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Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model

Gastrointestinal anastomoses are an important source of postoperative complications. In particular, the ideal suturing material is still the subject of investigation. Therefore, this study aimed to evaluate a newly developed suturing material with elastic properties made from thermoplastic polyureth...

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Autores principales: Schmitz, Sophia M., Helmedag, Marius J., Kossel, Klas-Moritz, Eickhoff, Roman M., Heise, Daniel, Kroh, Andreas, Mechelinck, Mare, Gries, Thomas, Jockenhoevel, Stefan, Neumann, Ulf P., Lambertz, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9141788/
https://www.ncbi.nlm.nih.gov/pubmed/35628199
http://dx.doi.org/10.3390/ijms23105389
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author Schmitz, Sophia M.
Helmedag, Marius J.
Kossel, Klas-Moritz
Eickhoff, Roman M.
Heise, Daniel
Kroh, Andreas
Mechelinck, Mare
Gries, Thomas
Jockenhoevel, Stefan
Neumann, Ulf P.
Lambertz, Andreas
author_facet Schmitz, Sophia M.
Helmedag, Marius J.
Kossel, Klas-Moritz
Eickhoff, Roman M.
Heise, Daniel
Kroh, Andreas
Mechelinck, Mare
Gries, Thomas
Jockenhoevel, Stefan
Neumann, Ulf P.
Lambertz, Andreas
author_sort Schmitz, Sophia M.
collection PubMed
description Gastrointestinal anastomoses are an important source of postoperative complications. In particular, the ideal suturing material is still the subject of investigation. Therefore, this study aimed to evaluate a newly developed suturing material with elastic properties made from thermoplastic polyurethane (TPU); Polyvinylidene fluoride (PVDF) and TPU were tested in two different textures (round and a modified, “snowflake” structure) in 32 minipigs, with two anastomoses of the small intestine sutured 2 m apart. After 90 days, the anastomoses were evaluated for inflammation, the healing process, and foreign body reactions. A computer-assisted immunohistological analysis of staining for Ki67, CD68, smooth muscle actin (SMA), and Sirius red was performed using TissueFAXS. Additionally, the in vivo elastic properties of the material were assessed by measuring the suture tension in a rabbit model. Each suture was tested twice in three rabbits; No major surgical complications were observed and all anastomoses showed adequate wound healing. The Ki67+ count and SMA area differed between the groups (F (3, 66) = 5.884, p = 0.0013 and F (3, 56) = 6.880, p = 0.0005, respectively). In the TPU-snowflake material, the Ki67+ count was the lowest, while the SMA area provided the highest values. The CD68+ count and collagen I/III ratio did not differ between the groups (F (3, 69) = 2.646, p = 0.0558 and F (3, 54) = 0.496, p = 0.686, respectively). The suture tension measurements showed a significant reduction in suture tension loss for both the TPU threads; Suturing material made from TPU with elastic properties proved applicable for intestinal anastomoses in a porcine model. In addition, our results suggest a successful reduction in tissue incision and an overall suture tension homogenization.
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spelling pubmed-91417882022-05-28 Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model Schmitz, Sophia M. Helmedag, Marius J. Kossel, Klas-Moritz Eickhoff, Roman M. Heise, Daniel Kroh, Andreas Mechelinck, Mare Gries, Thomas Jockenhoevel, Stefan Neumann, Ulf P. Lambertz, Andreas Int J Mol Sci Article Gastrointestinal anastomoses are an important source of postoperative complications. In particular, the ideal suturing material is still the subject of investigation. Therefore, this study aimed to evaluate a newly developed suturing material with elastic properties made from thermoplastic polyurethane (TPU); Polyvinylidene fluoride (PVDF) and TPU were tested in two different textures (round and a modified, “snowflake” structure) in 32 minipigs, with two anastomoses of the small intestine sutured 2 m apart. After 90 days, the anastomoses were evaluated for inflammation, the healing process, and foreign body reactions. A computer-assisted immunohistological analysis of staining for Ki67, CD68, smooth muscle actin (SMA), and Sirius red was performed using TissueFAXS. Additionally, the in vivo elastic properties of the material were assessed by measuring the suture tension in a rabbit model. Each suture was tested twice in three rabbits; No major surgical complications were observed and all anastomoses showed adequate wound healing. The Ki67+ count and SMA area differed between the groups (F (3, 66) = 5.884, p = 0.0013 and F (3, 56) = 6.880, p = 0.0005, respectively). In the TPU-snowflake material, the Ki67+ count was the lowest, while the SMA area provided the highest values. The CD68+ count and collagen I/III ratio did not differ between the groups (F (3, 69) = 2.646, p = 0.0558 and F (3, 54) = 0.496, p = 0.686, respectively). The suture tension measurements showed a significant reduction in suture tension loss for both the TPU threads; Suturing material made from TPU with elastic properties proved applicable for intestinal anastomoses in a porcine model. In addition, our results suggest a successful reduction in tissue incision and an overall suture tension homogenization. MDPI 2022-05-11 /pmc/articles/PMC9141788/ /pubmed/35628199 http://dx.doi.org/10.3390/ijms23105389 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schmitz, Sophia M.
Helmedag, Marius J.
Kossel, Klas-Moritz
Eickhoff, Roman M.
Heise, Daniel
Kroh, Andreas
Mechelinck, Mare
Gries, Thomas
Jockenhoevel, Stefan
Neumann, Ulf P.
Lambertz, Andreas
Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title_full Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title_fullStr Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title_full_unstemmed Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title_short Novel Elastic Threads for Intestinal Anastomoses: Feasibility and Mechanical Evaluation in a Porcine and Rabbit Model
title_sort novel elastic threads for intestinal anastomoses: feasibility and mechanical evaluation in a porcine and rabbit model
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9141788/
https://www.ncbi.nlm.nih.gov/pubmed/35628199
http://dx.doi.org/10.3390/ijms23105389
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