Numerical simulation of suture tension dependent on fiber material and puncture modalities

Most surgical interventions require joining of soft tissue, and suturation is the most common approach. While high suture tension may result in ischemia or even necrosis, a loose structure holds the risk of hemorrhage of the wound edges, causing postoperative complications and a potential necessity for reoperation. Estimating and controlling the tension within the suture is therefore a crucial factor for suture stability and thus successful treatment. In this study a numerical evaluation of different fiber materials and puncture modalities is presented. In total, 120 combinations of fiber material and number and distance of punctures are compared in terms of maximum shear rates representing suture tension. The results indicate that Vicryl fibers provide lower suture tension compared to PDS, and that an increased number of punctures decreases suture tension. Results are in good agreement with experimental studies. The presented method can be used to analyze various suture techniques and thus help to achieve successful treatment.