Portal de Periódicos da CAPES

Growth of tracheal anastomoses: Advantage of absorbable interrupted sutures

1991; Elsevier BV; Volume: 51; Issue: 4 Linguagem: Inglês

10.1016/0003-4975(91)90324-j

1552-6259

Peter P. McKeown, Hidetoshi Tsuboi, T Togo, Robert Thomas, Richard Tuck, David Gordon,

Tracheal and airway disorders

Growth of the trachea after complete transection and anastomosis was studied in four groups of 1-month-old New Zealand white rabbits.The trachea was transected at the fifth cartilaginous ring and then anastomosed with continuous 6-0 polypropylene (Prolene) (group 11, interrupted 6-0 polypropylene (group 21, continuous 6-0 polydioxanone (PDS) (group 3), or interrupted 6-0 PDS (group 4).The animals were followed up for 90 to 103 days (mean follow-up, 95 days).At the time the animals econstruction of the trachea may be required in pedi-R atric patients for congenital stenosis, tracheotomy and postintubation injuries, or tracheomalacia secondary to vascular compression.Tracheal anastomosis in these instances and in pediatric heart and lung transplantation carries the risk of stenosis at the site of anastomosis.Early experimental work by Maeda and Grillo [l] and Mendez-Picon and colleagues [2] demonstrated that satisfactory growth of the trachea was possible in puppies, although narrowing did occur.Controversy exists as to the best method of anastomosis and the choice of suture material [3-71.Clinically, Grillo [8] found absorbable suture (Vicryl; Ethicon, Johnson & Johnson, Somerville, NJ) to be advantageous for reconstruction of the trachea because of a decrease in granulation tissue at the anastomosis.In a series of pediatric patients, Alstrup and Sorensen [9] achieved satisfactory results using interrupted Dexon (Davis + Geck, Danbury, CT) or chromic catgut sutures.Polydioxanone (PDS; Ethicon) is an absorbable suture with some theoretical advantages, including monofilament structure and predictable absorption rates, that should make it even more suitable for tracheal anastomoses [lo-131.This study was designed to compare the use of interrupted versus continuous suturing techniques and absorbable (PDS) versus nonabsorbable (polypropylene [Prolene]; Ethicon) suture material by evaluating the degree of postsurgical stenosis of the trachea in a growing animal model.