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The double loop mattress suture.

Biddlestone J, Samuel M, Creagh T, Ahmad T - Wound Repair Regen (2014)

Bottom Line: An interrupted stitch type with favorable tissue characteristics will reduce local wound complications.Additionally, the double loop mattress reduces tissue tension by 66% compared with just 53% for the loop mattress (p ≤ 0.001).Wound dehiscence is reduced because this stitch type is stronger and exerts less tension on the tissue than the mattress stitch.

View Article: PubMed Central - PubMed

Affiliation: CRUK Clinical Research Fellow, Centre for Gene Regulation and Expression, College of Life Sciences, University of Dundee, Dundee, United Kingdom; Honorary Speciality Registrar, Department for Plastic and Reconstructive Surgery, Ninewells Hospital, Dundee, United Kingdom.

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(A) Mechanical model: This bespoke rig was wire cut from mild steel and seated in a bed of virgin polytetrafluroethylene (PTFE) (V) to operate a frictionless array of pulleys (P) for any suture confirmation under test. A fixed load was applied to stimulate wound recoil (right side). The effort required to overcome this was measured using a load ring attached to the opposite end of the rig (left side). String in loop mattress conformation is used for illustrative purposes only. (B) Bar chart to show the actual mechanical advantage of each stitch type. The double loop mattress (DLM) provides an advantage of 2.9 which compares favorably with the other stitch types tested.
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fig04: (A) Mechanical model: This bespoke rig was wire cut from mild steel and seated in a bed of virgin polytetrafluroethylene (PTFE) (V) to operate a frictionless array of pulleys (P) for any suture confirmation under test. A fixed load was applied to stimulate wound recoil (right side). The effort required to overcome this was measured using a load ring attached to the opposite end of the rig (left side). String in loop mattress conformation is used for illustrative purposes only. (B) Bar chart to show the actual mechanical advantage of each stitch type. The double loop mattress (DLM) provides an advantage of 2.9 which compares favorably with the other stitch types tested.

Mentions: The mechanical advantage of each suture conformation was measured using a bespoke mechanical model (University of Cambridge Department of Materials Science and Metallurgy), wire cut from mild steel (Figure 4A). The sliding segment and loop facets were seated in a bed of virgin 100% polytetrafluroethylene to allow for frictionless movement (Engineering and Design Plastics Ltd., Cambridge, United Kingdom). For each stitch conformation, the suture material was arranged across the relevant, low-friction steel pulleys and resting state marked. A 2N load was applied across the sliding segment using a hanging weight system to simulate wound recoil (load). A constant force was applied to simulate the effort of closure, and the running tension to balance the load was measured using a load ring. Apposition was deemed complete when both effort and load were balanced and the sliding segment was returned to the resting position.


The double loop mattress suture.

Biddlestone J, Samuel M, Creagh T, Ahmad T - Wound Repair Regen (2014)

(A) Mechanical model: This bespoke rig was wire cut from mild steel and seated in a bed of virgin polytetrafluroethylene (PTFE) (V) to operate a frictionless array of pulleys (P) for any suture confirmation under test. A fixed load was applied to stimulate wound recoil (right side). The effort required to overcome this was measured using a load ring attached to the opposite end of the rig (left side). String in loop mattress conformation is used for illustrative purposes only. (B) Bar chart to show the actual mechanical advantage of each stitch type. The double loop mattress (DLM) provides an advantage of 2.9 which compares favorably with the other stitch types tested.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265851&req=5

fig04: (A) Mechanical model: This bespoke rig was wire cut from mild steel and seated in a bed of virgin polytetrafluroethylene (PTFE) (V) to operate a frictionless array of pulleys (P) for any suture confirmation under test. A fixed load was applied to stimulate wound recoil (right side). The effort required to overcome this was measured using a load ring attached to the opposite end of the rig (left side). String in loop mattress conformation is used for illustrative purposes only. (B) Bar chart to show the actual mechanical advantage of each stitch type. The double loop mattress (DLM) provides an advantage of 2.9 which compares favorably with the other stitch types tested.
Mentions: The mechanical advantage of each suture conformation was measured using a bespoke mechanical model (University of Cambridge Department of Materials Science and Metallurgy), wire cut from mild steel (Figure 4A). The sliding segment and loop facets were seated in a bed of virgin 100% polytetrafluroethylene to allow for frictionless movement (Engineering and Design Plastics Ltd., Cambridge, United Kingdom). For each stitch conformation, the suture material was arranged across the relevant, low-friction steel pulleys and resting state marked. A 2N load was applied across the sliding segment using a hanging weight system to simulate wound recoil (load). A constant force was applied to simulate the effort of closure, and the running tension to balance the load was measured using a load ring. Apposition was deemed complete when both effort and load were balanced and the sliding segment was returned to the resting position.

Bottom Line: An interrupted stitch type with favorable tissue characteristics will reduce local wound complications.Additionally, the double loop mattress reduces tissue tension by 66% compared with just 53% for the loop mattress (p ≤ 0.001).Wound dehiscence is reduced because this stitch type is stronger and exerts less tension on the tissue than the mattress stitch.

View Article: PubMed Central - PubMed

Affiliation: CRUK Clinical Research Fellow, Centre for Gene Regulation and Expression, College of Life Sciences, University of Dundee, Dundee, United Kingdom; Honorary Speciality Registrar, Department for Plastic and Reconstructive Surgery, Ninewells Hospital, Dundee, United Kingdom.

Show MeSH
Related in: MedlinePlus