Separation of Sutured Tendon Ends When Different Suture Techniques and Different Suture Materials Are Used: An Experimental Study in Rabbits

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Abstract
Calcaneal tendons in rabbits were divided and then sutured with varying suture techniques and suture materials. The separation of the tendon ends after suturing was registered with an X-ray technique—the tendon ends being identified by thin steel wires. Independently of the suture techniques and the suture materials a biphasic separation of the tendon ends was registered. The first separation took place during the first 4–5 days while the second separation began after 20–24 days. A small initial separation seems to indicate that the tendon suture used is adequate. The initial separation can therefore be used to evaluate a suturing technique and how the result is influenced by the suture material used. In the present study we could show that steel wire was ideal for a Bunnell suture. Prolene® and Ethiflex® cannot be recommended. A suture technique with a single short loop gave good results with all suture materials. Dexon® ligatures placed around the tendon ends according to Schink in order to prevent the strands of the suture from cutting the tissue, did not reduce the initial separation. When a complex suture technique, like a Bunnell suture, is used the physical properties of the suture material influence the result. With a simple suture technique, a single short loop, good results can be achieved with every suture material.

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