Assistant Professor Small Animal Orthopedics North Carolina State University, North Carolina
Influence of Preconstructed Effector Loop Location Using a Barbed Unidirectional Suture on Leakage Pressures Following Canine Enterotomy Closure. Chang Y1, Duffy DJ1, Moore GE2. 1North Carolina State University, Raleigh, NC; 2Purdue University, West Lafayette, NC.
Unidirectional barbed suture uses a preconstructed effector end-loop that allows for initial suture security following simple continuous canine enterotomy closure. Our objective was to evaluate the influence of effector loop location using a barbed suture on initial leakage pressure (ILP) and maximum intraluminal pressure (MIP) following canine enterotomy closure. Fifty-four jejunal segments (n = 12/ group) were harvested and randomly assigned based upon effector loop location from the beginning of the incisional line. Groups included 0 mm, 5 mm, 10 mm, 15 mm, and intact controls, repaired using a 3-0 unidirectional barbed suture in a simple continuous pattern. ILP, MIP, and leakage location were recorded. Significance was set at P < 0.05. Mean ILP for 0 mm group (24.42 ± 8.43 mmHg) was significantly lower (P < 0.001) compared to all experimental groups with ILP ∼ 40% lower. There was no difference in MIP among experimental groups (P = 0.239). Repair time significantly increased (P < 0.0001) as the distance of the effector loop increased > 5 mm from the beginning of the incisional line. Leakage location differed among groups (P < 0.001) with leakage in the 0 mm group from the incisional line (75%), compared to leakage from predominantly from the suture holes in other groups respectively. Effector loops placed at the beginning of the incisional line (0 mm) significantly decreased ILP compared to loops placed at 5 mm, 10 mm, and 15 mm. Effector loop location using a unidirectional barbed suture should be placed at least 5 mm from beginning of the incisional line for canine enterotomy closure. Further in vivo studies are necessary to determine the clinical significance of these findings in vivo.