Absorbable Monofilament Suture Research Articles

Suture Granuloma following Ventral Herniorrhaphy

Skillful wound closure requires proper knowledge of the physical characteristics of the wound; knowledge of surgical technique; and familiarity with different types of needles, sutures, and instruments to use for a specific condition. Better randomized, double-blind, and controlled studies are needed to confirm that long-lasting absorbable monofilament sutures reduce the risk of suture erosion without increasing surgical failure. There seems to be enough evidence for surgeons to use long-lasting monofilament absorbable sutures instead of permanent sutures with their potential unfavorable consequences. This should help prevent repeated surgeries, and in the case described here could have potentially avoided three extra surgeries with significant reduction of morbidity.

In Vivo Assessment of Absorbable Knotless Barbed Suture for Single Layer Gastrotomy and Enterotomy Closure

AbstractObjectiveTo compare the performance of an absorbable barbed suture device to absorbable monofilament suture after single layer, appositional gastrotomy and enterotomy closure.Study DesignExperimental comparative study.AnimalsPurpose‐bred adult mongrel hounds (n = 14).MethodsBursting strengths up to 250 mmHg of incisional closure with either monofilament or barbed suture in a simple continuous, appositional pattern at sites in the stomach (2), jejunum (4), and colon (4) were compared at postoperative Days 3, 7, and 14. Time for incisional closure was compared between materials.ResultsBursting strength was not significantly different between gastrotomies/enterotomies closed with the monofilament suture or the barbed device. Closure time was significantly reduced with the barbed device in jejunal enterotomy closure.ConclusionThe barbed device compared favorably with monofilament suture for gastrotomy and enterotomy (small intestine, colon) closure. Results demonstrate comparable burst strengths between monofilament suture and the barbed device. Closure time was significantly reduced in jejunum closure using the barbed device.

Hand-sewn gastrojejunostomy using knotless unidirectional barbed absorbable suture during laparoscopic gastric bypass

This report describes the authors' institutional experience using knotless unidirectional barbed absorbable suture to close the common enterotomy of the jejunojejunostomy (JJ) and to create a hand-sewn gastrojejunostomy (GJ) during laparoscopic Roux-en-Y gastric bypass. A retrospective review of morbidly obese patients who underwent laparoscopic gastric bypass with a hand-sewn GJ between April 2011 and 2012 was performed. The authors' traditional technique (TT) consisted of using standard monofilament absorbable suture to close the common JJ enterotomy in a single running layer and to create the GJ with a two-layer anastomosis. A novel technique (NT) was introduced using knotless unidirectional barbed monofilament absorbable suture to perform both tasks. A comparison between these two techniques was performed. In this study, 84 patients with a mean body mass index of 41.7 ± 4.7 kg/m(2) underwent laparoscopic gastric bypass using a hand-sewn technique. For the 84 patients, 75 primary procedures (89.3 %) and 9 revisional procedures (10.7 %) were performed. In 38 procedures (45.2 %), the TT was used, whereas 46 cases (54.8 %) were managed using the NT. For the primary procedures, the average operating room times were slightly faster in the NT group (178.9 ± 44.4 vs 154.2 ± 74.7 min; p = 0.08). The average hospital length of stay was comparable between the two groups (2.3 ± 0.7 vs 2.6 ± 1.4 days; p = 0.25). A 30-day follow-up assessment was obtained for all 84 patients, without a significant difference in the overall complication rate between the two groups (TT 18.4 % vs NT 13 %; p = 0.77). No complications were secondary to the JJ closure or gastrojejunostomy. The complications included bleeding (n = 1), small bowel obstruction (n = 1), dehydration (n = 2), esophagitis (n = 1), and subarachnoid hemorrhage (n = 1). No anastomotic leak or stenosis occurred in either group. The mean percentage of excess weight loss at 1 month was 21.3 % ± 5.4 %, without a significant difference between the two groups. In the study cohort, the use of knotless unidirectional barbed suture instead of traditional monofilament absorbable suture had similar 30-day outcomes and appears to be a feasible option for laparoscopic bowel closure and anastomosis creation.

A comparison of 2 methods of vaginal cuff closure during robotic hysterectomy

ObjectiveTo compare 2 methods of vaginal cuff closure with regard to safety, ease of use, and postoperative outcome. MethodsAll patients undergoing robotic-assisted total hysterectomy by a gynecologic oncologist from July 1, 2010, to July 1, 2011, at Northwestern Memorial Prentice Women's Hospital were included in a retrospective analysis. Providers used either 2–0 monofilament synthetic absorbable suture to close the vaginal cuff in a running fashion, secured with an absorbable suture clip at the angles and then knotted in the middle, or 2–0 absorbable unidirectional barbed suture with a welded-loop closure in a running fashion. ResultsA total of 134 patients underwent robotic-assisted total hysterectomy. The 2–0 tied monofilament closure was used in 58 patients, and the 2–0 barbed knotless closure was used in 76 patients. There were no instances of vaginal cuff dehiscence or vaginal cuff cellulitis. Rates of vaginal spotting and bleeding were comparable between the groups (12.0% spotting in the monofilament suture group vs 13.0% spotting in the barbed suture group). All vaginal cuff bleeding resolved on its own without significant intervention. ConclusionThe use of either a 2–0 welded-loop unidirectional barbed suture or a 2–0 monofilament absorbable suture to close the vaginal cuff is safe and well tolerated.

The Influence of Absorbable Subcuticular Staples, Continuous Subcuticular Absorbable Suture, and Percutaneous Metal Skin Staples on Infection in Contaminated Wounds

Wound infection is a threatening, troublesome, and costly complication contributing to increased mortality and morbidity. The methods and materials used to close a wound significantly influence the quality of the repair process and the risk of surgical site infection. Six pigs were used to evaluate the influence of four separate skin-closure modalities on the potentiation of infection in contaminated wounds. Full-thickness skin wounds on the abdomen were contaminated with S. aureus and then closed with one of four devices: a novel absorbable staple (InsorbTM) placed in the subcuticular tissue; a braided absorbable suture (VicrylTM); a monofilament absorbable suture (MonocrylTM); percutaneous metal staples. Wound infection was assessed 7 days after closure by clinical signs and quantitative bacterial swabs. InsorbTM staples had significantly lower infection rates than continuous VicrylTM (39% vs. 100%, p=0.002) or MonocrylTM suture (39% vs. 89%, p=0.014). The InsorbTM subcuticular staple and the metal percutaneous skin staple were statistically equivalent in wound infection rate and parameters of inflammation. The combined data for both interrupted staple modalities documented less inflammation compared to the combined data for continuous sutures. These lower levels of inflammatory metrics were statistically significant for edema (p=0.018), gauze exudate observed (p=0.007) and purulent exudate in wound (p<0.0001). In conclusion, InsorbTM staples were shown to be an acceptable choice for the closure of contaminated wounds because they had a significantly lower incidence of wound infection and inflammation when compared to continuous intradermal suture.

The Effects of Demineralization Process on Diameter, Tensile Properties and Biodegradation of Chitosan Fiber

Chitosan fiber is one of the potential fibers that can be used as absorbable monofilament suture in biomedical application. In chitosan synthesis, aside from deproteination and deacetylation, demineralization is a crucial step where the major minerals within crustacean shells are removed. This demineralization process is carried out with two parameters, i.e. time and temperature. This research studies the influence of demineralization time on the diameter, tensile properties and biodegradability of chitosan fibers. Chitosan was synthesized from shrimp shells using 1 × 2h and 3 × 2h demineralization process. Chitosan fibers were produced by means of wet spinning. The chemical properties of chitosan fibers were characterized by means of Fourier Transform Infrared (FTIR) spectroscopy and X-Ray Diffractometry (XRD) technique. Physical properties characterization was carried out to measure the fibers’ diameter, density and viscosity. Tensile properties were evaluated by means of tensile test. The results were compared to standard of absorbable suture from the United States Pharmacopoeia (USP). Furthermore, in vitro degradation testing was also performed for analyzing biodegradation properties. Chitosan fibers were successfully made with diameter and maximum tensile force of chitosan fibers in a range of 364 - 460μm and 5.6 - 8.3N, respectively. The results of this research pointed that adding demineralization time would increase the diameter of chitosan fiber. However, the degradation occurred in prolonged demineralization process broke the bonds within the fiber which lead to a decrease in fiber's density. It is due to the degradation of chitosan occurred during extended demineralization process, which leads to degree of crystallinity reduction. Extensive demineralization process has been found to lower fibers’ tensile strength from 80.4MPa to 38.4MPa (52.2%), but increase their biodegradability by 17% and maximum elongation from 6.9% to 16.2% (136%). Despite that extensive demineralization process lowered chitosan fiber's tensile strength, both fibers made could still fit the standard for synthetic absorbable suture from USP number 0 and 1.

MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate

A long-term absorbable monofilament suture was developed using poly-4-hydroxybutyrate (P4HB) made from a biosynthetically produced homopolymer of the natural metabolite 4-hydroxybutyrate. The suture, called MonoMax, has prolonged strength retention. At 12 weeks, a size 3-0 MonoMax suture retains approximately 50% of its initial tensile strengthin vivoand is substantially degraded in one year with minimal tissue reaction. In contrast, PDS II monofilament suture (Ethicon, Inc., Somerville, NJ) has no residual strengthin vivoafter 12 weeks.In vivo, the MonoMax suture is hydrolyzed primarily by bulk hydrolysis, and is then degraded via the Krebs cycle. MonoMax is substantially more compliant than other monofilament sutures, and incorporates an element of elasticity. Its tensile modulus of 0.48 GPa is approximately one-third of the value of the PDS II fiber providing an exceptionally flexible and pliable fiber with excellent knot strength and security. These features are further enhanced by the fiber's elasticity, which also improves knot security and may help prevent wound dehiscence. Because of its performance advantages, this suture may find clinical utility in applications where prolonged strength retention, and greater flexibility are required, particularly in procedures like abdominal wall closure where wound dehiscence is still a significant post-surgical complication.

An investigation of the fixation materials for cartilage frames in microtia

When performing auriculoplasty for microtia surgery, wires are typically used to fix the costal cartilage frames. However, cases in which such wires become exposed during a long-term follow-up were frequently observed at our facility. Hence, using various materials, we conducted an investigation of the materials most suitable for fixation. The subjects consisted of 122 cases in which auriculoplasty by costal cartilage graft surgery was performed and the postoperative course was traceable, within approximately 24 years from January 1984 to March 2007. Regarding the fixation materials used in the 84 cases in which wire was used, 5 cases used monofilament non-absorbable sutures (Nylon(®)), 5 cases used monofilament absorbable sutures (PDS(®)), and 28 cases used braided absorbable sutures(VICRYL(®)).Their postoperative course was investigated, and the presence of auricular deformities caused by a loosening of the fixation materials and the exposure of the fixation materials was examined. An exposure of the wire was observed in 19 cases (22.6%) of the 84 cases that used wires. An exposure of nylon was observed in 2 (40%) of 5 the cases that used nylon, and of those, a mild deformation was observed in the lower helix in one case that was suspected to have been caused by a loosening of the surgical suture. Regarding the 33 cases in which absorbable sutures were used (5 cases used monofilament absorbable sutures and 28 cases used braided absorbable sutures), neither any auricular deformities nor exposure of the fixation materials was observed in any of the cases. Whether using monofilament or braided sutures, absorbable sutures are therefore believed to be the most suitable material for the fixation of cartilage.

Bronchoplastic Operation Using a Continuous Anastomosis for Mucous Gland Adenoma

Mucous gland adenoma is an uncommon tumor that seems to be truly benign, and parenchyma-saving bronchoplastic operations are feasible. We applied a continuous anastomosis using an absorbable monofilament suture for bronchoplasty to treat mucous gland adenoma in the segmental bronchus. Continuous anastomosis is easy, quick, and safe, needing fewer knots. Continuous anastomosis for segmental bronchi is an efficient technique, and no stenosis or stricture occurred in this case.

Spontaneous prelabor uterine rupture in a primigravida: a case report and review of the literature

A rare case of prelabor uterine rupture in a primigravida was reported. A woman with a history of uterine perforation during hysteroscopy became pregnant after donor oocyte in vitro fertilization. To provide more insight into the possible risk factors for prelabor uterine rupture in primigravidae, a literature review was performed.

Uterosacral ligament vaginal vault suspension using delayed absorbable monofilament suture

We investigated the incidence of suture complications and recurrent prolapse following uterosacral ligament suspension (USLS) using delayed absorbable polyglyconate monofilament suture (Maxon). We reviewed the medical records of subjects who underwent vaginal USLS using polyglyconate suture. Primary outcomes were suture complications and anatomic failures defined as recurrent apical prolapse stage 1 or greater. Secondary outcomes were subjective failures and reoperation rate for apical prolapse. Fifty-seven out of 68 subjects who underwent USLS with polyglyconate suture over the study period were included in analysis. At median follow-up of 12 months, 3.5% had suture complications. The anatomic and symptomatic failure rate was 7%. One subject underwent repeat surgery for prolapse. Suture complications are uncommon using polyglyconate suture for USLS, and failure rates are low. This is in comparison to a 44.6% suture erosion rate with permanent suture reported by our institution using the same surgical technique.

Optimum suture material for locking technique in tendon repair: Effects of suture friction in mobilization

BackgroundThe 2-strand side-locking loop technique allows secure locking formation easily, yielding maximum tensile force. However, not all suture materials are suitable for this technique. MethodsThe bovine gastrocnemius tendons were transected and repaired end-to-end by the side-locking loop technique using USP2 braided polyblend, braided polyester, monofilament nylon, braided nylon, or monofilament absorbable polydioxanone sutures. A repetitive loading protocol from 10N to 100N was used, and the loading was repeated 10,000 times. In ruptured samples during the repetitive loading test, the number of loading was recorded. In samples which did not rupture, the ultimate tensile strength was measured after repetitive loading. After testing, ruptured sutures were examined microscopically. For comparison of ultimate tensile strength before and after repetitive loading, we performed a one-time loading test on samples which did not undergo the repetitive loading. FindingsWith monofilament nylon, braided nylon, or monofilament absorbable polydioxanone, suture rupture occurred during repetitive loading. In contrast, no suture rupture occurred with braided polyblend or braided polyester. Microscopic observation showed abrasion of the surface in braided polyester, though the friction effects were not seen with braided polyblend. The mean ultimate tensile strength before and after repetitive loading was 395N and 399N, respectively, for braided polyblend. For braided polyester, they were 208N and 174N, respectively. InterpretationBraided polyblend suture material has an excellent resistivity to friction and is suitable for the side-locking loop technique.

An In Vivo Comparison of Barbed Suture Devices and Conventional Monofilament Sutures for Cosmetic Skin Closure Biomechanical Wound Strength and Histology

Very little biomechanical or histological data exist in the peer-reviewed literature comparing absorbable monofilament sutures to commercially-available knotless, absorbable barbed suture devices for cosmetic closure of skin incisions. The authors compare two commercially-available knotless, barbed suture devices against a conventional monofilament suture in a porcine model for biomechanical wound strength and histological quality of healing. This prospective randomized trial included 18 animals randomly assigned among three groups, with six in each. A total of 192 incisions were closed in a porcine in vivo model and assessed for biomechanical strength and histology at postoperative Days 0, 3, 10, and 21. Each animal received all three test devices in a randomized, three-way matched design. Immediately following euthanasia, the skin incisions were excised for ex vivo biomechanical testing. In the ex vivo analysis, Biosyn proved significantly stronger than the V-Loc 90 device at Day 0 and Quill Monoderm at Day 3. At no time point was there any difference in biomechanical strength between the two barbed suture devices. Differences in barb geometry, barb number, and helicity between the two barbed suture devices resulted in failure modes that were significantly different. All three test articles resulted in mild tissue reaction scores on histology. The V-Loc 90 device consistently had the lowest tissue reaction scores at all time periods, with the difference between the V-Loc 90 device and Quill being significant at postoperative Day 10. Knotless, absorbable barbed suture devices are a safe and efficacious alternative for cosmetic skin closures and yield wound strength and tissue reaction scores that are comparable to those from closures performed with absorbable monofilament sutures and secured with knots.

Prevention of incisional hernia by mesh implantation after median laparotomy: a preclinical trial

BACKGROUND: Mesh implantation by median laparotomy is believed to reduce the rate of incisional hernia. The present study was performed to determine the types of meshes and fixation that would provide the required reinforcement of the midline. METHODS: Median laparotomies were performed on 17 recently deceased cadavers. By the onlay technique, 6 different meshes were fixed by the following methods: Tissucol Duo Quick, ProGrip, A.M.I. EasyTack, AbsorbaTack, ProTack, continuous absorbable monofilament suture fixation using 4-0, 3-0, 2-0, 0, 1 (PDS). Tensile forces were applied to the meshes, using a tensiometer, until mesh ablation or mesh disruption. RESULTS: With regard to the suture fixations, retention strength increased in direct proportion to thread thickness. All other fixation techniques failed to achieve the stipulated fixation strength of 40 Newton. CONCLUSIONS: By continuous suture fixation and by using the onlay technique, a mean mesh stability of 58 N in tissue can be achieved with at least 3-0 sutures. In addition to its simple applicability, this fixation method is economical and may be recommended for clinical use in order to achieve prophylactic reinforcement of the midline.

Surgical implantation techniques for electronic tags in fish

Intracoelomic implantation of transmitters into fish requires making a surgical incision, incision closure, and other surgery related techniques; however, the tools and techniques used in the surgical process vary widely. We review the available literature and focus on tools and techniques used for conducting surgery on juvenile salmonids because of the large amount of research that is conducted on them. The use of sterilized surgical instruments properly selected for a given size of fish will minimize tissue damage and infection rates, and speed the wound healing of fish implanted with transmitters. For the implantation of transmitters into small fish, the optimal surgical methods include making an incision on the ventral midline along the linea alba (for studies under 1 month), protecting the viscera (by lifting the skin with forceps while creating the incision), and using absorbable monofilament suture with a small-swaged-on swaged-on tapered or reverse-cutting needle. Standardizing the implantation techniques to be used in a study involving particular species and age classes of fish will improve survival and transmitter retention while allowing for comparisons to be made among studies and across multiple years. This review should be useful for researchers working on juvenile salmonids and other sizes and species of fish.

Technical modifications in the robotic-assisted surgical approach for gynaecologic operations.

To investigate the development of new technical approaches for improving the implementation of robotics in gynaecologic surgery, we conducted a prospective evaluation of five technical modifications developed during the implementation of a robotics program that included 171 robotic endometrial staging procedures from December 2007 until May 2010. Modification of the use of a Hohl uterine manipulator by applying only the intravaginal component minimizes the theoretical risk of spillage of endometrial cancer cells, without losing the capability of delineating the vaginal fornices. Entry to the peritoneal cavity under visual control using a left upper quadrant approach and a 5-mm endoscope through a 5-mm Endopath(®) trocar is quick and decreases the risk of bowel or vessel injury. Use of 12-mm Endopath(®) trocars with blunt tips without closure of the fascia was not associated with post-operative hernias. Positioning the DaVinci(®) Surgical System at a 30° angle at the side of the patient allows easy access to the vagina for removal of large surgical specimens and does not interfere with proper movements of the robotic arms. Use of a tissue specimen bag introduced via the vagina at completion of surgery allows removal of large uteri vaginally to avoid (mini-)laparotomy and its morbidities. Finally, suturing of the vault using interrupted delayed absorbable monofilament sutures was not associated with vaginal cuff dehiscence. Early evaluation of evolving minor technical and surgical approaches was associated with low morbidity, and appears to benefit patients undergoing robotic surgery for gynaecologic cancers.

A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury

BackgroundLong-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence.MethodsIn a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]).ResultsAn anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group).ConclusionsA modified suturing technique was followed by significant improved one-year symptoms of anal incontinence as compared to historical cases.

Extraperitoneal transvaginal myomectomy

OBJECTIVE: To prevent postoperative peri-uterine adhesions caused by the stitches and blood clots on the surface of the uterine serosa after myomectomy, the feasibility and safety of an extraperitoneal transvaginal approach was investigated. DESIGN: Experimental study. MATERIALS AND METHODS: Uterine myomas planned for myomectomy were scanned by ultrasonography for its number and locations. Trans-abdominal and/or transvaginal ultrasonography was used to map the myoma locations. Myomas less than 2 in number and not pedunculated subserosal or submucous myomas were included. An anterior or posterior colpotomy incision was made. Dissection was done into the myometrium toward the myoma without entering into the peritoneal cavity. The myoma was morcelated and removed. The dead space of the myomectomy site was closed with 1-0 absorbable monofilament suture. RESULTS: Six cases of uterine myoma with size ranging from 6 to 15 cm was removed by a transvaginal extraperitoneal route. The myoma weighed from 80 to 650gm. The operation time was 40 minutes to 95 minutes. The blood loss was 50 to 320ml. The postoperative hospital stay was 1 day in all cases. No complication was found. CONCLUSION: In optimally selected cases, the transvaginal extraperitoneal myomectomy is safe and practical. This approach exempted from the rough uterine surface, which is inevitable during a traditional transserosal myomectomy, thus decreases the possibility of periuterine adhesions.

Absorbable Suture Made from Rice Starch

The main objective of this work is to make an absorbable monofilament suture from Thai rice starch. The improvement of the mechanical properties of Thai rice starch polymer films were achieved by addition of small amount of gelatin, carboxymethylcellulose (CMC) and carbon nanopowders. The carbon nanopowders were produced from coconut shell in our laboratory room by milling method. The incorporation of carbon nanopowders with a high aspect ratio and/or an extremely large surface area into Thai rice starch polymer films improves their mechanical performances significantly. Additionally, the black color from carbon nanopowder is easily visualized in tissue during surgery. The manufacturing processes are very simple by blending of the raw materials in hot water and then dry heating in electric oven. The final product was characterized of microstructures and mechanical properties. The resulting Thai rice starch-carbon nanocomposites possess several advantages for manufacture of sutures: 1. high water resistance that can be uses in the human body. 2. high mechanical strength that appropriate to manufacture of sutures. 3. biocompatibility and bioabsorbable. 4. low cost. 5. Eco-friendly green nanocomposites. However, the method of size designation of sutures fibers and needle attachment are the problem which restricts our suture in really applications. The investigation of knowledge and simple technology of manufacture of suture and needle attachment will be performed.

Performance Assessment of Suture Type, Water Temperature, and Surgeon Skill in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters

AbstractThis study assessed performance of seven suture types in subyearling Chinook salmon Oncorhynchus tshawytscha implanted with acoustic microtransmitters and held at two water temperatures (12°C and 17°C). Nonabsorbable (Ethilon) and absorbable (Monocryl) monofilament sutures and nonabsorbable (Nurolon and silk) and absorbable (Vicryl, Vicryl Plus, and Vicryl Rapide) braided sutures were used to close incisions in Chinook salmon. When differences existed among suture types, tag and suture retention were generally highest for monofilament sutures. Wound inflammation and ulceration were generally lower for Ethilon and Monocryl than for most of the braided sutures. In this study, Nurolon (braided) often resulted in low wound inflammation and ulceration, although suture retention was poor. Generally, fish held in 12°C water had more desirable postsurgery healing characteristics (i.e., higher tag and suture retention; lower incision openness, wound inflammation, and ulceration) at 7 and 14 d postsurgery than fish held in 17°C water. On days 34 and 63, tag retention remained high among fish in 12°C water, while suture retention decreased dramatically in both water temperatures. We found a significant effect of surgeon on tag and suture retention, wound inflammation and ulceration, and incision openness. Surgeons in this study were initially thought to have similar surgical proficiency based on their extensive previous experience. However, surgeons who had received feedback on their previous surgical technique performed better in this study. Results indicate that surgical training (i.e., feedback) and perhaps aptitude, rather than surgeon experience alone, may be as important as suture type in influencing the retention of sutures and tags. The overall results support the conclusion that Monocryl is the best suture material for closing incisions created during surgical implantation of acoustic microtransmitters in subyearling Chinook salmon. Future research should include testing different suturing patterns and knotting techniques as well as the number of knots required for different incision lengths.