Product Manual

Suture failure also may occur if the knotted suture loop cuts through the

tissue. The type of tissue has considerable influence on the magnitude of

force required to tear the suture through the tissue. Howes and Harvey

reported that the forces required to tear gut sutures through canine

fascia was the greatest followed by muscle, peritoneum and then fat.

Using cadaver specimens 6 to 93 days after death, Tera and °Aberg

measured the magnitude of forces required for suture to tear through

excised musculoaponeurotic layers of laparotomy incisions. The rationale

for this study was that the forces required to tear sutures through a

musculoaponeurotic layer would provide a basis for the choice of a

suture whose strength is at least as strong as the forces required to tear

the suture through the tissue. When the suture was passed lateral to the

transition between the linea alba and the rectus sheath, the force required

to tear the suture through the tissue was greater than that for any other

musculoaponeurotic layer tested; the paramedian incision required the

lowest forces to pull sutures through its sheaths. When they recorded the

forces needed for sutures to tear through structures involved in the repair of

inguinal hernia, the structures making up the conjoined tendon and Cooper’s

ligament were the strongest and exhibited twice the resistance to suture

tearing than those of the other structures.

As expected, the force required for sutures to tear through tissue changes

during healing. Aberg

reported that the forces needed for sutures to tear

through the aponeurotic muscle layer reduced significantly during the first

week of healing. When the wound edges were approximated by suture tied

tightly around this aponeurotic muscle layer, the reduction in force needed

for the suture to pull through this tissue persisted for two weeks.

suture cutting

tissue