Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba.
Abstract: To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba. Methods: Laboratory study. Methods: Adult light horse cadavers (n = 24). Methods: A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern. Closure time was recorded for each suture type. The bladder was air-insufflated at 40 L/min, and the pressure at body wall failure recorded. The length of suture used for wound closure and wound failure modes were recorded. Suture length, closure time, bursting pressure, and failure modes were compared using Welch-Aspin t-tests. Results: The incisional bursting pressure was comparable between the two groups (p > .05). Less suture material (p < .01) was required with the barbed suture than the standard suture. Closure time was less for the barbed suture than the standard suture (p < .01). Suture failure was the main failure mode in both groups (83% cases). Conclusions: Closure of the equine linea alba using bidirectional barbed suture material reduced the amount of foreign material in the wound and decreased closure time without compromising incisional strength. Conclusions: Bidirectional barbed suture material could be considered as an alternative to standard suture materials for closure of the equine line alba.
© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2023-09-01 PubMed ID: 37655506DOI: 10.1111/vsu.14022Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study compares the effectiveness of a bidirectional absorbable knotless suture material with a standard continuous absorbable suture material for closing abdominal incisions in horses. The key findings reveal that the use of bidirectional barbed suture material decreases the quantity of foreign material in the wound and reduces closure time without sacrificing incisional strength.
Experimental Procedure
- Adult light horse cadavers (24 in total) were used in the experiment. A 25 cm incision was made through the linea alba (the midline of the abdomen). A 200 L polyurethane bladder was then placed inside the abdomen.
- The linea alba was sealed either using DS26 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture. This suture process was timed for each type.
- The bladder was filled with air at a rate of 40 L/min. The pressure at which the body wall failed was then recorded.
- The length of suture used for wound closure and the modes of wound failure were also documented. These data points, along with closure time and bursting pressure, were compared using a statistical test known as the Welch-Aspin t-tests.
Results
- The incisional bursting pressure (the pressure that the sutured incision could withstand before bursting) was found to be similar between the two groups (p > .05).
- Less suture material was needed with the barbed suture than with the standard suture (p < .01).
- The closure time was also shorter for the barbed suture than for the standard suture (p < .01).
- The majority of failures in both groups (83% of cases) were due to the sutures themselves failing.
Final Conclusions
- Using a bidirectional barbed suture material to close the equine linea alba reduced both the amount of foreign material in the wound and the closure time. It did not weaken the strength of the incision.
- The authors suggest that bidirectional barbed suture material could be considered as a potential alternative to standard suture materials for closure of the linea alba in horses.
Cite This Article
APA
Bellitto NA, Oliver FB, Pollock PJ.
(2023).
Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba.
Vet Surg, 52(8), 1121-1127.
https://doi.org/10.1111/vsu.14022 Publication
Researcher Affiliations
- Glasgow Equine Hospital & Practice, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK.
- Department of Equine Surgery, Private Practice, Mallorca, Spain.
- Glasgow Equine Hospital & Practice, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK.
MeSH Terms
- Horses / surgery
- Animals
- Polydioxanone
- Suture Techniques / veterinary
- Abdominal Wall
- Surgical Wound / veterinary
- Sutures / veterinary
- Horse Diseases
Grant Funding
- 237-275 / Petplan Charitable Trust
References
This article includes 45 references
- Lin Y, Lai S, Huang J, Du L. The efficacy and safety of knotless barbed sutures in the surgical field: a systematic review and meta-analysis of randomized controlled trials.. Sci Rep 2016;6:1-8.
- Kümmerle JM, Fogle C. Suture materials and patterns.. Equine Surg 5th ed. Elsevier; 2019:255-280.
- Paul MD. Bidirectional barbed sutures for wound closure: evolution and applications.. J Am Col Certif Wound Spec 2009;1(2):51-57.
- Zhang W, Xue D, Yin H. Barbed versus traditional sutures for wound closure in knee arthroplasty: a systematic review and meta-analysis.. Sci Rep 2015;6:19764.
- Chan VWK, Chan PK, Chiu KY, Yan CH, Ng FY. Does barbed suture lower cost and improve outcome in Total knee arthroplasty? A randomized controlled trial.. J Arthroplasty 2017;32(5):1474-1477.
- Lee S, Kee T, Jung MY, Yoon PW. A comparison of barbed continuous suture versus conventional interrupted suture for fascial closure in total hip arthroplasty.. Sci Rep 2022;12(1):1-7.
- Ruzickova P, Burns P, Piat P, Frasch MG, Beauchamp G, Elce YA. Ex vivo biomechanical comparison of 4 suture materials for laparoscopic bladder closure in the horse.. Vet Surg 2016;45(3):374-379.
- Major DS, Duff AH, Cohen ND, Hardy J. Ex vivo comparison of single-layer and double-layer laparoscopic closure of equine bladders with 2 types of barbed sutures.. Vet Surg 2017;46(8):1145-1153.
- Albanese V, Hanson RR, McMaster MA, Koehler JW, Caldwell FJ. Use of a barbed knotless suture for laparoscopic ablation of the Nephrosplenic space in 8 horses.. Vet Surg 2016;45(6):824-830.
- Nelson BB, Hassel DM. In vitro comparison of V-loc™ versus biosyn™ in a one-layer end-to-end anastomosis of equine jejunum.. Vet Surg 2014;43(1):80-84.
- Sinovich M, Archer DC, Meunier NV, Kelly PG. Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses.. Vet Surg 2020;49(3):487-495.
- Adler DMT, Østergaard S, Jørgensen E, Jacobsen S. Bidirectional knotless barbed versus conventional smooth suture for closure of surgical wounds in inguinal castration in horses.. BMC Vet Res 2020;16(1):1-8.
- Gandini M, Nannarone S, Giusto G. Laparoscopic nephrosplenic space ablation with barbed suture in eight horses.. J Am Vet Med Assoc 2017;250(4):431-436.
- Ragle CA, Yiannikouris S, Tibary AA, Fransson BA. Use of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse.. J Am Vet Med Assoc 2013;242(2):249-253.
- Corsalini J, Gialletti R, Lotto E, Nannarone S. Laparoscopic uteropexy (Mesometrium Imbrication) in three mares using a barbed suture.. J Equine Vet Sci 2016;40:102-105.
- Kamus L, Ruzickova P, Piat P, Trencart P, Bonilla A. Use of barbed suture for thoracoscopic repair of diaphragmatic hernias: three cases.. Equine Vet Educ 2022;35:e180-e185.
- Simón-Allué R, Pérez-López P, Sotomayor S. Short- and long-term biomechanical and morphological study of new suture types in abdominal wall closure.. J Mech Behav Biomed Mater 2014;37:1-11.
- Bellón JM, Pérez-López P, Simón-Allue R. New suture materials for midline laparotomy closure: an experimental study.. BMC Surg 2014;14(1):70.
- Kushner BS, Arefanian S, McAllister J. Examination of abdominal wall perfusion using varying suture techniques for midline abdominal laparotomy closure.. Surg Endosc 2022;36(6):3843-3851.
- Ruiz-Tovar J, Llavero C, Jimenez-Fuertes M, Duran M, Perez-Lopez M, Garcia-Marin A. Incisional surgical site infection after abdominal fascial closure with triclosan-coated barbed suture vs triclosan-coated polydioxanone loop suture vs polydioxanone loop suture in emergent abdominal surgery: a randomized clinical trial.. J Am Coll Surg 2020;230(5):766-774.
- Kelmer G. What do we currently know about incisional complications of colic surgery?. Equine Vet Educ 2023;35:489-497.
- Shearer TR, Holcombe SJ, Valberg SJ. Incisional infections associated with ventral midline celiotomy in horses.. J Vet Emerg Crit Care 2020;30(2):136-148.
- Davis W, Fogle CA, Gerard MP, Levine JF, Blikslager AT. Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003-2010).. Equine Vet J 2013;45(2):224-228.
- Hann MJ, Mair TS, Gardner A. Acute abdominal dehiscence following laparotomy: a multicentre, international retrospective study.. Equine Vet J 2022;54(4):719-725.
- Freeman DE, Rötting AK, Inoue OJ. Abdominal closure and complications.. Clin Tech Equine Pract 2002;1(3):174-187.
- Anderson SL, Bracamonte JL, Hendrick S. Ex vivo evaluation of 7 polydioxanone for closure of equine ventral midline celiotomies.. Can J Vet Res 2014;78(2):156-160.
- Anderson SL, Bracamonte JL, Hendrick S, Carmalt JL, Wilson DG. Ex vivo comparison of 7 polydioxanone, 2 polyglactin 910 for closure of ventral median celiotomy in horses.. Vet Surg 2013;42(4):463-467.
- Anderson SL, Devick I, Bracamonte JL. Occurrence of incisional complications after closure of equine celiotomies with USP 7 polydioxanone.. Vet Surg 2015;44(4):521-526.
- Magee AA, Galuppo LD, Acvs D. Comparison of incisional bursting strength of simple continuous and inverted cruciate suture patterns in the equine Linea Alba.. Vet Surg 1999;28:442-447.
- Rinnovati R, Romagnoli N, Stancampiano L, Spadari A. Occurrence of incisional complications after closure of equine ventral midline celiotomies with 2 polyglycolic acid in simple interrupted suture pattern.. J Equine Vet Sci 2016;47:80-83.
- Salciccia A, La Rebière D, De Pouyade G, Gougnard A. Complications associated with closure of the linea alba using a combination of interrupted vertical mattress and simple interrupted sutures in equine laparotomies.. Vet Rec 2020;187(11):94.
- Souza CRS, Farnsworth KD, Ragle CA. Comparison of incisional bursting strength of 2-strand continuous crossing and simple continuous patterns for closure of the equine linea alba.. Can Vet J 2018;59(2):171-173.
- McGlinchey L, Hanson RR, Boone LH. Bursting strength of surgeon's and self-locking knots for closure of ventral midline celiotomy in horses.. Vet Surg 2018;47(8):1080-1086.
- Hassan KA, Galuppo LD, Van Hoogmoed LM. An In vitro comparison of two suture intervals using braided absorbable loop suture in the equine Linea Alba.. Vet Surg 2006;35(3):310-314.
- Verkade ME, Ugahary F, Martens A, Wiemer P. Clinical and ultrasonographic evaluation of three suture techniques for closure of the equine linea alba.. Equine Vet Educ 2020;32(12):646-653.
- Fierheller EE, Wilson DG. An In vitro biomechanical comparison of the breaking strength and stiffness of polydioxanone (sizes 2, 7) and polyglactin 910 (sizes 3, 6) in the equine Linea Alba.. Vet Surg 2005;34(1):18-23.
- Anderson SL, Bracamonte JL, Hendrick S, Carmalt JL, Wilson DG. Ex vivo comparison of bursting strength of ventral median and right ventral paramedian celiotomies in horses.. Vet Surg 2013;42(4):468-472.
- Weatherall KM, Boone LH, Munsterman A, Hanson RR. Ex vivo comparison of the bursting strength of an equine ventral midline celiotomy covered by two standard abdominal bandages.. Vet Surg 2021;50(3):615-621.
- Colbath AC, Patipa L, Berghaus RD, Parks AH. The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.. Equine Vet J 2014;46(2):156-160.
- Southwood LL. Complications of the postoperative colic patient.. Complications in Equine Surgery Wiley-Blackwell; 2021:310-373.
- Durand CL. Comparison of knotless barbed suture versus monofilament suture in the oral cavity of cats.. J Vet Dent 2017;34(3):148-154.
- Ting NT, Moric MM, Della Valle CJ, Levine BR. Use of knotless suture for closure of Total hip and knee arthroplasties. A prospective, randomized clinical trial.. J Arthroplasty 2012;27(10):1783-1788.
- Duffy DJ, Duddy HR, Keating S, Gutierrez-Nibeyro SD. Influence of barbed suture on leak pressures after double-layer inverting closure of cystotomy sites in sheep.. Vet Surg 2018;47(7):902-907.
- Freeman KD, Southwood LL, Lane J, Lindborg S, Aceto HW. Post operative infection, pyrexia and perioperative antimicrobial drug use in surgical colic patients.. Equine Vet J 2012;44(4):476-481.
- Weatherall KM, Boone LH, Caldwell FJ. Tensile strength and early healing of self-locking and surgeon's knots.. Vet Surg 2020;49(8):1580-1589.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists