title: Short- and long-term biomechanical and morphological study of new suture types in abdominal wall closure.
abstract: To perform an abdominal-wall closure, a continuous suture is the preferred method. The suture materials that are most commonly employed in abdominal surgery are polypropylene and polydioxanone. However, in recent times, new products have been marketed, such as non-absorbable polyurethane with elastic properties (Assuplus(®), Assut Europe, Italy) and absorbable barbed polydioxanone (Filbloc(®), Assut Europe, Italy). The purpose of this study was to compare the ability of those against the standard polypropylene (Surgipro(TM), Covidien, USA) and polydioxanone (Assufil(®), Assut Europe, Italy) to mimic the biomechanical behavior of the abdominal wall closure. Comparison of the sutures was made first with the materials alone and later in a laparotomy closure of a rabbit abdomen, used as an animal model. The biomechanical analysis consisted of uniaxial tensile tests of threads and sutured samples of the animal abdomen. In the latter case, results were analyzed at short- (21days) and long- (180days) term intervals after the surgery. The morphology studies and collagen expression of the samples were also investigated. The results determined that polydioxanone and polypropylene sutures showed a linear elastic behavior, with barbed polydioxanone as the most compliant suture and polyurethane as the stiffest. The sutured samples showed a statistically significant loss of resistance, measured as the load needed to perform a certain stretch, when compared with the corresponding control tissue. Analysis of the stress-stretch curves showed that elastic polyurethane was the only suture able to reproduce the mechanical behavior of healthy tissue in the short term, while the rest of the sutures remained less stiff. This coincides with the expression of type I collagen observed in this group at this point in the study. In the long term, there was no difference among the sutures, and none was able to mimic control behavior.
authors.affiliation: Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: R
authors.initials: R
authors.lastname: Simón-Allué
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: P
authors.initials: P
authors.lastname: Pérez-López
authors.affiliation: Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: S
authors.initials: S
authors.lastname: Sotomayor
authors.affiliation: Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: E
authors.initials: E
authors.lastname: Peña
authors.affiliation: Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: G
authors.initials: G
authors.lastname: Pascual
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Bellón
authors.affiliation: Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain. Electronic address: bcalvo@unizar.es.
authors.forename: B
authors.initials: B
authors.lastname: Calvo
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000818:Animals; D001696:Biomechanical Phenomena; D040761:Biomimetic Materials; D003094:Collagen / Q000378:metabolism; D005786:Gene Expression Regulation; D007813:Laparotomy; D008297:Male; D008422:Materials Testing; D055595:Mechanical Phenomena; D011817:Rabbits; D013537:Sutures; D013997:Time Factors
chemical_list: D003094:Collagen
keywords: Linea alba closure; Mechanical properties; Morphological studies; Sutures