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Barbed Suture Tendon Repair ASPS
 

Barbed Suture Tendon Repair ASPS

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This is a podium presentation given at the American Society of Plastic Surgeons on tendon repair without knots.

This is a podium presentation given at the American Society of Plastic Surgeons on tendon repair without knots.

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    Barbed Suture Tendon Repair ASPS Barbed Suture Tendon Repair ASPS Presentation Transcript

    • Knotless flexor tendon repair using a barbed suture: An ex vivo comparison.
      W. Thomas McClellan
      Matt Schessler
      David Ruch
      L. Scott Levin
      Richard Goldner
      Kauai HI 2010
    • Disclosures
      No disclosures
    • Hypothesis
      Knotless flexor tendon repair is as strong as a traditional knot based repair with reduced cross sectional area at the repair site.
    • Methods
      66 fresh adult pig FDP tendons
      3 points established – cross-sectional area
      1cm proximal, transection site, 1cm distal
    • Methods
      Divided into 3 groups, transected, repaired
      Group A (n=22) –
      2 strand modified Kessler 3-0 ethibond
      Group B (n=22) –
      4 strand modified Savage 3.0 ethibond
      Group C (n=22) –
      4 strand Knotless Repair 0 barbed
    • Knotless Technique
    • Measured the x-sectional area at all 3 sites after repair and before insitron testing
      Results – X-Sectional Area(mm2)
      (p<0.0001)
    • Results - Strength
      (p<0.0001)
    • Summary
      A 4 strand Knotless repair is as strong as a 4 strand Savage and stronger than a 2 strand Kessler
      Must maximize # of barbs within the tendon
      Must incorporate grasps of the epitenon for increased repair strength
    • Summary
      Knotless repair has significantly reduced cross sectional area, at the repair site, compared to the Savage and Kessler
      This may reduce resistance within the pulley system.
    • Summary
      however
      Knotless repair is technically difficult and time consuming
      Increased handling of the tendon required
      must place limbs upstream
      Manipulation of larger core suture is more cumbersome
      Difficult to remove suture if needed
      Additional research should be performed to address shortcomings and limitations
    • Thank you