Skip to main content
Top
Published in: Hernia 4/2016

01-08-2016 | Original Article

An implantable sensor device measuring suture tension dynamics: results of developmental and experimental work

Authors: A. Schachtrupp, O. Wetter, J. Höer

Published in: Hernia | Issue 4/2016

Login to get access

Abstract

Purpose

Knowledge about suture tension dynamics after laparotomy closure is limited due to the lack of adequate measurement tools. As a consequence, a miniaturized implantable sensor and data logger were developed and applied experimentally in a porcine model to measure suture tension dynamics after laparotomy closure.

Material and methods

We developed an implantable device (6 × 3 × 1 mm) fitted with silicon strain gauges and an implantable data logger allowing long-term registration. In nine domestic pigs, sensors and loggers were implanted along the suture closing a median laparotomy registering suture tension over a period of 23 h.

Results

Fascial closure was achieved by a mean suture tension of 1.07 N. After 30 minutes, suture tension was reduced to 0.81N (−24.3 %, p = 0.0003). After 12 h, tension showed a further decrease to 0.69 N (−35.5 %, n.s.), after 23 h mean suture tension reached 0.56 N, (−47.7 %, p = 0.014).

Conclusions

The aim to develop an implantable miniaturized sensor device registering long-term suture tension dynamics was achieved. The use in the animal experiment was feasible and safe. We observed a loss of almost 50 % of suture tension 23 h after fascial closure. This could mean that up to 50 % of initial suture tension may be an unnecessary surplus not contributing to tissue stability but to the risk of suture failure.
Literature
1.
go back to reference Albertsmeier M, Seiler CM, Fischer L, Baumann P, Hüsing J, Seidlmayer C, Franck A, Jauch KW, Knaebel HP, Büchler MW (2012) Evaluation of the safety and efficacy of MonoMax® suture material for abdominal wall closure after primary midline laparotomy- a controlled prospective multicentre trial: ISSAAC [NCT 005725079]. Langenbecks Arch Surg 397(3):363–371CrossRefPubMed Albertsmeier M, Seiler CM, Fischer L, Baumann P, Hüsing J, Seidlmayer C, Franck A, Jauch KW, Knaebel HP, Büchler MW (2012) Evaluation of the safety and efficacy of MonoMax® suture material for abdominal wall closure after primary midline laparotomy- a controlled prospective multicentre trial: ISSAAC [NCT 005725079]. Langenbecks Arch Surg 397(3):363–371CrossRefPubMed
2.
go back to reference Höer J, Lawong G, Klinge U, Schumpelick V (2002) Einflußfaktoren der Narbenhernienentstehung: Retrospektive Untersuchung an 2983 laparotomierten Patienten über einen Zeitraum von 10 Jahren. Chirurg 73:478–480 Höer J, Lawong G, Klinge U, Schumpelick V (2002) Einflußfaktoren der Narbenhernienentstehung: Retrospektive Untersuchung an 2983 laparotomierten Patienten über einen Zeitraum von 10 Jahren. Chirurg 73:478–480
3.
go back to reference Cengiz Y, Blomquist P, Israelsson LA (2001) Small tissue bites and wound strength: an experimental study. Arch Surg 136:272–275CrossRefPubMed Cengiz Y, Blomquist P, Israelsson LA (2001) Small tissue bites and wound strength: an experimental study. Arch Surg 136:272–275CrossRefPubMed
4.
go back to reference Israelsson LA, Jonsson T (1993) Suture length to wound length ratio and healing of midline laparotomy incisions. Br J Surg 80:1284–1286CrossRefPubMed Israelsson LA, Jonsson T (1993) Suture length to wound length ratio and healing of midline laparotomy incisions. Br J Surg 80:1284–1286CrossRefPubMed
5.
go back to reference Högström H, Haglund U, Zederfeldt B (1990) Tension leads to increased neutrophil accumulation and decreased laparotomy strength. Surgery 107:215–219PubMed Högström H, Haglund U, Zederfeldt B (1990) Tension leads to increased neutrophil accumulation and decreased laparotomy strength. Surgery 107:215–219PubMed
6.
go back to reference Höer J, Töns Ch, Schachtrupp A, Anurov M, Titkova S, Oettinger A, Schumpelick S (2002) Quantitative evaluation of abdominal wall perfusion after different types of laparotomy closure using laser fluorescence videography. Hernia 6:11–16CrossRefPubMed Höer J, Töns Ch, Schachtrupp A, Anurov M, Titkova S, Oettinger A, Schumpelick S (2002) Quantitative evaluation of abdominal wall perfusion after different types of laparotomy closure using laser fluorescence videography. Hernia 6:11–16CrossRefPubMed
7.
go back to reference Höer J, Junge K, Schachtrupp A, Klinge U, Schumpelick V (2002) Influence of laparotomy closure technique on collagen synthesis in the incisional region. Hernia 6(3):93–98CrossRefPubMed Höer J, Junge K, Schachtrupp A, Klinge U, Schumpelick V (2002) Influence of laparotomy closure technique on collagen synthesis in the incisional region. Hernia 6(3):93–98CrossRefPubMed
8.
go back to reference Höer J, Wetter O, Klinge U, Junge K, Schumpelick V (2002) Can surgeons control suture tension? Results of a study with a newly designed device. Hernia 6(Supplement 1):27–28 Höer J, Wetter O, Klinge U, Junge K, Schumpelick V (2002) Can surgeons control suture tension? Results of a study with a newly designed device. Hernia 6(Supplement 1):27–28
9.
go back to reference Höer J, Wetter O, Peschke C, Schumpelick V, Weck M (2001) Einsatz miniaturisierter Sensoren zur Kontrolle von Naht- und Fadenspannung in der Chirurgie. In: Neue Technologien für die Medizin. Forschung, Praxis, Innovation. Shaker Verlag Aachen 2001, 321-340 Höer J, Wetter O, Peschke C, Schumpelick V, Weck M (2001) Einsatz miniaturisierter Sensoren zur Kontrolle von Naht- und Fadenspannung in der Chirurgie. In: Neue Technologien für die Medizin. Forschung, Praxis, Innovation. Shaker Verlag Aachen 2001, 321-340
10.
go back to reference Schachtrupp A, Graf J, Töns Ch, Höer J, Fackeldey V, Schumpelick V (2003) Intravascular volume depletion in a 24-hour porcine model of intra-abdominal hypertension. J Trauma 55:734–740CrossRefPubMed Schachtrupp A, Graf J, Töns Ch, Höer J, Fackeldey V, Schumpelick V (2003) Intravascular volume depletion in a 24-hour porcine model of intra-abdominal hypertension. J Trauma 55:734–740CrossRefPubMed
11.
12.
go back to reference Dunn AL, Buffa EA, Marchevsky AM, Heller J, Moores AP, Farell M (2012) Inter- and intra-operator variability associated with extracapsular suture tensioning: an ex vivo study. Vet Comp Orthop Traumatol 25(6):474–477CrossRef Dunn AL, Buffa EA, Marchevsky AM, Heller J, Moores AP, Farell M (2012) Inter- and intra-operator variability associated with extracapsular suture tensioning: an ex vivo study. Vet Comp Orthop Traumatol 25(6):474–477CrossRef
13.
go back to reference Rahbari NN, Knebel P, Kieser M, Bruckner T, Bartsch DK, Friess H, Mihaljevic AL, Stern J, Diener MK, Voss S, Rossion I, Büchler MW, Seiler CM (2012) Design and current status of CONTINT: continuous versus interrupted abdominal wall closure after emergency midline laparotomy - a randomized controlled multicenter trial [NCT00544583]. Trials. doi:10.1186/1745-6215-13-72 PubMedPubMedCentral Rahbari NN, Knebel P, Kieser M, Bruckner T, Bartsch DK, Friess H, Mihaljevic AL, Stern J, Diener MK, Voss S, Rossion I, Büchler MW, Seiler CM (2012) Design and current status of CONTINT: continuous versus interrupted abdominal wall closure after emergency midline laparotomy - a randomized controlled multicenter trial [NCT00544583]. Trials. doi:10.​1186/​1745-6215-13-72 PubMedPubMedCentral
14.
go back to reference Harlaar JJ, Deerenberg EB, van Ramshorst GH, Lont HE, van der Borst EC, Schouten WR, Heisterkamp J, van Doorn HC, Cense HA, Berends F, Stockmann HB, Vrijland WW, Consten EC, Ottow RT, Go PM, Hermans JJ, Steyerberg EW, Lange JF (2011) A multicenter randomized controlled trial evaluating the effect of small stitches on the incidence of incisional hernia in midline incisions. BMC Surg. doi:10.1186/1471-2482-11-20 PubMedPubMedCentral Harlaar JJ, Deerenberg EB, van Ramshorst GH, Lont HE, van der Borst EC, Schouten WR, Heisterkamp J, van Doorn HC, Cense HA, Berends F, Stockmann HB, Vrijland WW, Consten EC, Ottow RT, Go PM, Hermans JJ, Steyerberg EW, Lange JF (2011) A multicenter randomized controlled trial evaluating the effect of small stitches on the incidence of incisional hernia in midline incisions. BMC Surg. doi:10.​1186/​1471-2482-11-20 PubMedPubMedCentral
Metadata
Title
An implantable sensor device measuring suture tension dynamics: results of developmental and experimental work
Authors
A. Schachtrupp
O. Wetter
J. Höer
Publication date
01-08-2016
Publisher
Springer Paris
Published in
Hernia / Issue 4/2016
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-015-1433-y

Other articles of this Issue 4/2016

Hernia 4/2016 Go to the issue