Sutures in abdominal surgery: biomechanical study and clinical application

Abstract

<jats:title>Abstract</jats:title><jats:p>The aim of this study is to improve treatment results and SSI prevention by differential usage of the contemporary suture materials and choice of proper suturing technique. To simulate suturing process and compared two suturing techniques, two FE models were developed. Finite-element analysis (FEA) was based on experimental data of contemporary commercial sutures and soft tissue properties. We applied obtained results for abdominal wall closure in rats and compared non-absorbable suture (capron) with absorbable suture (PDS Plus) for chosen technique. Cross-sections were examined by lighting electron microscope. Afterwards, the results of patients’ treatment are also presented. It was shown that running sew was more appropriate for aponeurosis suturing compared to interrupted sew. The optimal parameters of suturing techniques were computed. Single-row running sew by PDS Plus was proved to hold wound edges for 90 days with less inflammatory response compared to other suture in the result of histological analysis. Application of contemporary synthetic absorbable suture materials with antibacterial coating for laparotomic wounds closure and anastomosis decreases local inflammatory reaction and provides the successful tissue regeneration. Application of advanced SSI prophylactics algorithm was shown to decrease risk of post-operative suppurative complications from 14.2 to 1.6 %.</jats:p>

A virtual simulation approach to assess the effect of trocar-site placement and scar characteristics on the abdominal wall biomechanics

“…A wide variability in the mechanical properties of wounds can be found in the literature. For example, Ibrahim et al 15 reported E values of a few kPa for uninjured human skin, whereas Samartsev et al 16 obtained elastic moduli of a few GPa in their experiments with sutured samples. In the current study, we performed simulations within a wide range of E values for the SWs, namely 0.1 MPa ≤ E w ≤ 10,000 MPa.…”

“…In the current study, we performed simulations within a wide range of E values for the SWs, namely 0.1 MPa ≤ E w ≤ 10,000 MPa. The Poisson ratio for SW tissue was set to ν w = 0.40 16 .…”

Abdominal wall augmentation techniques used in complex postincisional hernias repair

“…The posterior rectus sheath is reapproximated in the midline with a running absorbable suture. [23]. The mesh is placed in the retromuscular space and secured with transabdominal permanent sutures and is covered by reapproximation of the anterior sheath in the midline.…”