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Repair of growing vessels. Continuous absorbable or interrupted nonabsorbable suture?
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1985
Summary
This study compared two aortic repair techniques in piglets. Absorbable sutures showed significantly less anastomotic stricture and inflammation than nonabsorbable sutures, indicating better long-term aortic healing.
Area of Science:
- Cardiovascular Surgery
- Surgical Techniques
- Pediatric Cardiology
Background:
- Aortic transection and repair is a critical surgical procedure.
- Choosing the appropriate suture material is crucial for preventing complications such as anastomotic stricture and inflammation.
- Nonabsorbable sutures have been traditionally used, but their long-term effects on vascular healing are debated.
Purpose of the Study:
- To compare the efficacy of a posterior-running, anterior-interrupted nonabsorbable suture technique versus a circumferential continuous absorbable suture technique for primary aortic repair in a juvenile animal model.
- To evaluate the incidence of anastomotic stricture, adhesion formation, fibrosis, and foreign-body reaction between the two techniques.
Main Methods:
- Twenty 1-month-old piglets underwent aortic transection and primary repair using one of two techniques: Group 1 (nonabsorbable sutures) or Group 2 (absorbable sutures).
- Piglets were monitored for nine months, with assessments of weight gain, aortic cross-sectional area, and anastomotic integrity.
- Histopathological analysis was performed to evaluate tissue reactions at the anastomosis.
Main Results:
- Both groups demonstrated significant growth and aortic expansion.
- Group 1 experienced minimal but detectable anastomotic stricture (5.8% at 6 months, 3.5% at 9 months) and common adhesion/fibrosis.
- Group 2 showed negligible stricture (-0.1% at 9 months) and minimal adverse tissue reactions, with a significantly thinner mean wall thickness at nine months (1.0 mm vs 2.0 mm).
Conclusions:
- Circumferential continuous absorbable sutures are superior to posterior-running, anterior-interrupted nonabsorbable sutures for primary aortic repair in this juvenile model.
- Absorbable sutures lead to reduced anastomotic stricture, inflammation, and fibrosis, promoting better long-term aortic healing.
- These findings suggest absorbable sutures may be a preferable option for pediatric aortic reconstruction.