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Veterinary surgery : VS2020; 49(8); 1580-1589; doi: 10.1111/vsu.13497

Tensile strength and early healing of self-locking and surgeon’s knots.

Abstract: To compare the biomechanical properties and healing of ventral midline celiotomies (VMC) closed with a self-locking knot combination and forwarder start and Aberdeen end (F-A) vs a traditional knot combination and surgeon's start and end (S-S). Methods: In vivo, experimental. Methods: Twenty-one horses. Methods: Fourteen horses underwent VMC, which was closed with either an F-A (n = 7) or an S-S (n = 7) knot combination. Incisions were subjectively graded by masked evaluators for dehiscence, edema, and drainage. Biomechanical testing was performed on three abdominal segments, and histology was performed on one segment from each animal after humane euthanasia 10 days post-VMC. The abdominal wall of control horses (n = 7, no celiotomy) was collected for biomechanical testing. Results: Forwarder start and Aberdeen end and S-S horses had less tensile strength compared with control horses (P ≤ .001). No differences were detected between treatment groups for any variable evaluated, including tensile strength (P = .975), location of failure (P = .240), and histologic healing at the knot (P = .600). Conclusions: Closure of VMC with self-locking knots resulted in biomechanical and healing features similar to those with a traditional closure technique, with neither restoring the tensile strength of the linea alba. Conclusions: Results of this study provide evidence to support a clinical trial to evaluate long-term performance of the F-A self-locking knot closure in horses.
© 2020 American College of Veterinary Surgeons.
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Publication Date: 2020-08-11 PubMed ID: 32780444DOI: 10.1111/vsu.13497Google Scholar: Lookup
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Summary

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The research article discusses a study comparing the effectiveness and healing properties of self-locking knot and surgeon’s knot techniques in closing ventral midline celiotomies (VMC) in horses. The study revealed that both techniques resulted in similar biomechanical and healing outcomes, though neither restored the tensile strength of the abdominal wall to its original condition.

Study Design and Methodology

  • The study was an in vivo experiment involving 21 horses. Out of these, 14 horses went through a VMC, a surgical incision in the abdominal midline.
  • The VMC was closed using either a self-locking knot technique known as Forwarder start and Aberdeen end (F-A, used on 7 horses) or a traditional Surgeon’s start and end (S-S, used on 7 horses).
  • Subjective evaluation was carried out by masked evaluators on the incision sites for dehiscence (wound separation), edema (swelling), and drainage.
  • Ten days after the surgical procedure, the horses were euthanized, and three segments of the abdominal wall were collected for biomechanical evaluation, while one segment was used for histological analysis.
  • For reference, the abdominal wall from a control group of seven horses that did not undergo a celiotomy was collected as well.

Results

  • Regardless of the knotting technique used, the horses that underwent the VMC had lesser tensile strength (the capacity of a material or structure to withstand loads tending to elongate) in their abdominal wall when compared to control horses.
  • There were no notable differences between the F-A and S-S groups in any of the aspects evaluated. This included tensile strength, the location of failure, and histological healing at the knot insertions.

Conclusions

  • Both the F-A self-locking knot technique and the traditional S-S knot technique resulted in similar outcomes with regards to healing and biomechanics. However, neither method was capable of restoring the tensile strength of the linea alba, the midline of the abdomen, to its pre-operative level.
  • The findings of the study support the potential for future clinical trials to further investigate the long-term performance of the F-A self-locking technique in equine surgery.

Cite This Article

APA
Weatherall KM, Boone LH, Caldwell FJ, Cole RC, Cattley RC, Lascola KM, Clark-Price SC, Farag R, Perkins E, Hanson RR. (2020). Tensile strength and early healing of self-locking and surgeon’s knots. Vet Surg, 49(8), 1580-1589. https://doi.org/10.1111/vsu.13497

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 49
Issue: 8
Pages: 1580-1589

Researcher Affiliations

Weatherall, Kathleen M
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Boone, Lindsey H
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Caldwell, Fred J
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Cole, Robert C
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Cattley, Russell C
  • Department of Pathobiology, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Lascola, Kara M
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Clark-Price, Stuart C
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Farag, Ramsis
  • Center for Polymer and Advanced Composites, Auburn University Samuel Ginn College of Engineering, Auburn, Alabama, USA.
  • Department of Textile Engineering, Mansoura University, Mansoura, Egypt.
Perkins, Edmon
  • Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA.
Hanson, R Reid
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.

MeSH Terms

  • Animals
  • Biomechanical Phenomena
  • Female
  • Horses / injuries
  • Horses / surgery
  • Male
  • Suture Techniques / veterinary
  • Sutures / veterinary
  • Tensile Strength
  • Wound Healing

Grant Funding

  • Birmingham Racing Commission; Department of Clinical Sciences of Auburn University.

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