title: New technology applications: Knotless barbed suture for tracheal resection anastomosis.
abstract: OBJECTIVE
  Tracheal resection anastomoses are often under tension and can be technically challenging. New suture materials such as V-loc (barbed, knotless wound closure device) may offer advantages over conventional methods. The objective of this study is to determine if a running V-loc suture is of comparable tensile strength to conventional closure.
  
  
  METHODS
  Laboratory based study of human cadaveric tissue.
  
  
  METHODS
  Fresh human cadaveric tracheas were dissected and incised into segments. Anastomosis of adjacent segments was then performed with either submucosal interrupted 3-0 Vicryl, or a running submucosal 3-0 V-loc suture. Anastomosed specimens were stretched to failure on an Instron force tension machine. Surgeon satisfaction was recorded by visual analog scale (VAS).
  
  
  RESULTS
  The tensile strength of 12 tracheal anastomoses was tested. Video documentation of V-loc suture technique and anastomosis failure was recorded. In both Vicryl (80%) and V-loc (100%) anastomoses, failure occurred at the membranous intercartilaginous region. In 20% of the Vicryl anastomoses, the suture was noted to break prior to tissue failure. Anastomoses with V-loc suture had equivalent failure force (mean, 59 N) compared to interrupted Vicryl (51 N), with P = .57. On VAS, surgeons were more satisfied with V-loc suture closure compared to interrupted Vicryl closure (paired t test, P = .003).
  
  
  CONCLUSIONS
  Tracheal anastomosis with running v-loc suture is a feasible alternative to conventional closure with interrupted Vicryl suture. V-loc suture provided a surgical advantage by improved ease of use.
authors.affiliation: Department of Otolaryngology and Center for Voice, Airway, and Swallowing Disorders, Georgia Health Sciences University, Augusta, Georgia, USA.
authors.forename: Carrie M
authors.initials: CM
authors.lastname: Bush
authors.forename: John D
authors.initials: JD
authors.lastname: Prosser
authors.forename: Michele P
authors.initials: MP
authors.lastname: Morrison
authors.forename: Guri
authors.initials: G
authors.lastname: Sandhu
authors.forename: Karl H
authors.initials: KH
authors.lastname: Wenger
authors.forename: David H
authors.initials: DH
authors.lastname: Pashley
authors.forename: Martin A
authors.initials: MA
authors.lastname: Birchall
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Postma
authors.forename: Paul M
authors.initials: PM
authors.lastname: Weinberger
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D002102:Cadaver; D004867:Equipment Design; D006801:Humans; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery; D014140:Tracheotomy