Barbed Suture in Tendon Repair - (Pages 5-9)
Abstract: Hand tendon lacerations are difficult to treat with over 25% of patients achieving an unsatisfactory clinical outcome as assessed by the clinician, and 7.7% of repairs re-rupture, requiring further surgery. The suture materials, which are available today possess tensile strengths capable of withstanding forces far above what occurs during active treatment. The current suture techniques have some disadvantages of bulky repair, adhesion formation and delayed tendon rupture. With availability of better designs of Barbed sutures like Quill™, Vloc™ and Stratafix™ it has opened up a scope for new research into tendon repair. Various ex vivo studies have shown that a four strand repair using barbed suture has similar strength to conventional repair and adding an epitendinous suture adds on to repair strength. The Barbed suture repair reduces the cross sectional area at repair site, which may translate to reduced gliding resistance. There is need for clinical studies to analyze the effectiveness of Barbed suture in tendon repair in clinical setting and explore the potential advantages. Level of evidence II.
Keywords: Barbed suture, Vloc, Quill, Stratafix, Tendon repair, Gliding resistance, Breaking strength.