Application of a novel suture anchor to abdominal wall closure

Jason L Green; David Ruppert; Richard Glisson; Mohamed Ibrahim; Ken Gall; Howard Levinson

doi:10.1016/j.amjsurg.2019.04.016

Application of a novel suture anchor to abdominal wall closure

Am J Surg. 2019 Jul;218(1):1-6. doi: 10.1016/j.amjsurg.2019.04.016. Epub 2019 Apr 26.

Authors

Jason L Green¹, David Ruppert², Richard Glisson³, Mohamed Ibrahim², Ken Gall³, Howard Levinson⁴

Affiliations

¹ School of Medicine, Duke University, Durham, NC, 27710, USA.
² Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, 27710, USA.
³ Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, 27710, USA.
⁴ Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, 27710, USA; Department of Dermatology, Duke University, Durham, NC, 27710, USA; Department of Pathology, Duke University, Durham, NC, 27710, USA. Electronic address: howard.levinson@duke.edu.

PMID: 31060731
DOI: 10.1016/j.amjsurg.2019.04.016

Abstract

Background: Mesh suture used in high-tension wound closures produces large knots susceptible to increased palpability, infection, and foreign body response; yet has superior tensile strength and increased resistance to cutting through tissue compared to standard suture. This study investigates mesh suture fixation in abdominal tissue with a knotless novel, low-profile anchor-clip.

Methods: Single and double end fixation of mesh suture in swine rectus abdominus fascia with an anchor-clip, a knot, and predicate device fixation underwent cyclic testing followed by pull-to-failure testing.

Results: Failure load of standard knot, single corkscrew and double anchor-clip were not statistically different, but were significantly greater than single anchor-clip and double corkscrew fixation (p > 0.05).

Conclusions: The anchor-clip is ∼60% smaller than a standard knot while maintaining fixation strength when exposed to physiologic forces using double anchor-clip fixation in abdominal wall closure.

MeSH terms

Abdominal Wall / surgery*
Animals
Equipment Design
Materials Testing
Suture Anchors*
Suture Techniques / instrumentation*
Swine
Wound Closure Techniques / instrumentation*