Abstract
Objective: 1) Determine what additional stability, if any, the addition of cartilaginous reinforcing sutures adds to tracheal stability. 2) Further clarify mechanisms of tracheal rupture.
Method: Prospective cadaver study. Eleven cadaver tracheas were harvested and divided in half. Each half trachea was cut and anastomosed using circumferential sutures. The other half underwent the exact same procedure with the addition of cartilaginous reinforcing sutures. The force necessary for anastomosis rupture was measured for each half trachea.
Results: Eleven tracheas were used for a total of 22 trials. Analysis demonstrated a mean anastomotic rupture point for tracheas with reinforcing sutures was 297 N ± 94.6, while the mean for trials without reinforcing sutures was 173 N ± 51.4 (P < .05). The point of rupture occurred at the anastomosis in 1 out of 11 cases with reinforcing sutures and in 8 out of 11 cases without reinforcing sutures. In all trials, the reinforcing sutures remained intact.
Conclusion: Cartilaginous reinforcing sutures were found to provide a higher force requirement for rupturing tracheal anastomoses when compared to anastomoses without these sutures. This improved stability in tracheal anastomoses may result in a decreased risk of tracheal rupture after anastomosis.
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