Growth of suture line and anastomosis is required for long-term success after the tracheal and bronchial surgery in infant and pediatric patient.
We used various suture materials in these cases, but the results were differ.
To select the adequate suture material in tracheal surgery. We tried next.
Tracheal anastomoses were performed in 150 Sprague Dawley rats, aged 4 to 8(mean 5.80 weeks and weight 62 to 106(mean 83.6) gram, to compare polydioxanone(PDS) 7-0, polyglactin 910(Vicryl) 7-0, and polypropylene(prolene) 8-0 suture materials.
In 150 rats, only 29(20%) were lived over 300 days, and the weight was 250 to 320(mean 289.5) gram.
Gross sectional area of the anastomoses and two or three tracheal rings below anastomosis site were measured under microscope, and calculated and compared as Hsieh's equition. Cross-sectional area, anastomosis site/normal site*100, were
89.4*5.34%
in
PDS group(n=9), 75.7*6.06% in Vicryl group(n=10), and 80.8*4.06% in Prolene group(n=10).
Histopathologic studies were done for all autopsies or put in death around 300 days postoperatively. PDS absorbtion was not seen 16 weeks after suture but disappeared over 24 weeks slide. Vicryl absorbtion was noted postoperative 8 to 16 weeks,
with
marked tissue reaction. Prolene showed least tissue reaction, but the suture material was persisted with regional fibrotic capsule.
Causes of death were respiratory failure in 76 cases, tracheal rupture in 22 cases, hemorrhage, biting, starvation and etc. in 23 cases.
With the brief review of literatures, we report the results. (Korean J Thoracic Cardiovas Surg 1994; 27:343-348)
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