Today's medical textile market is producing state of the art polymeric textile implantable devices that are redefining traditional materials and methods of surgery. These sophisticated high-tech polymer materials are engineered for specific uses in surgical and interventional procedures. One of the new biotextile products is an absorbable bi-directional barbed surgical suture that does not require surgical knots for wound closure. This novel idea has the attention of many physicians and surgeons where wound closure or tissue approximation is needed. The barbed suture has the potential to change the way wound closure is perceived in various clinical fields of surgery and veterinary medicine.

Orientador: Juliany Gomes Quitzan / Resumo: Devido à alta incidência de cirurgias gastrointestinais nas diferentes espécies, incluindo o homem, diversas técnicas e materiais são continuamente desenvolvidos visando otimizar os procedimentos e diminuir as principais complicações observadas, dentre elas deiscência, extravasamento de conteúdo, aderências, peritonite e sepse. O fio farpado é uma recente opção de sutura, que beneficia especialmente as modalidades cirúrgicas laparoscópicas ou videoassistidas, pois a dispensabilidade de nós facilita a sutura e diminui o tempo cirúrgico. Ainda, as farpas ao redor do fio permitem melhor adesão ao tecido e distribuição uniforme da tensão. Com o objetivo de comparar três tipos suturas realizadas com o fios absorvíveis monofilamentares, farpado ou liso, em relação ao tempo de sutura, escore de aderência, resistência ao teste de ruptura e avaliação histológica, foram executadas enterorrafias em jejuno de 12 suínos (sutura farpada, sutura contínua e isolada simples). Os animais foram randomizados em três grupos (n=4), referindo-se aos dias pós-operatórios para coleta das amostras (G3, G10 e G21). Houve diferença entre as médias dos tempos de execução, quando comparadas as suturas farpada (274,33±70,48) e contínua (350,41±87,25), em relação à isolada (469,00±109,72). Comparando-se os três padrões, nos diferentes momentos, os escores de aderência e as pressões aferidas no teste de ruptura não apresentaram diferença significativa, assim como a análise histopatológica, onde não foi obser... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Due to the high incidence of gastrointestinal surgeries in many species including humans, several techniques and materials have been continuously investigated to improving the procedures towards to avoid the most common complications, including dehiscence, leakage of contents, adhesions, peritonitis and sepsis. Barbed suture has recently come under focus for laparoscopic or video-assisted procedures, once it is a knotless suture and makes the suturing time shorter. In addition, the barbs around the suture promotes better adhesion to the tissue and uniform distribution of the tension. To compare three types of sutures performed with monofilament conventional or barbed suture, both absorbable, in relation to suture time, adhesion score, burst pressure and histology, jejunal sutures were performed in 12 pigs (barbed suture, continuous suture and simple interrupted). The groups (n = 4) were randomized, referring to the postoperative days for final evaluation (G3, G10 and G21). There was a difference on suturing time, when compared barbed (274.33 ± 70.48) and continuous (350.41 ± 87.25) to the interrupted pattern (469.00 ± 109.72). Among the 3 techniques at G3, 10 or 21, adherence scores and bursting pressure were not significantly different as well as histology evaluation, since no difference could be detected, in the grade of inflammation, fibrosis, tissue alignment, necrosis and neovascularization, at the suturing sites. No complications due to suture failures were observed. Ba... (Complete abstract click electronic access below) / Mestre

Tensile strength of flexor tendon repair using barbed suture material in a dynamic ex vivo model. The purpose of this study was to compare two sutures; a knotted polydioxane with a knotless barbed in a 4-strand Kirchmayr-Kessler suture technique. Human flexor digitorum tendons were separated into four groups. Group 1 - polydioxane; Group 2 - barbed suture; Group 3 and 4 - same as group 1 and 2 with an additional peripheral running suture. In each group the repaired tendons were subjected to linear and cyclical loads. No difference in maximum tensile strength after linear and cyclical force could be detected between the knotted polydioxane suture and the knotless barbed suture. On linear force tests an additional circumferential repair increased the maximum tensile strength of both sutures. Cyclical force loading did not lead to a reduction of maximum strength. Following linear and cyclical loading the 4-strand barbed suture achieved maximum tensile strengths comparable to the 4-strand repair using the polydioxane suture. Barbed suture repair may offer the advantage of knotless suture techniques. / In einem ex vivo Modell wurde die Stabilität verschiedener Beugesehnennähte mit unterschiedlichen Nahtmaterialien und -methoden verglichen. Darunter eine knotenlose Technik mit Nahtmaterial mit Widerhaken. Des weiteren wurde der Stabilitätsvorteil durch eine zusätzliche Feinadaptionsnaht getestet. Angelehnt an eine frühe postoperative aktive Nachbehandlung wurde auch ein dynamisches Testmodell mit zyklischer Vorbelastung angewendet.