title: Lapra-Ty holding strength and slippage with various suture types and sizes.
abstract: OBJECTIVE
  To investigate the holding strength and slippage of Lapra-Ty clips on various suture types and sizes.
  
  
  METHODS
  Using an automated materials testing system with the Lapra-Ty in a fixed position, Lapra-Ty holding strength and displacement were determined with 0, 2-0, 3-0, and 4-0 Vicryl, Monocryl, and polydioxanone suture (PDS). To simulate clinical application, Lapra-Tys were also tested by applying a load to these sutures after being passed through a full-thickness layer of tautly suspended fresh porcine bladder tissue. Three trials were performed with each suture type and size.
  
  
  RESULTS
  The Lapra-Ty holding strength with Vicryl suture was significantly higher than with Monocryl or PDS of the same suture size in bladder tissue trials. Monocryl suture had a significantly higher displacement than Vicryl or PDS of the same suture size in bladder tissue trials (except for 4-0 Monocryl and PDS having insignificantly different displacements). Lapra-Tys slipped off Vicryl, Monocryl, and PDS in 25%, 67%, and 67% of their respective trials. Lapra-Tys did not slip during any of the trials with 2-0 suture of any type or 3-0 Vicryl. Lapra-Tys with holding strengths on suture less than approximately 8 Newtons (N) slipped and greater than 8 N pulled through the bladder tissue without slipping.
  
  
  CONCLUSIONS
  The optimal suture type and size to maximize Lapra-Ty holding strength and minimize slippage was determined to be 2-0 and 3-0 Vicryl, 2-0 Monocryl, and 2-0 PDS. Monocryl suture stretches more than Vicryl and PDS at higher loads.
authors.affiliation: Department of Urology, Wilford Hall Medical Center, Lackland AFB, Texas 78236, USA. Kyle.weld@lackland.af.mil
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Weld
authors.forename: Jorge
authors.initials: J
authors.lastname: Arzola
authors.forename: Claudio
authors.initials: C
authors.lastname: Montiglio
authors.forename: Anneke C
authors.initials: AC
authors.lastname: Bush
authors.forename: R Duane
authors.initials: RD
authors.lastname: Cespedes
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D008422:Materials Testing; D016687:Polydioxanone; D011098:Polyglactin 910; D013537:Sutures; D013552:Swine; D013718:Tensile Strength; D001743:Urinary Bladder / Q000601:surgery; D013520:Urologic Surgical Procedures
chemical_list: D016687:Polydioxanone; D011098:Polyglactin 910