The Study Of Suturing The Tendons With Absorptive Thread By Core Crossover Side Whipstitch Method

ObjectiveThe purpose of this study was to create a new tendon repair method called core crossoverside whipstitch method with absorptive thread. It was established by combineing Kessler′ssuture with continuous cross side suture. This new suture method could make the end of tendonsmooth and strengthen its ability to resist stretching.As a result, it can meet the requirement offunctional exercise completely in an early stage. The core crossover side whipstitch method is akind of ideal tendon repair method.Methods1.14rabbit flexor tendons in toe were divided into2groups randomly(group A and group B).The tendons were cut off neatly in the mediate position all of them. Then the tendons in group Awere sutured by core crossover side whipstitch method with prolene suture, while the group Bwere sutured by improved Kessler method with the same prolene suture. The maximum limit ofthe tension force in the two groups were tested so as to analyze which group had a strongertension force.2.28New Zealand rabbits were divided into four groups(group A, group B, group C, groupD)randomly. The model of tendinous rupture were made on them. The left and right flexortendons in toe of every rabbit were repaired with prolene suture(5-0) or Coated Vicryl(5-0)suture by core crossover side whipstitch method seperately and randomly.The adhesion degreebetween tendons and surrounding tissues were observed and tested. And then the biomechanicaldifference of sutures were comparaed immediately and1st-3id week after surgery respectively.3.10New Zealand rabbits were divided into5groups. They were dealt with by the samemethod as just mentioned above. The left and right tendon specimens of each rabbit were madeinto histologic section right after1st-8th week respectively.Then the pathologic reaction in the sutures of the tendons were observed carefully.Result1. Adhesion degree observation: The tendon adhesion degree significantly increased from thefirst to the third week, no matter which kind of sutures we adopted.2. Pathology examination: Coated Vicryl suture could be absorbed completely and theinflammation disappeared quickly. Prolene suture could remain for life-long time.3. The tension force maximum limit of the tendons which were repaired by core crossover sidewhipstitch method with prolene suture were stronger than the that repaired by improved Kesslermethod. Coated Vicryl suture was as good as, even better than Prolene suture, because it couldbe absorbed completely.ConclusionThe tencile strength of the tendon repaired by core crossover side whipstitch method withprolene suture were stronger than that repaired by improved Kessler method. It can satisfy therequirement of rehabilitation exercise completely and actively in an early stage. Coated Vicrylsuture can be absorbed and remain nothing in the end of the tendon as time go on, so that it canalso meet the requirement of functional exercise biomechanically.