In vitro biomechanical comparison of the strength of the linea alba of the llama, using two suture patterns

Linda Van Hoogmoed From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Jack R. Snyder From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Susan M. Stover From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Christiana Drake From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Kenneth Taylor From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Faye A. Harmon From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Laurie McDuffee From the Veterinary Medical Teaching Hospital (Van Hoogmoed) and Departments of Surgical and Radiological Sciences (Snyder, Harmon), Anatomy/Physiology and Cell Biology (Stover, Taylor, McDuffee), and Statistics (Drake), University of California, Davis, CA 95616.

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Abstract

Objective

To compare the strength of the sutured linea alba, in vitro, using 2 suture patterns.

Animals

12 clinically normal llamas.

Procedure

2 incisions in the linea alba of 12 llamas were closed with a simple continuous or inverted cruciate pattern, and tissue was harvested after 10 days. In 6 llamas, the simple continuous line was intact; the inverted cruciate specimens contained 6 sutures. In 6 llamas, 1 knot was excised in the simple continuous pattern to simulate a failed line; the cruciate pattern contained 5 knots. Tissue sections were taken from cranial, between, and caudal to the linea alba incisions to compare fascial thickness. The sutured specimens were mounted in a mechanical testing system and tested to failure. A mixed-model ANOVA was used to evaluate the effects of suture pattern and incisional position on mechanical properties.

Results

Significant differences were not found between suture patterns or between location for yield force, failure force, or yield strain, whereas failure strain was lower for the intact simple continuous pattern than the inverted cruciate pattern (P = 0.003). From histomorphometric analysis, the caudal tissue specimens were significantly thinner than the middle tissue specimen cranial to the umbilicus (P = 0.006).

Conclusion

There was no significant difference in monotonic breaking strength of the linea alba sutured with the simple continuous or inverted cruciate pattern.

Clinical Relevance

These results justify the use of the simple continuous pattern over the cruciate pattern for ventral midline closure in llamas because of the ease of placement and speed. (Am J Vet Res 1996;57:938–942)

Abstract

Objective

To compare the strength of the sutured linea alba, in vitro, using 2 suture patterns.

Animals

12 clinically normal llamas.

Procedure

2 incisions in the linea alba of 12 llamas were closed with a simple continuous or inverted cruciate pattern, and tissue was harvested after 10 days. In 6 llamas, the simple continuous line was intact; the inverted cruciate specimens contained 6 sutures. In 6 llamas, 1 knot was excised in the simple continuous pattern to simulate a failed line; the cruciate pattern contained 5 knots. Tissue sections were taken from cranial, between, and caudal to the linea alba incisions to compare fascial thickness. The sutured specimens were mounted in a mechanical testing system and tested to failure. A mixed-model ANOVA was used to evaluate the effects of suture pattern and incisional position on mechanical properties.

Results

Significant differences were not found between suture patterns or between location for yield force, failure force, or yield strain, whereas failure strain was lower for the intact simple continuous pattern than the inverted cruciate pattern (P = 0.003). From histomorphometric analysis, the caudal tissue specimens were significantly thinner than the middle tissue specimen cranial to the umbilicus (P = 0.006).

Conclusion

There was no significant difference in monotonic breaking strength of the linea alba sutured with the simple continuous or inverted cruciate pattern.

Clinical Relevance

These results justify the use of the simple continuous pattern over the cruciate pattern for ventral midline closure in llamas because of the ease of placement and speed. (Am J Vet Res 1996;57:938–942)

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