• G A Dumanian, A Tulaimat, and Z P Dumanian.
• Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
• Br J Surg. 2015 Sep 1; 102 (10): 1285-92.

BackgroundThe failure of sutures to maintain tissue in apposition is well characterized in hernia repairs. A mesh suture designed to facilitate tissue integration into and around the filaments may improve tissue hold and decrease suture pull-through.MethodsIn vitro, the sutures were compared for resistance to pull-through in ballistics gel. In vivo, closure of midline laparotomy incisions was done with both sutures in 11 female pigs. Tissue segments were subsequently subjected to mechanical and histological testing.ResultsThe mesh suture had tensile characteristics nearly identical to those of 0-polypropylene suture. Mesh suture demonstrated greater resistance to pull-through than standard suture (mean(s.d.) 4.27(0.42) versus 2.23(0.48) N; P < 0.001) in vitro. In pigs, the ultimate tensile strength for repaired linea alba at 8 days was higher with mesh suture (320(57) versus 160(56) N; P < 0.001), as was the work to failure (24.6(14.2) versus 7.3(3.7) J; P < 0.001) and elasticity (128(9) versus 72(7) N/cm; P < 0.001) in comparison with 0-polypropylene suture. Histological examination at 8 and 90 days showed complete tissue integration of the mesh suture.ConclusionThe novel mesh suture structure increased the strength of early wound healing in an experimental model. Surgical relevance Traditional sutures have the significant drawback of cutting and pulling through tissues in high-tension closures. A new mesh suture design with a flexible macroporous outer wall and a hollow core allows the tissues to grow into the suture, improving early wound strength and decreasing suture pull-through. This technology may dramatically increase the reliability of high-tension closures, thereby preventing incisional hernia after laparotomy. As suture pull-through is a problem relevant to all surgical disciplines, numerous additional indications are envisioned with mesh suture formulations of different physical properties and materials.© 2015 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

17 keywords...

hide…