Needle-to-suture ratio, as well as suture material, impacts needle-hole bleeding in vascular anastomoses

Sergeant, Paul; Kocharian, Richard; Patel, Bababhai; Pfefferkorn, Matthew; Matonick, J.P.

doi:10.1093/icvts/ivw042

Cited by 9 publications

(5 citation statements)

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“…Foreign body reaction is another adverse outcome of sutures, especially at a site of knotting which represents a major mass of foreign body. [1][2][3][4][5][6] A primary closure of wounds, suturing sometimes may not be feasible because of the inadequacy of the skin aps, especially aer trauma or following excision of lesions. 1 In this regard, alternative methods for surgical wound closure such as biological glues and tissue adhesives have gained more attentions recently.…”

Section: Introductionmentioning

confidence: 99%

Mussel-inspired hydrogel tissue adhesives for wound closure

2017

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Section: Introductionmentioning

confidence: 99%

Mussel-inspired hydrogel tissue adhesives for wound closure

2017

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“…Taper cut needle is a combination of a reverse cutting point with a taper point, facilitating a smoother passage with less risk of cutting through the needle hole (Dunn, 2005;Schmiedt, 2012). In a recent study it was found that the needle-to-suture ratio plays an important role in reducing needle hole bleeding in vascular anastomoses (Sergeant et al, 2016). Needle-to-suture ratio may impact leakage hole creation in intestinal surgery as well but this was not investigated in the study presented here.…”

Section: Introductionmentioning

confidence: 87%

Investigation of leakage holes created by four needle types used for closure of canine enterotomies

Mitsou¹,

Papazoglou²,

Savvas³

et al. 2018

Open Vet J.

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The creation of leakage holes in the intestinal wall by four types of swaged-on needles used to close enterotomy incisions in canine cadavers was studied. Twenty-four enterotomies were performed in 10 cm jejunal sections obtained from five dogs following euthanasia. After placement of Doyen intestinal forceps to the ends of each section, a 3 cm antimesenteric incision was performed and closed using 4-0 polydioxanone suture armed in a swaged-on needle in a simple interrupted pattern. One group served as control, with no enterotomies performed. The four groups that we used consisted of six sections each: group CC was closed with a polydioxanone suture armed in a conventional cutting needle, group RC was closed with a reversed cutting needle, group TPP was closed with a taper point plus needle, and group TC was closed with a taper cutting needle. Leak testing was performed by infusion of 13.5 mL methylene blue solution into the intestinal lumen. Significant differences between leakage and non-leakage sections of group CC were detected (P=.027). No statistical differences were detected among other groups. Conventional cutting needles seem to create leaking holes in cadaveric healthy jejunum during needle passage for closing an enterotomy incision.

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“…This procedure has an additional risk of bleeding through the needle hole formed upon suturing the graft to the tissue as the size of the needle is larger than the diameter of the suture itself. [19] As the graft has no natural hemostatic capacity, bleeding may occur from the suture points(Figure 1C); [20,19] thus, proper coverage of the suture can provide an extra degree of sealing to the anastomotic line (Figure 1D).…”

Section: Materials Design and Tissue-biomaterials Interactionsmentioning

confidence: 99%

Sprayable Hydrogel for Instant Sealing of Vascular Anastomosis

Taboada¹,

Dosta

Edelman

et al. 2022

Advanced Materials

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Bleeding‐related complications following vascular surgeries occur in up to half of the patients—500 000 cases annually in the United States alone. This results in additional procedures, increased mortality rate, and prolonged hospitalization, posing a burden on the healthcare system. Commercially available materials rely, in large, on forming covalent bonds between the tissue and the biomaterial to achieve adhesion. Here, it is shown that a biomaterial based on oxidized alginate and oxidized dextran together with polyamidoamine (PAMAM) dendrimer amine provides simultaneous electrostatic and covalent interactions between the biomaterial and the tissue, maximizing adhesion. This study finds that the material withstands supraphysiological pressures (≈300 mmHg) and prevents bleeding in a rabbit aortic puncture model and in a pig carotid bilateral poly(tetrafluoroethylene) graft model—achieving superior performance to commercially available materials such as Tisseel and BioGlue. Material biocompatibility is validated in comprehensive in vitro and in vivo studies in accordance with the US Food and Drug Administration (FDA) guidelines, including in vitro neutral red uptake test, subcutaneous implantation in rabbits, ames genotoxicity, and guinea pig maximization test. This material has the potential to provide with adequate seal and reduced complications following complex vascular surgeries, including hard‐to‐seal tissue–graft interfaces.

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Needle-to-suture ratio, as well as suture material, impacts needle-hole bleeding in vascular anastomoses

Abstract: The N:S ratio as well as the physical characteristics of the suture material are important factors in reducing needle-hole bleeding in vascular anastomoses.

Cited by 9 publications

References 10 publications

Mussel-inspired hydrogel tissue adhesives for wound closure

Mussel-inspired hydrogel tissue adhesives for wound closure

Investigation of leakage holes created by four needle types used for closure of canine enterotomies

Sprayable Hydrogel for Instant Sealing of Vascular Anastomosis

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