Holding Strength of Suture: An Experimental Study Using Porcine Kidney

Abstract

Background and Objectives:The search for the perfect suture is going on and has resulted in the introduction of many different suture types into the market. The purpose of this study is to investigate the holding strength (HS) of different sutures in the renal parenchyma in an experimental study on pig kidneys.Methods:The HS that caused sliding of the suture was investigated in 5 adult porcine kidneys with 7 suture variants. HS-caused tearing of the kidney was investigated with 3 suture types on 5 kidneys. The third investigation, performed on 5 porcine kidneys, was a comparison between 2-0 Vicryl sutures with a Hem-o-lok clip and 2-0 V-Loc sutures with 1 knot. The Friedman test was used to compare the groups. Post hoc analysis was performed with the Wilcoxon signed ranks test (Bonferroni corrected).Results:For HS causing sliding of the suture, the mean HSs of the tested sutures were as follows: 2-0 Vicryl with 1 Hem-o-lok clip, 3.26 ± 0.55 N; 2-0 Vicryl with 2 Hem-o-lok clips, 4.1 ± 0.46 N; 2-0 V-Loc, 2.52 ± 0.63 N; 4-0 V-Loc, 1.62 ± 0.17 N; 0 Quill, 0.48 ± 0.16 N; 2-0 Vicryl with 1 Hem-o-lok clip (halfway), 3.62 ± 0.66 N; and 2-0 V-Loc (halfway), 1.02 ± 0.40 N. For HS causing tearing of the kidney, the mean value of 2-way 2-0 Vicryl (Hem-o-lok in the middle) was 13.28 ± 1.38 N, 2-0 2-way Vicryl (Hem-o-lok at the end) was 5.86 ± 0.75 N, and 2-way 2-0 V-Loc was 3.98 ± 1.60 N. For the third group, the difference between the 2 suture variants was not statistically significant.Conclusion:Our study revealed that 2-0 Vicryl (polyglactin 910) sutures with 2 Hem-o-lok clips had the maximum HS in renal parenchyma when compared with other sutures.

Fascia Repair with Vicryl Suture in Urologic Surgeries

“…Nevertheless, comparing PDS with Prolene sutures showed the superiority of PDS, primarily when sutures are performed with 5-mm intervals (4). Vicryl suture maintains its strength in kidney parenchyma; thus, it is more acceptable than other sutures (8). Vicryl suture is a synthetic, biocompatible, and regenerative tool that minimizes tissue reaction complications of surgical wounds.…”

Effect of Suture Type and Suture Distance on Holding Strength in Nasal Septal Laceration Model

“…Different tissues show varying resistance to stress. Several studies have measured the maximum resistance strength before tears in some tissues and organs ( 6 , 7 , 8 ). Rodrigues et al ( 8 ) measured HS max values in 10 pigs using 3-0 vicryl in eight intra-abdominal organs (fascia, aorta, vena cava, peritoneum, small and large bowel, uterus, and fallopian tube).…”

“…Holding the tissue sample with the aid of a Cottle elevator and pulling the Newton-meter downwards, tensile force was applied to the sutures ( Figure 2 ). This measurement method is similar to that used in a recent study on tissue holding strength of porcine kidney ( 7 ). All measurement procedures were recorded on video using the digital camera of a cellphone (iPhone ® 7 Plus, Apple Inc, Cupertino, California, USA) by one of the authors (A.K).…”

“…Tensile strength is the maximum power of the suture resisting breakage. Holding strength, on the other hand, is defined as the amount of force that results in violation of the tissue or slippage of the suture ( 7 ). Together with the tensile strength of the suture, the holding strength of the tissue is also important to achieve stable wound closure.…”

“…Approximation of the wound edges in nasal septal lacerations may result in tension in the flaps, making the holding strength of the flaps critical for the successful repair of the defect. There are studies in the literature that have measured the holding strength in various tissues such as the kidney ( 7 , 8 ). To the best of our knowledge, the holding strength of nasal septal mucosa is unknown.…”