Daniel J Duffy1, Cameron G Kindra2, George E Moore3. 1. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina. 2. Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois. 3. Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana.
Abstract
OBJECTIVE: To compare initial leakage pressure after double-layer inverting and single-layer appositional closures with unidirectional barbed suture or an analogous monofilament absorbable suture in an ex vivo ovine model. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Ovine cadaveric bladders (n = 48). METHODS: A 4-cm ventral cystotomy was performed in each bladder. Bladders were randomly divided into 4 groups (n = 12 each group) and sutured in an open setting with a single-layer appositional or a double-layer inverting pattern of unidirectional 2-0 barbed or an analogous monofilament suture. Intraluminal pressure at initial leakage and leakage location were recorded. Analysis of variance was used to compare initial leak pressure between the 4 groups (P < .05). RESULTS: Ovine urinary bladders closed with double-layer inverting closures leaked at intraluminal pressures about twofold greater than bladders closed with single-layer appositional closures (P < .0001) whether barbed or nonbarbed suture was used (P ≥ .987). Bladders most commonly leaked at the suture hole after single-layer closure. Bladders that had been repaired with a double-layer closure leaked at the knot in nonbarbed closures or at the preconstructed end loop in barbed closures. CONCLUSION: Double-layer closure increased leakage pressures compared with single-layer closures, irrespective of the suture type used. CLINICAL SIGNIFICANCE: This study provides evidence to support double-layer rather than single-layer closure of cystotomies in clinical cases. The use of barbed suture may be suitable for cystorrhaphy in sheep.
OBJECTIVE: To compare initial leakage pressure after double-layer inverting and single-layer appositional closures with unidirectional barbed suture or an analogous monofilament absorbable suture in an ex vivo ovine model. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Ovine cadaveric bladders (n = 48). METHODS: A 4-cm ventral cystotomy was performed in each bladder. Bladders were randomly divided into 4 groups (n = 12 each group) and sutured in an open setting with a single-layer appositional or a double-layer inverting pattern of unidirectional 2-0 barbed or an analogous monofilament suture. Intraluminal pressure at initial leakage and leakage location were recorded. Analysis of variance was used to compare initial leak pressure between the 4 groups (P < .05). RESULTS: Ovine urinary bladders closed with double-layer inverting closures leaked at intraluminal pressures about twofold greater than bladders closed with single-layer appositional closures (P < .0001) whether barbed or nonbarbed suture was used (P ≥ .987). Bladders most commonly leaked at the suture hole after single-layer closure. Bladders that had been repaired with a double-layer closure leaked at the knot in nonbarbed closures or at the preconstructed end loop in barbed closures. CONCLUSION: Double-layer closure increased leakage pressures compared with single-layer closures, irrespective of the suture type used. CLINICAL SIGNIFICANCE: This study provides evidence to support double-layer rather than single-layer closure of cystotomies in clinical cases. The use of barbed suture may be suitable for cystorrhaphy in sheep.