How to close a colpotomy? Barbed suture and conventional suture effects on soft tissue: an ex vivo pilot study.
OBJECTIVE
To evaluate the effects of different suture materials and techniques on soft tissue in relation to defined tensions and time points.


METHODS
Two bovine intestine samples, 4 × 4 cm size and ~3 mm thickness, were adapted with interrupted and continuous techniques using three types of suture materials: Vicryl (polyglactin 910), PDS II (polydioxanone), and V-Loc 180 (knotless, barbed polyglyconate). Four stitches or loops 9 mm apart with three knots, and 10 mm end length were performed by one gynecologist. Forces were applied from 6 newtons (N) to 14 N continuously. Outcome measures included breakage of tissue, tearing of thread, and shortening of the end length of thread. They were evaluated immediately and then at first, third, and fifth minute.


RESULTS
Tissue breakage using No. 3/0 suture materials appears in the applied force from 10 N. polydioxanone causes more tissue tearing than polyglactin 910. The least to withstand tension is knotless polyglyconate. Interrupted stitches hold the sutured sites better than continuous stitches in all groups of threads. Shortening of the knotless polyglyconate end length by half took place with 6 N force.


CONCLUSIONS
Simulating reparation of colpotomy, the ex vivo study supports that polyglactin 910 appears better in holding soft tissue than polydioxanone and knotless polyglyconate.
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. bananachenge@yahoo.com
Chenchit
C
Chayachinda
Andreas
A
Hackethal
Hans-Rudolf
HR
Tinneberg
D000818:Animals; D002417:Cattle; D020884:Colpotomy / Q000379:methods*; D005260:Female; D006801:Humans; D007422:Intestines / Q000601:surgery; D010865:Pilot Projects; D016687:Polydioxanone / Q000627:therapeutic use; D011098:Polyglactin 910 / Q000627:therapeutic use; D011108:Polymers / Q000627:therapeutic use; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome
D011108:Polymers; D016687:Polydioxanone; D011098:Polyglactin 910; C046409:polyglyconate