Scientific articleBiomechanical Evaluation of Flexor Tendon Repair Using Barbed Suture Material: A Comparative Ex Vivo Study
Section snippets
Materials and Methods
We randomly separated 60 human flexor digitorum tendons into 4 groups and sutured them with either a modified 2-strand (groups A and B) or 4-strand (groups C and D) Kirchmayr-Kessler technique. For groups A and C, an absorbable, monofilament polydioxane suture was used (PDS 3-0; Johnson & Johnson Medical GmbH, Norderstedt, Germany). In groups B and D we used an absorbable, unidirectional, barbed glycolic-carbonate suture material (V-Loc 3-0; Covidien Deutschland GmbH). In the case of the
Results
The repairs of the knotted, 2-strand polydioxane technique and both 4-strand techniques failed in terms of suture breakage. The repairs of the knotless, 2-strand barbed suture technique failed with suture pullout. The comparison between the knotted, 2-strand polydioxane and the knotless, 2-strand barbed suture technique showed a significantly reduced value at the ultimate load (p < .001). With the 4-strand-techniques, a markedly higher maximum force was achieved when compared with the 2-strand
Discussion
Early mobilization after repairing tendon injuries is desired, as this promotes the intrinsic healing response of lacerated flexor tendons20, 21, 22 stimulation, adhesion reduction,23 and an overall improved clinical result.24, 25
To improve the biomechanical conditions, various suture materials and methods are used. Absorbable suture materials for flexor tendon tenorrhaphy are under consideration, as several authors have suggested that appropriate absorbable suture materials can be used safely
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The authors thank Melanie Henle for support. The work was done at the Wuerzburg University Hospital/Germany, Department of Trauma, Hand, Plastic and Reconstructive Surgery.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.