Positioning of the cross-stitch on the modified Kessler core tendon suture. 2018

L Gil-Santos, and M Monleón-Pradas, and F Gomar-Sancho, and J Más-Estellés
Hospital Intermutual de Levante, CV-35, Km 11, Valencia, España; Centro de Biomateriales e Ingeniería Tisular, Universitat Politécnica de València, Camino de vera s/n, 46022 Valencia, España; Instituto Universitario de Investigación en Enfermedades Músculo-esqueléticas Universidad Católica de Valencia (San Vicente Mártir), C/Quevedo, 2, 46001 Valencia, España.

Cryopreserved human tendons were sutured with different variations of a modified Kessler-type grasping suture in a series of different designs in order to assess the influence of the distance between the cross-stitch on the core suture (5 and 10 mm from the cut tendon edge) on the peripheral suture. An original mathematical model was employed to explain the mechanical behavior (strength, deformation, and distribution of load) of the different suture designs. The effect of the peripheral epitendinous suture, combined with the distance of the core suture, was evaluated. The variation of core suture distance had no relevant consequences on the overall resilience of the design. However, increasing the distance between the cross-stitches of the core suture reduces the deformation that is absorbed not only by the core suture itself but also by the peripheral suture. Adding a peripheral epitendinous suture to a 10-mm design almost doubles the breaking load in absolute values. The mathematical model predicts that the peripheral suture will support a greater load when the distance of the core suture cross-stitches is increased. The evidence level is II.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D013537 Sutures Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed) Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture
D013708 Tendon Injuries Injuries to the fibrous cords of connective tissue which attach muscles to bones or other structures. Injuries, Tendon,Injury, Tendon,Tendon Injury
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular
D013718 Tensile Strength The maximum stress a material subjected to a stretching load can withstand without tearing. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed, p2001) Strength, Tensile,Strengths, Tensile,Tensile Strengths
D019637 Orthopedic Procedures Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures. Orthopedic Surgery,Surgery, Orthopedic,Orthopedic Rehabilitation Surgery,Orthopedic Surgical Procedures,Orthopedic Procedure,Orthopedic Rehabilitation Surgeries,Orthopedic Surgeries,Orthopedic Surgical Procedure,Procedure, Orthopedic,Procedure, Orthopedic Surgical,Procedures, Orthopedic,Procedures, Orthopedic Surgical,Rehabilitation Surgeries, Orthopedic,Rehabilitation Surgery, Orthopedic,Surgeries, Orthopedic,Surgeries, Orthopedic Rehabilitation,Surgery, Orthopedic Rehabilitation,Surgical Procedure, Orthopedic,Surgical Procedures, Orthopedic
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic

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