Background Cardiac surgeons at our hospital asked the pharmacy for a new device to reduce bleeding during aortic suture. HEMO-SEAL (ETHICON) suture offers a decrease in the ratio of needle-to-suture diameters that would reduce needle-hole bleeding. This device is more expensive than an equivalent classic suture. According to the only study available from ETHICON, a 67% reduction in bleeding was observed with this technology.
Purpose The purpose of this work was to compare in vitro a classic suture and a HEMO-SEAL (HS) suture.
Material and methods We used two equivalent sutures: a classic and a HS suture of the same diameter (USP 5/0), with identical needle characteristics (tip geometry, curvature, length). First, we compared the two sutures with a binocular loupe. Then, we developed an experimental model to compare the bleeding with the two sutures. We created a circuit with water sent at a pressure of 90 mmHg into a vascular prosthesis in which we passed each suture model without making a knot. We collected the water that flowed from the holes in our suture through our prosthesis over 5 min. Then, we compared the weight of water collected with the two sutures. A sample size of n=6 was completed for each group. Results are expressed in terms of mean ±standard deviation.
Results The two sutures both strictly look the same with the binocular loupe, except the region at the needle attachment of the HS suture, which had a smaller diameter. The average weight of the water collected was 28 g (±5) and 8 g (±1) for the classic suture and HS suture, respectively. We obtained a 71% reduction with the HS suture (p<0.05). Despite this important difference, we identified biases such as: we did not use blood but water, pressure at 90 mmHg and we did not make a real knot.
Conclusion The HS suture really seems to reduce needle-hole bleeding. In order to get as close as possible to the in vivo conditions, it would be interesting to repeat tests with anastomoses performed by a surgeon. Furthermore, clinical impact of this reduction in bleeding remains to be assessed.
References and/or acknowledgements https://www.ncbi.nlm.nih.gov/pubmed/?term=needle+to+suture+ration%2C+as+well+as+suture+material#
No conflict of interest.
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