This study was internally funded by the Department of Otolaryngology and Center for Voice, Airway, and Swallowing Disorders at Georgia Health Sciences University, Augusta, Georgia. Covidien Inc. provided V-loc wound closure devices for this study, but did not have access to data acquisition, analysis, or manuscript preparation.
Head and Neck
Version of Record online: 30 MAR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 5, pages 1062–1066, May 2012
How to Cite
Bush, C. M., Prosser, J. D., Morrison, M. P., Sandhu, G., Wenger, K. H., Pashley, D. H., Birchall, M. A., Postma, G. N. and Weinberger, P. M. (2012), New technology applications: Knotless barbed suture for tracheal resection anastomosis. The Laryngoscope, 122: 1062–1066. doi: 10.1002/lary.23229
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue online: 18 APR 2012
- Version of Record online: 30 MAR 2012
- Accepted manuscript online: 1 FEB 2012 01:18AM EST
- Manuscript Accepted: 9 JAN 2012
- Manuscript Revised: 31 DEC 2011
- Manuscript Received: 30 AUG 2011
- Tracheal resection;
- tracheal anastomosis;
- barbed suture
Tracheal resection anastomoses are often under tension and can be technically challenging. New suture materials such as V-loc (barbed, knotless wound closure device) may offer advantages over conventional methods. The objective of this study is to determine if a running V-loc suture is of comparable tensile strength to conventional closure.
Laboratory based study of human cadaveric tissue.
Fresh human cadaveric tracheas were dissected and incised into segments. Anastomosis of adjacent segments was then performed with either submucosal interrupted 3-0 Vicryl, or a running submucosal 3-0 V-loc suture. Anastomosed specimens were stretched to failure on an Instron force tension machine. Surgeon satisfaction was recorded by visual analog scale (VAS).
The tensile strength of 12 tracheal anastomoses was tested. Video documentation of V-loc suture technique and anastomosis failure was recorded. In both Vicryl (80%) and V-loc (100%) anastomoses, failure occurred at the membranous intercartilaginous region. In 20% of the Vicryl anastomoses, the suture was noted to break prior to tissue failure. Anastomoses with V-loc suture had equivalent failure force (mean, 59 N) compared to interrupted Vicryl (51 N), with P = .57. On VAS, surgeons were more satisfied with V-loc suture closure compared to interrupted Vicryl closure (paired t test, P = .003).
Tracheal anastomosis with running v-loc suture is a feasible alternative to conventional closure with interrupted Vicryl suture. V-loc suture provided a surgical advantage by improved ease of use.