Ex vivo biomechanical comparison of barbed suture and standard polypropylene suture for acute tendon laceration in a canine model

Abstract

SummaryObjectives: Evaluate performance and resistance to gap formation of a non-absorbable, barbed, monofilament suture, in comparison with a non-absorbable, smooth, monofilament polypropylene suture, in two different suture patterns: three-loop pulley (3LP) and modified Bunnell-Mayer (BM).Sample size: Seventy-two medium-sized cadaveric superficial digital flexor muscle tendon units.Methods: After manual transection and suture repair, individual specimens were placed in an electromechanical tensile testing machine and tested to monotonic failure using tensile ramp loading. Video data acquisition allowed evaluation of failure mode and quantification of gap formation.Results: Incidence of gap formation between tendon ends was significantly greater in tenorrhaphies repaired with barbed suture compared to those repaired with smooth polypropylene. Use of a 3LP suture pattern caused significantly less gapping between tendon ends when compared to the BM pattern.Conclusion: Smooth polypropylene suture was consistently superior in load performance than a unidirectional barbed suture. The 3LP pattern was more resistant than a BM pattern at preventing gap formation.Clinical significance: Smooth polypropylene should be recommended over barbed unidirectional suture for use in canine tendinous repair to provide increased resistance to gap formation. The 3LP is superior to the BM suture pattern, requiring significantly more force to cause tenorrhaphy gap formation and failure, which may translate to increased accrual of repair site strength and tendinous healing in clinical situations.