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Optimization of tissue anchoring performance and mechanical properties of barbed sutures for flexor tendons repair

Plastic and Aesthetic Research 2018年第4期5卷 1-17页

作者： Joseph bakhach Ahmad Oneissi elsa bakhach Reem Karameh Mireille Hantouche EIie Shammas American University of Beirut Medical Center Beirut 1107-2020Lebanon

Aim: The ideal flexor tendon repair should be reliable, simple and strong enough without impairing the tendon healing. Based on these requirements, we have imagined the use of a single barbed intra-tendinous suture for stumps connection. The aim of our research is to quantify the stress that the suture and barbs should withstand in order to ensure perfect stumps connections. Methods: Seven different cross-section sutures were selected for the research study. One circular and 6 different elliptical shapes were defined according to the ratio of their minor and major axes (ρ = b/a). Barbs were designed with 3 different depths and 3 different cut angles. Thus, 9 different situations were considered for each suture geometry. Finally, 2 loading conditions were applied on each barb and tested in ANSYS Workbench using a finite element analysis technique. Results: Studies showed that a barbed suture with 0.18-mm depth, 150° cut angle and ρ = 3 produced the lowest stresses within the barb itself, while a barbed suture with 0.18-mm depth, 160° cut angle and ρ = 4 demonstrated lowest stress within the entire suture. Conclusion: The stress values in these two configurations are observed to be very close and both can fit a single barbed suture for tendon insertion and repair.

关键词： Flexor tendon hand suture finger sheath pulley barb

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Optimization of the design of a barbed suture for flexor tendon repair using extended finite element analysis

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Plastic and Aesthetic Research 2018年第6期5卷 18-40页

作者： Joseph bakhach Ahmad Oneissi Dimitri bakhach Reem Karami Kobeissi Hiba Shammas Elie American University of Beirut Medical Center Faculty of MedicineBeirut 2020Lebanon

Aim: Use of barbed sutures for fiexor tendon repair is a promising technique. These sutures lie within the substance of the tendon, avoiding the need of external knots and so improving tendon gliding. The load is dispersed equally along the length of the barbed suture, decreasing the possibility of rupture. The purpose of this article is to propose enhanced suture geometry by comparing different cross-sectional configurations, barb cut angles and cut depths using the finite element method. Methods: lnspired by the geometry of fiexor tendons, an elliptical cross-sectional wire was investigated. Mechanical behavior of five different aspect ratios (ρ = 1/3, 1/2, 1, 2, 3), three different cut angles (150°, 154°, 160°) and three cut depths (0.07-mm, 0.12-mm, 0.18-mm) were studied via extended finite element analysis using ABAQUS, for two different loading conditions: one to assess the strength of the suture and the second to evaluate the strength of a single barb. An extended finite element method has been implemented on ABAQUS to predict crack growth in viscoelastic material. Results: Based on these results, an elliptical suture having an aspect ratio of 1/2, 160° of cut angle, and 0.12-mm of cut depth is recommended. Conclusion: Barbed sutures are a good option for tendon repair. Our experiments assessed the mechanical performance of barbed sutures and suggested an optimized suture geometry for a single-stranded repair technique.

关键词： Flexor tendon hand finger barbed suture tendon repair

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