Name: using q suture to enhance resistance to gap formation and tensile strength of repaired flexor tendons
Uploaded: 2020-06-03T15:00:00
Description: Watch this Scientific Journal Video about Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons at JoVE.com

作者感谢江苏省研究生研究创新项目（YKC16061）的支持。

所述所有实验程序都经南通大学实验动物管理委员会批准。30个猪肌腱通过三个2股修复修复：2股核心缝合线，2股核心缝合线加2Q，2股核心缝合线加上运行外围缝合线。其他30个猪肌腱通过三个4股修复修复：4股核心缝合线，4股核心缝合加2Q，4股核心缝合线加上运行外围缝合线。
1. 猪肌腱的准备
<ol><li>从屠宰场购买新鲜的成年猪后腿小跑。去除皮肤和皮下组织，露出滑轮和?...

<ol>
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目前的研究结果表明，Q缝合不仅减少了修复肌腱的间隙，提高了张力，而且省时省力。尽管如此，在目前研究中，应该注意关于肌腱修复的一些要点。
首先，我们尝试选择形状和尺寸相似的肌腱样本，因为我们不确定肌腱大小是否会对修复后拉伸强度产生显著影响。此外，肌腱样品如果无法及时修复和测试，可以保存在-20°C。研究表明，冻结肌腱不会显著改变肌腱的修复强?...

肌腱维修场地的间隙形成对肌腱的修复强度和滑翔阻力有很大影响。肌腱末端之间的间隙的后果可能最终阻碍肌腱愈合体内1。据报道，在维修现场存在大于2毫米的间隙，导致尸体手2号修复的肌腱的滑翔阻力显著增加。犬模型的研究表明，大于3毫米的间隙大小会损害肌腱愈合强度和刚度3。因此，提高肌腱末端之间的阻力和降低肌腱间隙的风险对肌腱修复至关重要。
外周缝合线的加入已被证明可以减少肌腱维修场地的间隙，从而改善修复的肌腱4、5、6,的滑翔功能。在过去的几十年里，已经开发出一些外围缝合线，包括联锁十字绣（IXS），联锁水平床垫（IHM），以及交叉链接的西尔弗斯基奥尔德和伦伯特，等等7，8，9，10。8,9,10这些外周缝合线已证明优于在肌腱修复中运行外设缝合线。然而，许多这种缝合线结构复杂，难以执行，从而限制了其广泛的应用。肌腱修复的理想缝合应旨在防止间隙的形成，同时避免在肌腱修复后向维修现场添加散装。目前，运行外设缝合仍然是一种流行的技术，由于其简单。
在最近的一项研究中，一种名为Q缝合的技术，称为Q缝合，因为它的形状类似于字母"Q"，被提出11。在这里，我们比较了这种缝合技术与运行外围缝合，以检查间隙阻力和修复肌腱的拉伸强度的差异。结果表明，Q缝合在循环载荷试验中，在提高修复肌腱的间隙阻力和最终强度方面效率更高。因此，本文旨在对如何执行Q缝合技术以及生物力学设置进行详细说明，以测试Q缝合对修复肌腱特性的影响。

<table>
	<tbody>
		<tr>
			<td>4-0 suture</td>
			<td>Ethicon, Somerville, NJ</td>
			<td>Ethilon 1667</td>
			<td></td>
		</tr>
		<tr>
			<td>6-0 suture</td>
			<td>Ethicon, Somerville, NJ</td>
			<td>Ethilon 689</td>
			<td></td>
		</tr>
		<tr>
			<td>biomechanical testing machine</td>
			<td>Instron Corp, Norwood, MA</td>
			<td>Instron 3365</td>
			<td></td>
		</tr>
		<tr>
			<td>biomechanical testing software</td>
			<td>Instron Corp, Norwood, MA</td>
			<td>Bluehill 2</td>
			<td></td>
		</tr>
	</tbody>
</table>

using q suture to enhance resistance to gap formation and tensile strength of repaired flexor tendons

外周性显性缝合被认为能增强肌腱修复中的核心缝合强度，并降低肌腱末端之间发生间隙的风险。这里Q缝合，外设缝合的替代品，提出了用于肌腱修复。与传统的运行外设缝合线相比，其对修复肌腱的间隙形成和拉伸强度的影响。三个2股缝合线和三个4股缝合线用于修复猪肌腱。记录了执行 2Q 和运行缝合线所需的时间。修复的肌腱经过循环加载测试，确定了形成2毫米间隙的周期数。循环加载后，测量肌腱末端的间隙大小和修复的肌腱的最终强度。使用 Q 缝合的增强减少了在循环加载期间在肌腱末端显示 2 mm 间隙的肌腱数量。随着Q缝合线2股缝合线的增加，修复的肌腱的终极强度显著增加，4股缝合线减少了肌腱修复场的间隙距离。执行 2Q 缝合所需的时间明显少于运行缝合线的时间。因此，我们得出结论，Q缝合线在增强抗拉力和肌腱修复强度方面是有效的，可以替代传统的外周缝合。

表1显示，Q缝合的加入减少了在2股和4股维修的循环加载过程中有2毫米间隙的肌腱数量。所有用2股和4股核心缝合修复的肌腱都形成了2毫米的间隙，而用2股加2Q修复的肌腱中，只有一半用4股加2Q修复的肌腱在10个周期后有2毫米的间隙。与 Q 缝合线增强的肌腱多，用 2 股加跑步或 4 股加跑步缝合线修复的肌腱显示 2 毫米的间隙。
表1还显示，通过2股修复...

Watch this Scientific Journal Video about Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons at JoVE.com

Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons

在这里，我们提出了一个"Q"缝合技术，可以在肌腱修复中执行，它对修复的肌腱的间隙形成和拉伸强度的影响。Q缝合显示在增强抗拉力和肌腱修复强度方面是有效的。

使用 Q 缝合增强对修复的屈肌的间隙形成和拉伸强度的抵抗力

Peripheral epitendinous sutures are believed to enhance core suture strength in tendon repair and decrease the risk of gapping between tendon ends. Here Q ...

外周缝合可以增强核心缝合强度，降低修复的肌腱末端之间间隙的风险。我们提出Q缝合线作为传统外设缝合的替代品。与传统运行的外设缝合线相比，Q缝合线非常容易执行，省时，在抵抗肌腱修复中具有卓越的抗间隙性能。要进行肌腱修复，首先标记一个猪肌腱树桩的前部表面，两个点是10毫米的切口肌腱，四分之一的方式从肌腱的左右两侧在肌腱方向。标记肌腱的左、右横向表面，一个点，即每个切肌腱端的八毫米。并找到前后方向中间的点。然后使用更维的卡钳测量每组点之间的所有长度。使用四个零缝合线，将一根针从前后向的中间点插入一个肌腱树桩的切割表面，从左侧向中侧方向插入四分之一的针。在所选神经元周围绘制一个感兴趣区域，并在尾部周围绘制第二个较大的感兴趣区域，其中包括第一个感兴趣区域。将针头斜点从第三点重新插入，横向地将针头向第四点传递。拉出缝合线，在肌腱的侧表面形成一个小环，然后斜插入针头，将针头纵向地向切口方向插入。然后拉出缝合线。要形成对称修复，请将针头插入另一个肌腱树桩的切割端，用相同的构造缝合另一个树桩。用核心缝合内肌腱段 10% 的缩短来拧紧缝合。将肌腱末端与三到四节配合，以完成双链核心缝合。要完成四股芯缝合，请重复刚刚演示的缝合过程。要添加 Q 缝合线，请将相同的针插入肌腱前表面，离连接肌腱端两毫米远。并提取肌腱后表面的针头。将针头插入肌腱的后表面，在两毫米远的连接肌腱端的另一侧。从肌腱前表面拉出缝合线，并系上三个结，完成第一个 Q 缝合线。然后重复该过程以完成第二个 Q 缝合。要在双股或四股核心缝合线加跑步组中添加运行缝合线，请使用六根零缝合线在肌腱末端添加 9 到 10 针的运行缝合线，保持 1.5 毫米和 1 毫米的深度的类似购买。当所有缝合线都放置后，用湿纱布盖住修复的肌腱。在进行修复的生物力学测试之前，请打开测试软件并导航到主屏幕。单击方法以创建测试方法，然后单击"新"以打开创建新的测试方法对话框。选择张力测试配置文件方法测试类型，然后单击创建。单击"保存以命名并保存测试方法文件"，然后单击导航栏中的控件和预测试以打开方法选项卡中的控件预测试屏幕。单击预加载，将控制模式设置为拉伸扩展，速率设置为每分钟 25 毫米，加载通道，将值设置为 5 牛顿。启用自动平衡，并将可用的负载通道添加到所选通道。单击"测试"可打开设置控制测试屏幕，然后单击此循环加载的编辑配置文件以打开测试配置文件或对话框。插入四个块。在第一个区块中，将模式设置为拉伸延伸，将形状设置为三角形，在双股维修中将最大负载设置为 8 牛顿，在四股维修中将最大负载设置为 15 牛顿，将最小负载设置为零牛顿，将速率设置为每分钟 25 毫米，循环设置为 10 牛顿。在第二个块中，将模式设置为拉伸延伸，形状设置为绝对斜坡，速率设置为每分钟 25 毫米，终点设置为双股维修中的 8 牛顿和四股修复中的 15 牛顿。在第三个块中，将模式设置为拉伸扩展，将形状设置为保留，将条件设置为持续时间，将持续时间设置为 8 秒。在第四个块中，将模式设置为拉伸扩展，将形状设置为绝对斜坡，将速率设置为每分钟 25 毫米，将终点设置为 100 牛顿。然后单击"保存"并退出。接下来，打开测试屏幕的控制端，将条件设置为负载速率，并将灵敏度设置为 40% 在计算设置屏幕中，将绝对峰值的可用计算添加到所选计算中。在通道下拉列表中选择负载，并应用绝对峰值到四个绝对斜坡。打开结果的"一列"屏幕，选择最大负载，并将负载添加到所选结果。然后单击"保存"，然后关闭。要执行生物力学测试，请将测试机上部和下夹之间的初始距离设置为 5 厘米。用干纱布包裹肌腱，距离切口两到三厘米，然后将纱布包裹成段，放入上下夹，使肌腱尽可能垂直。安装肌腱后，单击主屏幕上的测试并选择保存以测试方法文件。单击"下一步"并选择一个位置，然后输入一个名称以保存示例数据文件。将显示测试选项卡。单击打开加载单元设置对话框，校准并清除负载单元。单击打开实时显示设置对话，并在通道一的下拉列表中选择拉伸扩展。在通道 3 的下拉列表中选择周期计数，并在实时显示中选择三个。单击打开控制面板设置对话框，在键 1 的下拉列表中选择平衡负载，并重置键 2 的仪表长度。单击平衡负载，重置仪表长度并开始对样品中的每个试样运行测试。在循环加载期间，记录两端之间有两毫米间隙的肌腱数量。在第 10 个循环后最大负载的 8 秒暂停中，测量肌腱末端之间的间隙距离。测量间隙后，向上拉肌腱直到修复破裂，并记录最终断裂应变。然后单击"停止"、返回并完成以保存结果。如表中所示，在此代表性分析中，Q 缝合的添加减少了在双股和四股维修中循环加载过程中有两毫米间隙的肌腱数量。所有用两根和四股核心缝合线修复的租户都形成了两毫米的间隙，而修用两股加两个Q的肌腱都没有，只有一半用四股加两个Q修复的肌腱在10个周期后有两毫米的间隙。此外，更多的肌腱修复与双股加运行或四股加运行缝合显示两毫米的差距，然后那些增加Q缝合线。通过两股修复，添加 Q 缝合线或运行缝合线既可缩短回旋加载后肌腱末端之间的间隙距离，但仅 Q 缝合线添加可显著增加修复肌腱的最终强度。Q缝合线的添加也通过四股修复将间隙距离降至最低，尽管修复的肌腱的最终强度没有受到影响。此外，执行两个 Q 缝合线所需的平均时间明显短于运行缝合线。Q缝合的事实，当结合其他类型的核心缝合，值得研究，以确认Q缝合的功效。

Research

JoVE Journal

Medicine

The Measurement and Treatment of Suppression in Amblyopia

测量和制止在弱视治疗

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

科研

医学

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

改编阻力训练提高力量在八周内的个人与多发性硬化症

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can ...

Murine Flexor Tendon Injury and Repair Surgery

鼠屈肌腱损伤修复手术

Tendon connects skeletal muscle and bone, facilitating movement of nearly the entire body. In the hand, flexor tendons (FTs) enable flexion of the fingers ...

Transplantation of Schwann Cells Inside PVDF-TrFE Conduits to Bridge Transected Rat Spinal Cord Stumps to Promote Axon Regeneration Across the Gap

氟 TrFE 导管内许旺细胞移植桥断大鼠脊髓残肢促进轴突再生跨越间隙

Among various models for spinal cord injury in rats, the contusion model is the most often used because it is the most common type of human spinal cord ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

一项临床试验，评估基于橄榄油的三腔袋的亲子营养的安全性、有效性和交付

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

改善肾去神经支配缓解血管紧张素II.诱导的高血压

The benefits of renal sympathetic denervation (RDN) on blood pressure have been proved in a large number of clinical trials in recent years. However, the ...

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

毛滴虫对肺腺癌作用机制的网络药理学预测及实验验证

We aimed to study the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma (LUAD) based on network pharmacology and ...

Standardized Tuina Manipulation for Knee Osteoarthritis in Rats

Tuina Manipulation to Reduce Inflammation and Cartilage Loss in Knee Osteoarthritis Rats

Understanding the Mechanism of Tuina Manipulation in Rats (Video) | JoVE

推拿操作以减少膝关节骨关节炎大鼠的炎症和软骨损失

Clinical trials suggest that Tuina manipulation is effective in treating knee osteoarthritis (KOA), while further studies are required to discover its ...

Standardized Tuina Protocol for Rat DRG Compression Model

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain (Video) | JoVE 

推拿对大鼠模型的镇痛作用，压迫背根神经节疼痛

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar ...