Abstract
Objectives: To evaluate the safety and efficacy of a commercially available absorbable barbed suture device in double-layer gastrotomy closure in a dog model. Methods: In this experimental comparative study a gastrostomy was performed in 12 adult healthy mongrel dogs (divided into two groups A and B). The stomach was closed using polyglactin 910 (Vicryle, Ethicon) suture in group A and using absorbable barbed suture (Stratafex, Ethicon) in group B. Results: Polyglactin 910 suture produced a more inflammatory reaction around the wound which caused a delay in gastric wound healing and gastric motility as well as gastric emptying time. The ultrasonographic examination revealed a significant increase in gastric wall thickness in group A compared to group B and a highly significant decrease of gastric contraction in group A in comparison to group B. Gastric closure time was significantly shorter in group B than in group A. No postoperative complications or deaths were observed in both groups. Conclusion: Absorbable barbed suture was recommended in gastric surgery as it is minimizing the time of gastric closure and optimizing the healing of the wound with faster returning of the stomach to its normal function.
Highlights
Suturing with knot-type sutures is increasingly more challenging (Thanakumar and John, 2011)
Absorbable barbed suture was recommended in gastric surgery as it is minimizing the time of gastric closure and optimizing the healing of the wound with faster returning of the stomach to its normal function
Barbed suture devices have been evaluated in various kinds of surgery; (Greenberg and Goldman, 2013; Manoucheri and Einarsson, 2013; Einarsson et al, 2011; Shah et al, 2012; de Blacam et al, 2012; Warner and Gutowski, 2009) less is known about general surgery (Manigrasso et al, 2019)
Summary
Suturing with knot-type sutures is increasingly more challenging (Thanakumar and John, 2011). The supposed advantages of knotless barbed sutures over traditional sutures are short operative time, maximum apposition, less wound dehiscence as the tension is uniformly distributed along the length of the wound, improved wound healing due to decrease of ischemia, and less suture extrusion (Murtha et al, 2006; Matarasso and Pfeifer, 2008; Villa et al, 2008; Paul, 2009; Rosen, 2010; Ruff, 2013) These suture devices are designed with an end loop permitting the suture needle to be passed through the loop after the first tissue bite. A knotless barbed suture device has been proposed to make the internal sutures easier, but there are only a few studies in the literature that propose its use for intestinal anastomosis (Lee et al, 2011; Facy et al, 2013; Tyner, et al, 2013)
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