Abstract
Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials.
Highlights
Hand injuries are one of the most frequent forms of trauma
Braided Sutures of Spider Silk Spider silk could be used to create sutures with different strand compositions. These silk sutures were prepared as polyfil threads consisting of up to 6 strands braided by a designed braiding apparatus [23]
Single fibres are clearly visible in regularly intertwined bundles
Summary
Hand injuries are one of the most frequent forms of trauma. More than one third of all professional accidents result in hand injuries [1,2]. The injuring of flexor tendons is problematic and often results in such functional disorders as necrosis and adhesions caused by connective tissue and capillary revascularisation. After the application of optimal surgical techniques and earlyfunctional training with Kleinert splints [2,3], the use of surgical sutures often causes problems. Decrease in tensile strength, cause foreign body reactions, and encourage infections [2,4]. Tendon tissue is characterised by high strength, elasticity, and plasticity; low strain (5–10%); and a failure stress of approximately 60–120 MPa [5,6]. Force-strain curves show a characteristic, curve progression that is first almost exponential and becomes nearly linear [6,7]
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