Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues

Ingle, Nilesh P.; King, Martin W.

doi:10.1016/j.jbiomech.2009.08.033

Cited by 39 publications

(44 citation statements)

References 12 publications

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“…Currently, barbed sutures are being used clinically by cosmetic and plastic surgeons for procedures such as face lifts. So far little is known about the basic mechanical behavior of barbed sutures and their barb geometry (Ingle and King, 2009). In this study, finite element analysis was used as a tool to classify these behaviors, and to improve our understanding of suture/tissue interactions.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of barbed sutures in skin and tendon tissues

Ingle

King

Zikry

2010

Journal of Biomechanics

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Section: Introductionmentioning

confidence: 99%

Finite element analysis of barbed sutures in skin and tendon tissues

Ingle

King

Zikry

2010

Journal of Biomechanics

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“…While this suture and associated patterns appear to increase the rate of healing, the suture itself has low retention and causes high secondary tissue damage when part of the suture fails. The delicate dermal tissue of juvenile Chinook salmon or the suture geometry may have influenced the appearance of secondary tissue damage [40]. Unlike monofilament suture, once a portion of the suture fails, the barbed suture can still remain functional and keep the incision closed, but subsequently increases secondary tissue damage.…”

Section: Discussionmentioning

confidence: 99%

Performance assessment of bi-directional knotless tissue-closure devices in juvenile Chinook salmon surgically implanted with acoustic transmitters

Woodley

Wagner

Bryson

et al. 2013

Animal Biotelemetry

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Background: Acoustic transmitters used in telemetry studies to assess fish migration and survival are often surgically implanted into the coelomic cavity of the fish. While intra-coelomic implantation is a well-established method, the surgical process and/or implanted device may affect the health, behavior and survival of the fish under investigation, thus affecting study results. Tag effect research has focused on minimizing the aforementioned effects and continues to look for novel solutions. The first use of bi-directional knotless (barbed) suture material in fish occurred in 2009 to close incisions in juvenile Chinook salmon (Oncorhynchus tshawytscha). The suture barbs eliminate the need for knots, thereby reducing surgical time and concomitantly anesthetic and handling time for the fish. The bi-directional knotless suture had higher transmitter retention compared to the monofilament material, which was in a simple interrupted pattern. However, the incisions closed with bi-directional knotless sutures had an increased occurrence of ulceration and erythema. The objective of this study was to refine the suturing patterns of the bi-directional knotless suture used in 2009 by altering the needle size and retest suture performance in juvenile Chinook salmon. We examined the effects from the bi-directional knotless suture using three different suture patterns and two needle lengths: 6-Point (12-mm needle length), Wide "N" (12-mm needle length), Wide "N" Knot 12 (12-mm needle length), and Wide "N" Knot 18 (18-mm needle length). Results: Using a performance rank index of observed metrics (mortality, transmitter expulsion, suture functionality, incision openness, ulceration and erythema), the Wide "N" Knot 12 suture pattern had an overall better performance than the other needle types and suture patterns. All needle types and suture patterns resulted in poor suture functionality by Day 14. The 6-Point, Wide "N" and Wide "N" Knot 18 treatments had no functional sutures by the end of the study; while the Wide "N" Knot 12 treatment had 33% functional sutures.

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“…Several surgery factors should be considered prior to use in field conditions. Tissue type and suture geometry can influence retention/loss of the bi-directional knotless tissue-closure device (Ingle and King 2010). When the sutures are embedded in tissue there are two primary modes of failure-peeling or bending of the barb.…”

Section: Discussionmentioning

confidence: 99%

“…Peeling occurs when the barb pulls away from the suture; bending occurs when the barb pulls back without breaking off. Bent barbs remain intact attached to the suture, but will eventually release from the surrounding tissue (Ingle and King 2010). A more flexible suture, barb geometry, or even number of barbs per suture may be required for better anchoring in juvenile Chinook salmon tissue.…”

Section: Discussionmentioning

confidence: 99%