Breaking Strength of Native and Sutured Trachea

Abstract

Tracheal anastomoses are, even more so than other sutures, often only possible to prepare under tension and thus in danger of breakage. No information is available regarding native tracheae and freshly sutured tracheae. For this reason, our objective was to examine the tensile strength of native tracheae and compare it with freshly sutured specimens. Fresh tracheae were collected from the local slaughterhouse within 30 min of slaughter. With the help of a suitable holding device, 24 fresh tracheae were mounted on a material testing machine and stretched to breaking point, during which the force and distance required were recorded. The same study was carried out on each 10 freshly anastomosed tracheae using three different suturing techniques. The mean value of the maximum force required for native tracheae was 198 N. With continuous suturing (polypropylene), a mean value of 171 N was attained, and with single interrupted suturing (polydioxanone and polyglactin 910), 123 N, respectively, 108 N. Differences between the groups proved to be highly significant. With respect to the mechanical strain from traction, the continuous suture proved to be statistically identical to native tracheae, whereas single interrupted sutures revealed a considerably lower stability under burden. Therefore, the continuous suture is of advantage in respect of the mechanical strain from traction and the suture protection of tracheal anastomoses. Further studies with differing survival times in vivo with this method provide insight into the stability of tracheal anastomoses during the healing process.

Reinforcement Bronchial Stump Increases Early Mechanical Integrity: an ExVivo Experimental Study

“…On the other hand, with the single interrupted suture, there are always individual stitches that are pulled more tightly than others (10). Under mechanical stress these individual stitches are exclusively exposed to the maximum force until the thread breaks or they cut into the tissue beneath (9). Although the continuous suture technique was reported to be superior (9-11), we did not find any statistical difference in air leakage pressure between interrupted and continuous suture patterns.…”

“…Behrend reported that a continuous suture leads to a homogeneous distribution of energy between the individual loops of the suture's spiral (9). Other reported advantages include reduced likelihood of focal ischaemia, air and watertight seal, and an increase of tensile strength (9).…”

“…Behrend reported that a continuous suture leads to a homogeneous distribution of energy between the individual loops of the suture's spiral (9). Other reported advantages include reduced likelihood of focal ischaemia, air and watertight seal, and an increase of tensile strength (9). On the other hand, with the single interrupted suture, there are always individual stitches that are pulled more tightly than others (10).…”

Initial Resistance of Carina Anastomoses with Increasing Tensile Stress: An ex vivo Model Comparing Different Suture Techniques

“…These showed that single-stitch sutures were significantly weaker than continuous sutures or sutures performed in mixed technique [14]. In experimental studies, involving the trachea of sheep, Behrend et al [15,16] tested the same three suture techniques as the authors of this study. Various lengths of resection (3, 6 and 9 cm) were observed at intervals of 1, 2, 4, 8 and 24 weeks regarding mechanical stability.…”

Defining the biomechanical properties of the rabbit trachea

“…However, limitations exist in interpretation of results secondary to a lack of normative data. Behrend et al established a method of measuring the normative tensile strength of sheep trachea as well as various anastomotic techniques applied to sheep trachea . This model has served as a framework to further define animal trachea characteristics, but is exclusive and species specific.…”