Barbed and Non-Barbed Suture Materials for Ventral Hernia Repair: An Experimental Study

Objectives: The objective of this study was to assess the tissue response and strength of traditional and unidirectional suture materials, depending on the conditions of use and the timing following implantation. Methods: Eighty male Wistar rats were randomly assigned to four groups depending on the suture used: unidirectional absorbable V-loc^TM 180 or non-absorbable V-loc^TM PBT and traditional absorbable Maxon^TM or non-absorbable Novafil^TM. Three and six weeks following the closure of the abdominal wall defect (AWD) and subcutaneous suture implantation at the withers according to group assignment, 10 animals from each group were euthanized for implanted sutures mechanical testing and histological examination. Results: The inflammatory reaction in the AWD closure area was maximal and significantly different from the subcutaneous implantation by week 3 for all groups. At six weeks, the tissue reaction did not depend on the place of implantation. However, four rats from the Maxon^TM group demonstrated suture failure with diastasis formation. Non-absorbable barbed sutures exhibited an absence of suture failure and the maximum scar thickness. Both intact absorbable materials (V-Loc^TM 180 and Maxon^TM) exhibited a significant breaking strength margin over the non-absorbable. By week 6, the preserved strength of the V-loc^TM 180 sutures at the AWD was 33% (15-58%), and under the skin-49.7% (48-59%) (p = 0.005). For Maxon^TM, these values were 38% (35-48%) for the AWD and 44% (34-49%) for the subcutaneous implantation. Conclusions: Absorbable and non-absorbable suture materials, depending on the conditions and timing of implantation, cause various tissue reactions which could affect the wound healing and the number of postoperative complications.