In-vitro comparison of 3 knotting techniques for lateral fabellotibial suture stabilization

This study evaluated the biomechanical characteristics of a single self-locking knot (sSLK) and a double self-locking knot (dSLK) compared with the square knot (SQ) for stabilization of cranial cruciate ligament rupture. Each knot underwent monotonic tensile and cyclical loading. Starting tension, elongation, stiffness, and load to failure were all evaluated. A value of P < 0.05 was considered significant. Starting tension, overall stiffness, and load to failure were all significantly greater in both the sSLK and dSLK compared with the SQ. There was no difference in elongation among the knots. There were no significant differences in starting tension, elongation, stiffness, and load to failure between the sSLK and the dSLK. The self-locking knots were stronger and stiffer than the SQ; there is no biomechanical advantage in using the dSLK compared with the sSLK.     

Biomechanical Evaluation of a Crimp Clamp System for Loop Fixation of Monofilament Nylon Leader Material Used for Stabilization of the Canine Stifle Joint

Objective —To test a crimp clamp system designed to secure monofilament nylon leader (MNL) material commonly used as lateral fabellotibial sutures (LFS) in extra-articular stabilization of the canine stifle joint.
Study Design — In vitro biomechanical tests of MNL loops secured with either the crimp clamp system or knots were performed. Suture loops (n = 94) were created from 27.3 kg tensile strength MNL and fastened with knots or crimp clamps. Tests were conducted on steam-sterilized, ethylene-oxide-sterilized, and nonsterilized MNL sutures. Loops were evaluated in single load tests and cycled tests. Values for load to failure, initial loop tension, loop elongation, mode of failure, and point of failure were determined.
Results —Crimp-clamped loops were superior to knotted loops in all parameters tested in both cycled and noncycled tests. Loop failure generally occurred by breaking within 3 mm of the fixation in both clamped and knotted tests. Loop elongation after cycling was greater in the knotted loops compared with clamped loops ( P < .001). Load to failure was greater in clamped tests than in knotted tests (P < .001), regardless of sterilization technique used. Significantly higher initial loop tension could be achieved with the clamp system compared with knot fixation ( P < .001).
Conclusions —The crimp clamp system provides superior in vitro loop fixation characteristics compared with knot fixation in 27.3 kg test MNL.
Clinical Relevance —Based on the results of biomechanical testing and the known biocompatibility of the system's implant components, clinical trials using the crimp clamp system are warranted.     

Mechanical comparison of two knots and two crimp systems for securing nylon line used for extra-articular stabilization of the canine stifle

OBJECTIVE: To compare mechanical properties of knotted and crimped nylon loops. STUDY DESIGN: In vitro mechanical evaluation. SAMPLE POPULATION: Loops of 27 kg-test nylon leader. Single strand-clamped square knot compared with 2 crimp systems. Two strand--self-locking knot compared with 2 crimped loops. METHODS: (a) Single pull to failure (n = 10) at 500 mm/min. Initial loop tension (N), peak load (N), peak elongation (mm), stiffness of the linear portion of the curve (N/mm), and failure mode were recorded. (b) Incremental cyclic loading to failure (n = 5)--each loop was cycled 5 times to 100 N at a loading rate of 200 mm/min. Cycling was repeated, with the load increased by 50 N after each set. Elongation (mm), tension remaining (N), and after permanent deformation was present, elongation at 10 N (mm) were measured. RESULTS: Initial tension and stiffness were greater for crimped loops when compared with knotted loops. There were no differences between crimped loops. The self-locking knot elongated more, and was less stiff, when compared with 2 crimped loops. With incremental loading, knotted loops elongated more than crimped loops. The tension remaining in the loop fell below 10 N more quickly for knotted loops compared with crimped loops. CONCLUSION: Crimped loops are stiffer, and resist both static and cyclic load more effectively before becoming permanently elongated, when compared with knotted loops. CLINICAL RELEVANCE: Stifle stability will be maintained more effectively by crimped nylon loops when compared with knotted loops.     

The Effect of Six Knotting Methods on the Biomechanical Properties of Three Large Diameter Absorbable Suture Materials

Objective— To evaluate the effect of 6 different knotting methods on the mechanical properties of 3 large absorbable suture materials used in large animal surgery. Study Design— In vitro mechanical study. Sample Population— Knotted suture loops (n=15 per group). Methods— Suture loops were created between two low‐friction pulleys with either 2 polydioxanone, 2 polyglactin 910 or 3 polyglactin 910. Strands were tied using 1 of 6 knotting technique: square knot, surgeon knot, clamped surgeon's knot, sliding half‐hitch knot (HH), Delimar knot and self‐locking knot (SLK). A single cycle to failure test was performed on each suture loop with a distraction rate of 100 mm/min. Failure modes were evaluated and breaking strength, elongation to failure and stiffness were compared. Results— All loops except two HH failed at the knot by acute breaking. The double‐stranded SLK was both stronger and stiffer than all other knots for each suture material. Clamping the first throw of the surgeon knot decreased load to failure significantly (143.11 ± 8.64 N) compared with not clamping (159.21 ± 6.14 N) for polydioxanone. Stiffness and elongation to failure were respectively lower and increased for 2 polydioxanone compared with both polyglactin 910 materials for all knotting techniques. Conclusions— Knotting techniques do influence structural properties of suture loops. The double strand loop conferred stiffer and stronger properties to the SLK Clinical Relevance— Clamping the first throw of polydioxanone should be avoided when tying a suture under tension even using large diameter suture materials. Using a SLK might be considered as a useful alternative when excessive tension is present.     

Mechanical evaluation of two crimp clamp systems for extracapsular stabilization of the cranial cruciate ligament-deficient canine stifle

OBJECTIVE: To compare the mechanical properties and interoperator variabilities of 2 crimp clamp systems for extracapsular, fabello-tibial, nylon loop stabilization of the cranial cruciate ligament-deficient stifle in dogs. STUDY DESIGN: In vitro mechanical testing. METHODS: Three operators with different grip strengths each secured 20 standardized nylon loops using stainless-steel crimp clamps: 10 using a Veterinary Instrumentation system (45 kg [100 lb] test nylon leader line, 12 mm crimp clamps) and 10 using a Securos system (36 kg [80 lb] test nylon leader line, 36 kg [80 lb] crimp clamps). Loops were tensile loaded to failure in a materials testing machine. RESULTS: Mean ultimate load and mean stiffness were significantly higher for the Securos (336.9 N, 60.6 N/mm) than for the Veterinary Instrumentation system (113.8 N, 37.0 N/mm). For both systems, ultimate load was subject to interoperator variability. CONCLUSIONS: The Securos loops were significantly stronger and stiffer than the Veterinary Instrumentation loops for all operators, but significant differences between operators for ultimate load existed for both systems. CLINICAL RELEVANCE: Securos fabello-tibial sutures will withstand greater loads than Veterinary Instrumentation sutures and this is particularly true for sutures created by surgeons with reduced grip strength. It may be necessary to use more than 1 Veterinary Instrumentation suture to match the ultimate load and stiffness of a Securos suture.     

Biomechanical evaluation of suture pullout from canine arytenoid cartilages: effects of hole diameter, suture configuration, suture size, and distraction rate

OBJECTIVE: To evaluate the mechanical properties of canine arytenoid cartilage-suture constructs. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Eighty canine cadaveric larynges. METHODS: Arytenoid cartilage-suture constructs were loaded to failure on a materials testing machine. The effect of hole size, suture configuration, suture size, and rate of distraction on load at failure, displacement at failure, energy to failure, and construct stiffness were evaluated. Polypropylene sutures were used exclusively. Specific variables evaluated were: (1) hole size-SH needle, 22, 20, and 18 ga hypodermic needles; (2) suture configurations-single dorsal and ventral articular sutures, double sutures, horizontal mattress, locking loop, and single non-articular sutures; (3) suture size-1, 0, 2-0, and 3-0; and (4) distraction rate-0.83 and 36.66 mm/s. RESULTS: Hole size had no effect on any biomechanical variable. Double suture and horizontal mattress configurations had the highest median load and energy at failure. Single dorsal suture configurations that did not include the arcuate crest had the lowest median load at failure. Larger suture sizes tended to result in stiffer constructs. Cartilage-suture constructs behaved in a viscoelastic manner where load at failure, energy at failure, and stiffness increased when distraction rate was increased, whereas displacement at failure did not. Most constructs failed by suture pullout regardless of distraction rate, although 50% of horizontal mattress configurations failed by avulsion of the muscular process. CONCLUSION: Suture and hole sizes appear to have few effects on the biomechanical performance of arytenoid-suture constructs. Double-suture and horizontal mattress suture patterns had the best overall mechanical properties for arytenoid lateralization. Single-suture techniques, which do not incorporate the arcuate crest, were biomechanically inferior. CLINICAL RELEVANCE: Cumbersome large-diameter sutures offer no advantage over smaller sutures when performing arytenoid lateralization. The cross-sectional geometry of the muscular process should be taken into account when placing sutures in the arytenoid cartilages. Single-suture techniques that do not incorporate the arcuate crest should be avoided.     

Mechanical comparison of two suture constructs for extra-capsular stifle stabilization

Objective: Mechanical evaluation of 2 suture constructs for extracapsular stifle stabilization. Study Design: In vitro study. Sample Population: Crimped interlocking loop constructs (ILC) of 45 kg nylon leader line (NLL) and Orthofiber^® (OF). Methods: ILC were tightened to 100 N, then crimp secured. Ramp to failure (n=10/group)—Data were derived from force/displacement plots. Stress–relaxation testing (n=10/group)—ILC's were nondestructively loaded and held at resultant displacement as force data were recorded. Incremental, cyclic loading (n=10/group)—ILC's were loaded (5 cycles/set) starting at 100 N and incrementally increased by 50 N (1 and 3 Hz protocols). Loop tension and elongation were recorded after each set. Results: Ramp to failure—initial loop tension was similar (NLL 75.5 ± 9.5 N; OF 68.7 ± 10.4 N, P=.140). Tested OF constructs were stiffer (NLL 125.7 ± 4.0; OF 234.6 ± 25.0 N/mm, P≤.001), had lower yield load (NLL 193.6 ± 13.8; OF 137.3 ± 94.3 N, P≤.001), lower peak load (NLL 873.7 ± 68.6; OF 653.6 ± 80.2 N, P≤.001), and lower elongation at failure (NLL 19.1 ± 1.4; OF 5.2 ± 1.0 mm, P≤.001) and at yield (NLL 1.52 ± 0.2; OF 0.3 ± 0.6 mm, P=.003) than NLL constructs. Yield in NLL ILC's was variable knot tightening/crimp slippage, but only crimp‐suture slippage in OF. Stress–relaxation testing—OF demonstrated greater relaxation. Incremental, cyclic loading—induced ILC elongation and tension loss in both groups, independent of loading frequency. NLL lost tension at lower rate, but elongated more than OF. Conclusions: NLL construct is mechanically superior to OF construct.     

The three-loop pulley suture versus two locking-loop sutures for the repair of canine achilles tendons

OBJECTIVE: To compare a 3-loop pulley suture pattern with 2 locking-loop sutures for the repair of components of the canine Achilles mechanism. STUDY DESIGN: In vitro biomechanical study. ANIMALS: Forty-eight paired tendons collected from 9 canine cadavers. METHODS: Paired tendons were repaired with either a 3-loop pulley suture or 2 locking-loop sutures and tensile tested to failure. To ensure accurate anastomosis gap measurement a direct, non-contact, method of gap measurement, using digital video, was devised. Load initiating gap formation (defined as load at a 1 mm gap) and load producing a 3 mm gap were evaluated in addition to maximum load, gap at failure, mode of failure, and time spent placing the sutures. RESULTS: Maximum load values were similar for both repairs. The mean 1 mm gap loads were 44.0 and 18.4 N, and the mean 3 mm gap loads were 56.3 and 34.7 N, for the 3-loop pulley pattern and the 2 locking-loops, respectively; these differences were statistically significant. The 3-loop pulley pattern was faster to place and resulted in a smaller gap at failure. All but 2 repairs failed by suture pull out. CONCLUSIONS: The 3-loop pulley pattern is more resistant to gap formation during tensile loading, and is quicker to place, than 2 locking-loop sutures. CLINICAL RELEVANCE: Gap formation can significantly delay tendon healing. Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively.     

The Effect of Knotting Method on the Structural Properties of Large Diameter Nonabsorbable Monofilament Sutures

OBJECTIVE: To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials. STUDY DESIGN: In vitro mechanical evaluation. METHODS: A conventional square knot was compared with the surgeon's knot, sliding half-hitch, and clamped square knot. Knotted suture loops were created in a uniform manner and acutely tensioned to failure (20 mm/min loading rate; n = 20 per knot type for each material). Stiffness, yield, and failure characteristics of USP #2 nylon, #2 polybutester, #2 polypropylene, 27 kg test monofilament nylon fishing line, and 27 kg nylon leader material were evaluated. RESULTS: Compared with a conventional square knot, a surgeon's knot decreased stiffness for #2 polypropylene, 27 kg fishing line, and 27 kg leader (P < .05). A sliding half-hitch weakened all materials except 27 kg leader (P < .05). Clamping the first throw of a square knot increased the stiffness of 27 kg leader loops (P < .05). CONCLUSIONS: Based on clinically relevant parameters (stiffness and yield), knotting method had no effect on #2 nylon and #2 polybutester. The surgeon's knot is not recommended for #2 polypropylene and 27 kg fishing line and leader material. A sliding half-hitch decreased the yield of leader material. Clamping the first throw of a square knot had no adverse effects on acute properties of tested materials; it increased the stiffness for leader material. CLINICAL RELEVANCE: Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension.     

The effects of ethylene oxide and gas-plasma sterilization on failure strength and failure mode of pre-tied monofilament ligature loops

OBJECTIVE: To evaluate the effects of ethylene oxide and gas-plasma sterilization on the failure strength and failure mode of pre-tied monofilament ligature loops. STUDY DESIGN: A randomized block design was used by blocking for suture (size 1 polyglyconate, size 2 polydioxanone) and sterilization technique (control, ethylene oxide, gas plasma). SAMPLE POPULATION: Twenty replicates of each suture-sterilization technique combination. METHODS: Ligature loops were pre-tied using a 4S-modified Roeder knot then exposed to 1 of 3 treatments (control, ethylene oxide, or gas-plasma sterilization). Ligature loops were mounted onto a mechanical testing machine to evaluate the effects of sterilization on failure strength and failure mode (disruption, untying). RESULTS: There were no differences between polydioxanone and polyglyconate suture materials in failure strength or mode within sterilization methods. Both sterilization methods significantly increased the likelihood that suture loops would untie compared with controls subjects. Ligature loops that disrupted had a greater breaking strength than those that untied, regardless of sterilization method or suture type. CONCLUSIONS/CLINICAL RELEVANCE: Sterilization with either ethylene oxide or gas plasma of pre-tied, polyglyconate, or polydioxanone ligature loops significantly increases the in vitro likelihood of a modified Roeder knot untying. Further studies need to be conducted to determine the in vivo requirements for ligature loops.     

Effect of Prosthesis Number and Position on Rima Glottidis Area in Equine Laryngeal Specimens

Objective— To assess the effect of 1 or 2 laryngeal prosthetic sutures on rima glottidis areas in equine laryngeal specimens. Study Design— Experimental, randomized design. Animals— Cadaveric equine larynges (n=16). Methods— Larynges were collected from 10 horses; 2 sutures each were preplaced in the right and left sides of each larynx. A dorsal suture (DS) was placed through the caudal rim of the dorsal midline of the cricoid cartilage, under the cricopharyngeus muscle and through the proximal and rostral aspect of the muscular process. A lateral suture (LS) was placed 1.5 cm lateral to the DS and through the muscular process more distal and caudal to the 1st suture. Larynges were positioned in a customized stand and the rima glottidis photographed after each suture (LS or DS) or suture combination (CS) was tied in random sequence. An additional 6 larynxes were used to determine whether the tension applied to the sutures was repeatable. Sutures were preplaced in both the right and left side of each larynx as described above and each suture and CS was tied and released 3 times in each larynx. Photographs were taken of the rima glottidis after each suture or CS was tied generating 3 replicates for each suture configuration on each side of the 6 larynges. Results— Mean rima glottidis area was not different between DS and LS when tied alone (P=.85); however, mean area after CS (DS+LS) was greater than DS (P<.001) and LS (P<.001) alone. The coefficient of variation for the 6 suture patterns were low (1–7%) and the intraclass correlation coefficient estimates were very high (0.997–0.998) demonstrating excellent repeatability between replicates for each of the 3 suture configurations. Conclusion— Our results suggest that laryngoplasty using 2 prostheses; 1 placed dorsally in the cricoid and through the rostral and proximal muscular process and 1 placed 1.5 cm lateral to the 1st and more caudal and distal in the muscular process results in a greater cross sectional area of the rima glottidis than either suture used alone. Clinical Relevance— Seemingly prosthetic sutures contribute independently to each other in determining the contour of the rima glottidis. Use of 2 prosthetic sutures improves crosssectional area of the rima glottidis compared with each suture alone and may improve surgical outcome in laryngoplasty.     

A mechanical study of ligature security of commercially available pre-tied ligatures versus hand tied ligatures for use in equine laparoscopy

OBJECTIVE: To determine a hand-tied ligature knot configuration, suture size, and suture type that would be an acceptable substitute to commercially available ligature knots for use in equine laparoscopic surgery. STUDY DESIGN: Three-factor ANOVA with the fixed effects being suture type, suture size, and knot type. The dependent variable was ligature security (load to failure). METHODS: Commercially available Endoloop and 4 hand-tied slipknot ligatures were compared with a 4-layer square knot. The hand tied ligature knots tested were the 4S modified Roeder knot, the Brooks knot, the modified Roeder knot, and the Weston knot. Two suture sizes (0, 2) of each of 2 suture types (polydioxanone, polyglactin 910) were tested with each hand tied knot. Two types (polydioxanone, polyglactin 910) of size 0 Endoloop were tested. Twenty repetitions of each knot suture type were tested for force to yield on a materials testing machine. Statistical analysis consisted of a 3-way ANOVA with individual comparisons made using the Bonferroni method. Significance was P< or = .05. RESULTS: Only the 4S modified Roeder knot in 2 polydioxanone (103 N) was comparable with the breaking strength of the square knots (157 N). All other knot suture combinations tested were significantly weaker than the square knot (range, 2-18 N). CONCLUSION: For equine laparoscopy, a 2 polydioxanone 4S modified Roeder knot would be an acceptable alternative to the commercially available Endoloop. CLINICAL RELEVANCE: Laparoscopic slip knots are commonly used in equine laparoscopic surgery. Various knot configuration and suture size and type combinations will affect the security of the slip knot.     

A comparison of knot security of commonly used hand-tied laparoscopic slipknots

OBJECTIVE: To compare the peak force required for failure of hand-tied laparoscopic slipknot ligatures. STUDY DESIGN: In vitro mechanical evaluation of suture material/knot combinations. Sample POPULATION: Four hand-tied laparoscopic slipknots were studied. Three suture materials and 2 suture sizes were evaluated. Twenty samples of each group were tested, for a total of 400 samples. METHODS: The 4S modified Roeder, modified Roeder, and Weston and Brooks laparoscopic slipknots using 0 polyglyconate, 0 polyglycolic acid, 1 polyglyconate, and 1 polydioxanone (PDS) were tested. A vertical distracting force (5 mm/s) was applied until failure. Mean peak force to failure was obtained for each suture material, size, and knot combination. RESULTS: Mean (+/-SEM) peak force to failure of hand-tied ligatures ranged from 156.8+/-9.1 N to 4.8+/-.4 N. The 4S-modified Roeder had the highest mean peak force to failure. Ligatures tied with polyglyconate and size 1 suture had the highest mean peak force to failure. CONCLUSIONS: The 4S-modified Roeder was significantly and consistently stronger than the other slipknots. Polyglyconate was superior to other suture materials. The 1 polyglyconate had the highest mean peak force to failure followed by 0 polyglyconate that exceeded the 1PDS. CLINICAL RELEVANCE: The 4S-modified Roeder slipknot using 1 polyglyconate has the greatest breaking strength of sutures tested and should be considered when performing laparoscopic ligatures.     

A comparison of ultra-high-molecular weight polyethylene cable and stainless steel wire using two fixation techniques for repair of equine midbody sesamoid fractures: an in vitro biomechanical study

OBJECTIVE: To compare the monotonic tensile and fatigue strength of 16-gauge stainless steel wire (SSW) to ultra-high-molecular weight polyethylene (UHMWPE) cable using a transfixed cerclage technique in an in vitro midbody sesamoid osteotomy model. Endoscopic modifications to Martins transfixed cerclage technique were developed. A new suture technique of fixation was compared with the transfixed cerclage technique by measuring gap formation after cyclic testing. STUDY DESIGN: An in vitro biomechanical paired equine cadaver limb study. SAMPLE POPULATION: Twenty-one paired cadaveric adult equine forelimbs. METHODS: Uniaxial medial midbody sesamoid osteotomies were created in paired adult equine forelimbs. Monotonic tensile strength was measured on 10 forelimbs repaired by a transfixed cerclage technique using wire or cable. Fatigue testing to failure was performed on 4 forelimbs repaired using the transfixed cerclage technique by cycling the limbs between 500 N and 2,000 N. The limbs were initially repaired with wire, cycled until the wire broke, then repaired with cable and cycled again to failure. Fatigue testing for gap displacement was performed on 8 limbs repaired with either the transfixed cerclage technique or the suture technique. Limbs were cycled between 500 N and 2,000 N for 10,000 cycles. The limbs were repaired with wire initially, tested, and then repaired with cable and tested again. Twenty-two limbs were used for mechanical testing. The remaining limbs (20) were used to develop and practice the endoscopic transfixed cerclage (10 limbs) and suture (10 limbs) techniques. RESULTS: Ultimate tensile strength (UTS) of UHMWPE cable constructs was 34% greater than the UTS of SSW constructs. Fatigue strength was 2 to 20 times greater for UHMWPE cable constructs than SSW constructs. Separation of fragments was 153% less for limbs repaired by the suture technique compared with those repaired by the transfixed cerclage technique. CONCLUSIONS: UHMWPE cable shows promise for this clinical application because of its greater tensile and fatigue strength. The newly described suture technique significantly reduced gap formation compared with the transfixed cerclage technique. Osteotomy gap formation occurred early in cycling, suggesting that rigid support in the form of a cast may be needed during the early postoperative period for wiring techniques. CLINICAL RELEVANCE: Clinical testing of UHMWPE cable should eliminate problems of wire breakage seen with SSW. The endoscopic transfixed cerclage technique can be used by surgeons familiar with arthroscopic surgery. However, the suture technique needs to be tested in vivo to determine whether there is a clinical advantage compared with the transfixed cerclage technique.     

Biomechanical analysis of suture anchors and suture materials used for toggle pin stabilization of hip joint luxation in dogs

OBJECTIVE: To compare in vitro mechanical properties of toggle pins and toggle rods used as suture anchors and of 3 suture materials (50-lb monofilament polybutester, No. 5 braided polyester, and 5-mm woven polyester) commonly used as prosthetic ligaments in the repair of hip joint luxation in dogs. SAMPLE POPULATION: Femoropelvic specimens from the cadavers of 18 dogs. PROCEDURE: Suture anchors were compared by use of pullout tests. Suture materials were compared by use of monotonic and cyclic tensile tests; cyclic tensile tests were performed with the suture placed over the edge of an aluminum bar to simulate the edge of the femoral bone tunnel. In vitro mechanical properties of the ligament of the femoral head were determined by use of monotonic tensile tests, using bone-ligament-bone cadaveric specimens. The in vitro mechanical properties of the acetabulum-ligament-femur complex and of this complex following rupture of the ligament and stabilization with a toggle rod and 5-mm woven polyester were determined by use of compression tests that simulated weight-bearing. RESULTS: Mechanical properties of the toggle rod were not significantly different from those of the toggle pin. Woven polyester had the longest fatigue life in cyclic testing. Hip joints stabilized with a toggle rod and woven polyester had less than half the strength in vitro of intact joints. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a toggle rod or toggle pin can be used for stabilization of hip joint luxations in dogs. Of the materials tested, braided polyester had the best in vitro mechanical properties.     

A Study of the Biomechanical Properties of the Adult Equine Linea Alba: Relationship of Tissue Bite Size and Suture Material to Breaking Strength

The purposes of this study were to mechanically determine the optimal tissue bite size and to evaluate seven suture materials at their largest commercially available size for breaking strength and stiffness using cadaveric adult equine linea alba. Soft tissues were removed from the abdominal fascia of 16 adult horses. Individual test sections were created from the entire linea alba and labeled (1 through 6) starting at the umbilicus and extending craniad. A single biomechanical test was performed on each test section. Tissue bite size (3, 6, 9, 12, 15, 18, and 21 mm) significantly altered breaking strength directly in a logarithmic fashion (P < .0001; R²= 0.94). Tissue bite size accounted for 44% and linea alba thickness for 24% of the variability in breaking strength of the equine linea alba. The optimal tissue bite size for adult horses was 15 mm from the edge of the linea alba based on lack of significant gain in breaking strength. There were no differences in breaking strength among horses, horses weight, or left and right test sections. Test sections taken from near or at the umbilicus had greater breaking strength (P < .005) and thicker linea alba (P < .001) when compared with more cranial test sections. Linea alba thickness alone accounted for 34% of the variability in breaking strength associated with test section position. There were no differences in linea alba stiffness among tissue bite sizes. All suture loops failed before complete fascial disruption, and 52 of 56 (93%) suture loops failed at the knot. Suture breaking strength and stiffness were significantly affected by the type of suture material examined (P < .0001). Size 5 polyester had a greater breaking strength and stiffness compared with the other suture materials tested. The next strongest suture materials were size 3 polyglactin 910 and size 2 polyglycolic acid, which were similar in breaking strengths and stiffness. Size 2 nylon was significantly weaker in breaking strength when compared with the other suture materials.     

In Vitro Loss of Tensile Strength and Elasticity of Five Absorbable Suture Materials in Sterile and Infected Canine Urine

The loss of breaking strength and elasticity of five absorbable suture materials (polydioxanone [PDS-II], polyglycolic acid [PGA], polyglactin 910 [PG-910], polyglyconate [GTMC], and chromic gut) after in vitro incubation in sterile, Escherichia coli- and Proteus mirab/tfs-inoculated canine urine was studied. Biomechanical testing, in a controlled environment, was performed during the 28-day study period. Polydioxanone and chromic gut retained greater than 90% of their original strengths after 28 days of incubation in sterile urine and 87% of original strengths in E. co//-inoculated urine. Polyglyconate retained 24% and 18% of original strength, respectively, after incubation in sterile and E. co/i-inoculated urine for 28 days. Polyglycolic acid and PG-910 retained less than 30% of original strength in sterile urine and only 7% in E. co/i-inoculated urine after 21 days of incubation. In P. m/rabi/is-inoculated urine, loss of tensile strength and elongation was significant for all suture materials. Polyglycolic acid and PG-910 lost all strength after 24 hours of incubation. Polydioxanone lost all strength after 7 days of incubation, whereas GTMC retained 19% at day 7. Chromic gut retained 78% at day 7 and 16% after 21 days of incubation, however, the absence of normal phagocytic destruction of chromic gut in this in vitro study may have artificially elevated these values. In sterile urine with chemically modified pH, loss of strength and elongation was greater in alkaline urine than in neutral or acidic urine for all types of suture materials.     

Functional suture-holding layer of the esophagus in the dog

Several investigators have stated that the suture-holding layer of the esophagus is the mucosa. In this study, the component layers of the esophagus were separated. Segments of the cervical esophageal wall, muscularis, submucosa, and submucosa-mucosa were each sutured, and the suture lines were subjected to tensile forces. When subjected to tensile force, all suture lines failed when sutures pulled through the tissue. The data were subjected to statistical analysis. Based on this analysis, it was concluded that the full esophageal wall had the greatest ability, and the muscularis the least ability, to hold sutures against tension. Therefore, when no significant difference in suture-holding ability between the submucosa alone and the submucosa-mucosa together was demonstrated, it was concluded that the submucosa was the suture-holding layer of the esophagus.     

Two-, three-, and four-breed rotational crossbreeding of beef cattle: carcass traits.

Carcass data from 1,494 straightbred and rotational crossbred steers were collected over four generations. Mating systems included straightbreds (Angus [A], Brahman [B], Charolais [C], and Hereford [H]); two-breed rotations (A-B, C-B, and H-B); three-breed rotations (A-B-C, A-B-H, and B-C-H); and a four-breed rotation (A-B-C-H). Steers were randomly allocated to one of four postweaning treatments that varied in length of grazing and feeding periods. Treatment and breed group (four straightbreds and seven rotational combinations) significantly influenced hot carcass weight (HCWT), retail yield (RY), longissimus muscle area (LM), fat thickness (FT), marbling score (MS), USDA quality grade (QG), and Warner-Bratzler shear force (WBS). Feeding for longer periods resulted in greater (P < .05) HCWT, RY, FT, and MS, higher QG, and lower (P < .05) WBS values. Among the straightbreds, C was heavier and larger for HCWT, RY, and LM (P < .01), whereas A and H had greater (P < .01) FT and MS. The B was similar to H for HCWT, RY, and LM and to C for FT but ranked last (P < .01) for MS and WBS. Three- and four-breed rotational mating systems were superior (P < .05) to the two-breed rotation for HCWT, RY, and LM but were similar for FT, MS, and WBS. Rotational combinations exceeded (P < .05) the straightbreds for all carcass traits except MS.     

Effects of Arytenoid Abduction and Modified Castellated Laryngofissure on the Rima Glottidis in Canine Cadavers

The percentages of change in cross-sectional area and dorsoventral height of the rima glottidis were measured after seven types of laryngoplasty in 30 postmortem canine specimens. The mean increases in area after each procedure were, in decreasing order, bilateral cricoarytenoid disarticulation with interarytenoid sesamoid band transection before placement of arytenoid abduction sutures 350% +/- 42%, bilateral placement of arytenoid abduction sutures 318% +/- 40%, bilateral cricothyroid disarticulation before placement of arytenoid abduction sutures 255% +/- 51%, modified castellated laryngofissure 244% +/- 30%, unilateral cricoarytenoid disarticulation with interarytenoid sesamoid band transection before placement of an arytenoid abduction suture 161% +/- 25%, unilateral placement of an arytenoid abduction suture 151% +/- 24% and unilateral cricothyroid disarticulation before placement of an arytenoid abduction suture 108% +/- 25%. Bilateral cricoarytenoid disarticulation with interarytenoid sesamoid band transection before placement of arytenoid abduction sutures resulted in a significantly greater increase in rima glottidis area than modified castellated laryngofissure and all unilateral arytenoid abduction techniques. Modified castellated laryngofissure resulted in a significantly greater increase than unilateral placement of an arytenoid abduction suture and cricothyroid disarticulation before placement of an arytenoid abduction suture. Bilateral disarticulation of the cricothyroid joint before placement of arytenoid abduction sutures resulted in significant collapse of the dorsoventral height of the rima glottidis.