Grasping Thin Polypropylene Sutures Even With Less Traumatic Instruments May Decrease Their Tensile Strength

Abstract

Objective: Anastomotic false aneurysms can form due to damaged polypropylene sutures (PS). This study aimed to examine whether pinching PS with modern less traumatic vascular instruments affects their tensile strength (TS). Methods: Fifteen pairs each of 3–0 Prolene and 4-0 and 5-0 Optilene, as well as 18 pairs each of 6–0 and 7-0 Surgipro II PS were tested. Half of the sutures were compressed with a Jacobson Micro Needle Holder (NH) and half with DeBakey atraumatic tissue forceps (TF) for two seconds using a standardised pressure force of 40.8 ± 5.0 g. The pressure was based on the mean pinch force produced by a total of six experienced vascular surgical consultants. The same unpaired numbers of these PS served as references. Samples were tested for breakage on a traction device with a tensile force sensor. The TS was calculated for each sample and compared with the reference. Two sets of sutures of each size, containing five NH and TF compressions on each set, were examined for possible surface damages with optical tomography. Results: A statistically significant TS decrease was detected only after NH compression of 6–0 (p = 0.003) and 7-0 (p < 0.001) PS. On optical tomography, the extent of post-compression changes increased with decreasing diameter; the changes were similar throughout the corresponding size and instrument groups. Surfaces compressed with an NH were evenly deformed and rough, with multiple cortex damages. PS pinched with TF were unevenly deformed. The visually detectable surface damage was less extensive compared with what was observed after NH compressions. Conclusion: Pinching of the tested PS led to structural deformations and superficial cortex damage. Compressions of 6–0 and 7-0 PS with an NH led to significant TS reduction.