不同规格缝线对猫腹壁组织炎症反应与缝合强度的影响

Effects of different suture gauges on inflammation and sutureintensity of abdominal wall tissue in cats

[目的]缝线可为手术切口提供充足的作用力并维持创缘对合,促进愈合,但缝线引起的异物反应可加剧组织炎症,影响组织愈合。本试验旨在探究不同规格缝线缝合猫腹壁后缝合强度及组织炎症反应差异。[方法]取猫皮肤与肌肉组织样本,使用USP 2-0、3-0、4-0、5-0 PGA缝线缝合,测定组织缝合强度。在猫腹壁肌肉植入不同规格缝线,分别于植入后1、14和90 d采样,检测炎性因子水平,评估炎症反应强度。[结果]在体外试验中,USP 5-0 PGA缝线组发生更多的缝线断裂,在50%应变以下,各组间应力无显著差异(P>0.05);最大抗张力时,各组间应变、应力及抗张力均无显著差异(P>0.05)。猫肌肉植入缝线后1和14 d,植入处炎性因子(IL-1β、IL-6和TNF-α)的mRNA和蛋白表达水平随缝线直径减小而减少,大直径缝线周围组织炎症反应更加剧烈(P<0.05)。[结论]USP 5-0 PGA可满足猫腹壁手术切口缝合张力需求,且小直径缝线可减少缝线引起的组织炎症。

[Objectives]Surgical sutures can provide sufficient tensile strength to hold the edges of a surgical incision together to promote healing.However,suture-induced foreign body reactions can exacerbate tissue inflammation depressing tissue healing.This study aimed to investigate variations in suture intensity and tissue inflammation after suturing the feline abdominal wall with different gauges of suture.[Methods]Feline abdominal skin and muscle were sutured using USP 2-0,3-0,4-0,5-0 PGA sutures,and tissue suture intensity was assessed through uniaxial tensile testing in vitro.USP 2-0,3-0,4-0,5-0 PGA sutures were implanted into feline abdominal muscles.After implantation,tissues were sampled at 1,14 and 90 d.The expression levels of inflammatory factors were quantified using RT-qPCR and ELISA.The degree of inflammatory infiltration was evaluated in tissue sections.[Results]The results of skin and muscle suture intensity tests showed that the USP 5-0 PGA suture group experienced more suture breakage.Below 50%strain,there were no significant differences in stress among the groups(P>0.05)in vitro.At maximum tensile strength,there were no significant differences in strain,stress,and tensile strength among groups(P>0.05).At 1 and 14 d after suture implantation in vivo,the mRNA and protein expression levels of inflammatory factors(IL-1β,IL-6 and TNF-α)decreased with decreasing suture diameter,and the inflammatory response of the tissues around the large-diameter suture was more severe(P<0.05).[Conclusions]USP 5-0 PGA suture is sufficient for matching the tensile strength requirements of general cat abdominal wall surgical incisions.Moreover,smaller-diameter sutures can significantly reduce tissue inflammation from suture implantation.