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Creating a small anchor to eliminate large knots in mesh and tape suture

Publication ,  Journal Article
Green, JL; Glisson, R; Hung, J; Ibrahim, M; Farjat, A; Liu, B; Gall, K; Levinson, H
Published in: Journal of Medical Devices, Transactions of the ASME
September 1, 2018

Wide mesh or tape sutures are used to close high-tension wounds such as in hernia or tendon repair. However, wide sutures produce large knots that are susceptible to increased palpability, infection, and foreign body response. To prevent such adverse events, we developed a small suture anchor to replace wide suture knots. The suture anchor was iteratively developed using threedimensional (3D) design software and produced via 3D printing. Anchor prototypes underwent monotonic, cyclic fatigue, and stress-life testing in a benchtop soft tissue suture model. Results were compared to a standard of care knot and alternative suture fixation devices. The final anchor design was selected based on minimal size and mechanical performance. The size of the final anchor (200mm3) was 33% smaller than a tape suture knot and 68% smaller than a mesh suture knot. Monotonic testing of mesh and tape sutures revealed a significantly greater anchor failure load compared to knot and alternative fixations (p < 0.05). Additionally, all anchors successfully completed cyclic fatigue testing without failure while other fixations, including knot, failed to complete cyclic fatigue testing multiple times. Stress-life testing demonstrated durable anchor fixation under varying tensile stresses. Failure mode analysis revealed anchor fracture and tissue failure as modes of anchor failure, each of which occurred at supraphysiologic forces. We created a small suture anchor that significantly outperforms knot and alternative suture fixations in benchtop testing and addresses concerns of increased palpability, infection, and foreign body response from large suture knots.

Duke Scholars

Published In

Journal of Medical Devices, Transactions of the ASME

DOI

EISSN

1932-619X

ISSN

1932-6181

Publication Date

September 1, 2018

Volume

12

Issue

3

Related Subject Headings

  • Biomedical Engineering
  • 4003 Biomedical engineering
  • 1103 Clinical Sciences
  • 0903 Biomedical Engineering
 

Citation

APA
Chicago
ICMJE
MLA
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Green, J. L., Glisson, R., Hung, J., Ibrahim, M., Farjat, A., Liu, B., … Levinson, H. (2018). Creating a small anchor to eliminate large knots in mesh and tape suture. Journal of Medical Devices, Transactions of the ASME, 12(3). https://doi.org/10.1115/1.4040186
Green, J. L., R. Glisson, J. Hung, M. Ibrahim, A. Farjat, B. Liu, K. Gall, and H. Levinson. “Creating a small anchor to eliminate large knots in mesh and tape suture.” Journal of Medical Devices, Transactions of the ASME 12, no. 3 (September 1, 2018). https://doi.org/10.1115/1.4040186.
Green JL, Glisson R, Hung J, Ibrahim M, Farjat A, Liu B, et al. Creating a small anchor to eliminate large knots in mesh and tape suture. Journal of Medical Devices, Transactions of the ASME. 2018 Sep 1;12(3).
Green, J. L., et al. “Creating a small anchor to eliminate large knots in mesh and tape suture.” Journal of Medical Devices, Transactions of the ASME, vol. 12, no. 3, Sept. 2018. Scopus, doi:10.1115/1.4040186.
Green JL, Glisson R, Hung J, Ibrahim M, Farjat A, Liu B, Gall K, Levinson H. Creating a small anchor to eliminate large knots in mesh and tape suture. Journal of Medical Devices, Transactions of the ASME. 2018 Sep 1;12(3).

Published In

Journal of Medical Devices, Transactions of the ASME

DOI

EISSN

1932-619X

ISSN

1932-6181

Publication Date

September 1, 2018

Volume

12

Issue

3

Related Subject Headings

  • Biomedical Engineering
  • 4003 Biomedical engineering
  • 1103 Clinical Sciences
  • 0903 Biomedical Engineering