anastomotic sites, while in the control group (n = 3) the anastomoses were not sealed with any surgical adhesive. The six samples were immersed in Dulbecco's phosphate buffered saline solution and mounted on a M-6 Six Position Heart Valve Durability Testing System and tested up to 120 million cycles for a 2-year period. During and upon completion of the testing, the integrity of Prolene® sutures, the anastomosis and aortic tissues was regularly assessed by visual inspection.ResultsIntraoperative findings included a stretched and thin aortic wall (some with thrombus), a small cleft between the aortic tissue and the Dacron vascular graft. An excessive amount of BioGlue® was often found around the anastomosis, with cracking material, but no signs of mechanical damage were observed in these cases. Upon visual inspection during and after in vitro testing, there was no apparent damage to the polypropylene sutures on the interior or exterior of the aortic anastomoses in any of the samples. No difference was observed in the physical integrity of the polypropylene sutures at anastomotic lines, the anastomoses and aortic tissues between the test and control samples.ConclusionsThe results of this study suggest that the use of BioGlue® was not associated with breakage of the polypropylene sutures at the anastomotic sites after aortic dissection repair.

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