Duffy et al: Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model
Veterinary Surgery 5, 2022

🔍 Key Findings

Oversewing the transverse staple line using barbed suture showed no difference in initial (ILP) or maximum leakage pressure (MLP) compared to monofilament suture (p = .439 and .644).
Barbed suture repairs were ~18% faster (25 seconds faster; p < .001) than monofilament suture.
No difference was found between unidirectional and bidirectional barbed sutures in leakage resistance or repair time (p = .697).
Mean ILP and MLP were significantly higher in control jejunal segments (6.6x and 5.1x greater respectively; p < .001).
Leakage consistently occurred at the crotch of the FEESA in all oversew groups (>80%), not the staple line.
All oversewn techniques leaked at supraphysiologic pressures, indicating clinical safety against in vivo leakage.
No leakage was observed from barbed suture holes, addressing concerns of tissue trauma due to barb design.
The study supports barbed suture as a viable alternative to conventional monofilament suture for FEESA oversew in dogs.

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Duffy et al: Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model
Veterinary Surgery 5, 2022

🔍 Key Findings

Oversewing the transverse staple line using barbed suture showed no difference in initial (ILP) or maximum leakage pressure (MLP) compared to monofilament suture (p = .439 and .644).
Barbed suture repairs were ~18% faster (25 seconds faster; p < .001) than monofilament suture.
No difference was found between unidirectional and bidirectional barbed sutures in leakage resistance or repair time (p = .697).
Mean ILP and MLP were significantly higher in control jejunal segments (6.6x and 5.1x greater respectively; p < .001).
Leakage consistently occurred at the crotch of the FEESA in all oversew groups (>80%), not the staple line.
All oversewn techniques leaked at supraphysiologic pressures, indicating clinical safety against in vivo leakage.
No leakage was observed from barbed suture holes, addressing concerns of tissue trauma due to barb design.
The study supports barbed suture as a viable alternative to conventional monofilament suture for FEESA oversew in dogs.

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Multiple Choice Questions on this study

In Duffy 2022 et al., on barbed suture oversew, what was observed regarding leakage through **suture holes in barbed suture constructs**?

A. Frequent leakage due to large barb holes

B. Leakage occurred at barbs but not knots

C. Leakage only occurred when barbs dislodged

D. No leakage observed through suture holes

E. Leakage from suture holes occurred in >25%

Answer: No leakage observed through suture holes

Explanation: Despite wider tissue tracks from barbs, no leakage was observed at suture holes.

In Duffy 2022 et al., on barbed suture oversew, what was the **most common leakage site** among all FEESA groups regardless of suture type?

A. Longitudinal staple line

B. Transverse staple line

C. Crotch of the anastomosis

D. Serosal tearing

E. Suture holes

Answer: Crotch of the anastomosis

Explanation: Over 80% of leakage in all groups occurred at the anastomotic crotch, not staple lines or suture holes.

In Duffy 2022 et al., on barbed suture oversew, which repair method demonstrated the **shortest completion time** during oversew of the transverse staple line?

A. FEESA with monofilament oversew

B. FEESA with unidirectional barbed suture oversew

C. FEESA with bidirectional barbed suture oversew

D. FEESA without oversew

E. Hand-sewn anastomosis using monofilament

Answer: FEESA with unidirectional barbed suture oversew

Explanation: Barbed suture repairs were ~18% faster than monofilament; unidirectional suture had the shortest average time.

In Duffy 2022 et al., on barbed suture oversew, which of the following statements is TRUE regarding **initial leakage pressure (ILP)** and **maximum leakage pressure (MLP)** among FEESA groups?

A. MLP was significantly higher with bidirectional barbed suture

B. ILP was lowest with unidirectional barbed suture

C. No differences in ILP or MLP among FEESA groups

D. Monofilament oversew had highest ILP and MLP

E. ILP and MLP were significantly higher than controls

Answer: No differences in ILP or MLP among FEESA groups

Explanation: ILP and MLP did not differ significantly between monofilament and barbed suture groups.

In Duffy 2022 et al., on barbed suture oversew, how did **control jejunal segments** (no surgery) compare to oversewn FEESA constructs in terms of leakage pressure?

A. Similar ILP and MLP

B. Higher ILP but lower MLP

C. Significantly lower ILP and MLP

D. 6.6x higher ILP and 5.1x higher MLP

E. Significantly lower ILP, similar MLP

Answer: 6.6x higher ILP and 5.1x higher MLP

Explanation: Controls showed significantly higher resistance to leakage than all FEESA constructs.

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