Biomechanical testing of flanged polypropylene sutures in sc
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A Study was conducted to optimize the flanged belt-loop technique of scleral fixation through biomechanical testing and report clinical outcomes of resultant modifications.

The force to disinsert flanged polypropylene suture from human cadaveric sclera was assessed using a tensile testing machine and compared to the breaking strengths of 9-0 and 10-0 polypropylene. The effects of modifying suture gauge (5-0, 6-0, 7-0 or 8-0), amount of suture cauterized (0.5 or 1.0mm), and sclerotomy size (27-, 30-, 32-, 33-gauge) were investigated.

Belt-loop intrascleral fixation using 6-0 and 7-0 polypropylene with 30- and 32-gauge needles respectively was performed in 5 patients.

Results:
--The average force to disinsert a flange created by melting 1.0mm of 5-0, 6-0, 7-0 and 8-0 polypropylene suture from human cadaveric sclera via 27-, 30-, 32- and 33-gauge needle sclerotomies was 3.0 ± 0.5N, 2.1 ± 0.3N, 0.9 ± 0.2N and 0.4 ± 0.1N respectively.

--The disinsertion forces for flanges formed by melting 0.5mm of the same gauges were 72-79% lower.

--In comparison, the breaking strengths of 9-0 and 10-0 polypropylene were 1.0 ± 0.2N and 0.5 ± 0.0N.

--Belt-loop fixation using 6-0 and 7-0 polypropylene with 30- and 32-gauge sclerotomies demonstrated good outcomes at 6 months.

Conclusively, the flanged belt-loop technique is a biomechanically sound method of scleral fixation using 1.0mm flanges of 5-0 to 7-0 polypropylene paired with 27-, 30- and 32- gauge sclerotomies. In contrast, 8-0 polypropylene and 0.5 mm flanges of any suture gauge will likely be unstable with this technique.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0002939421002166?dgcid=rss_sd_all
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