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Comparison of Continuous Appositional Suture Patterns for Cystotomy Closure in Ex Vivo Swine Model

  • Sang-hun, Park (College of Veterinary Medicine, Jeju National University) ;
  • Joo-Myoung, Lee (College of Veterinary Medicine, Jeju National University) ;
  • Hyunjung, Park (College of Veterinary Medicine, Jeju National University) ;
  • Jongtae, Cheong (College of Veterinary Medicine, Jeju National University)
  • Received : 2022.11.07
  • Accepted : 2022.12.28
  • Published : 2022.12.31

Abstract

Several suture patterns can be used for cystotomy closure, and a continuous suture pattern is the most commonly used. In this study, the fluid-tight ability and other suitabilities of continuous appositional sutures, such as the simple continuous suture pattern (SC), running suture pattern (RN), and Ford interlocking suture pattern (FI), were compared for cystotomy closure. Cystotomy closure was performed using each suture method in 10 cases of ex vivo swine bladders in each group. Suture time, leakage site, suture length, bursting pressure (BP), bursting volume (BV), and circular bursting wall tension (CBWT) were measured. Suture time and suture length were the shortest in RN and the longest in FI. Leakage occurred in two places: the incision line directly and the hole made by the suture. Leakage occurred through the incision line in 4 bladders of the RN group and 2 bladders of the FI group, but not in the SC group, and in the rest of the bladders, leakage occurred through the suture hole. The values of BP, BV, and CBWT increased in the order of FI, SC, and RN. Suture time and suture length can be considered as factors related to healing and side effects. In this study, leakage through the incision was found in a less appositional area; therefore, leakage through the hole could be considered an indicator of better apposition. Good apposition is one of the conditions required for ideal cystotomy closure. The bursting strength representing the fluid-tight ability can be expressed as the CBWT. RN is expected to be efficient and cause a small degree of foreign body reaction; however, it is expected to be less stable. FI has the greatest fluid-tightness ability, but it has been proposed that side effects due to foreign body reactions most frequently occur in FI. In conclusion, SC, which is expected to have a sufficient degree of fluid-tightness and appropriate recovery, is preferable to other continuous appositional suturing methods for cystotomy closure.

Keywords

Acknowledgement

This work was supported by the 2022 education, research and student guidance grant funded by Jeju National University.

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