Use of polyglyconate suture in paediatric gastrointestinal anastomosis.
The perfect suture has been defined, but in certain circumstances some features are more important than others. In paediatric gastrointestinal surgery lack of tissue drag is of great importance. Because the life expectancy of most paediatric patients having gastrointestinal operations is measured in many decades, and the long-term effects of retained suture materials are relatively undocumented, absorbability is also of importance. A polyglyconate copolymer suture (Maxon, Davis & Geck, Gosport, UK) has undergone trial. It is a monofilament absorbable suture. It has a low coefficient of friction, very low tissue drag and is stronger (straight pull and knot strength) than corresponding gauges of braided synthetic absorbable sutures. It is slowly absorbed, its half life (in relation to strength) being 5 weeks and complete disappearance occurring in 6-7 months. The trial was prospective and randomized. All members of the Department of Surgery at the Children's Hospital, Camperdown participated. Sixty-five anastomoses were performed in 56 patients. All varieties of joins were performed (oesophageal, duodenal, small and large bowel, and biliary-enteric). There were no statistically significant differences in the result in terms of outcome and complications. Overall handling and tissue drag were assessed by the surgeon at the end of the operation on a visual analogue scale and analysis of these results showed no significant difference in overall handling, but significantly less tissue drag (unpaired t-test). It is concluded that Maxon is superior to other currently available sutures for paediatric gastrointestinal surgery.
Martin
H C
HC
Department of Surgery, Children's Hospital, Camperdown, New South Wales, Australia.
Motbey
J
J
D000714:Anastomosis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D013505:Digestive System Surgical Procedures; D005500:Follow-Up Studies; D006801:Humans; D011108:Polymers; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013536:Suture Techniques / Q000706:statistics & numerical data; D013537:Sutures / Q000706:statistics & numerical data
D011108:Polymers; C046409:polyglyconate