Purpose: To determine if impregnating a suture with a cross-linking agent, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC), improved suture pull-out strength and cell viability.
Methods: Canine flexor digitorum profundus tendons were cut in canine zone D, and a single suture loop was placed in each end, with sutures soaked in either saline or an EDC solution with a concentration of 1%, 10%, or 50%. Suture pull-out strength, stiffness, and elongation to failure was determined by pulling the loop until failure. Cytotoxicity of the EDC treatment was evaluated by suspending treated sutures over cultured tenocytes.
Results: Mechanical properties for the EDC-treated side were improved over controls when treated with the 10% and 50% EDC solutions. The ratio of dead to live cells was significantly increased at all distances from the suture for the 50% EDC-treated group.
Conclusions: Suture treated with a 10% EDC solution provided the best combination of mechanical reinforcement and limited toxicity.
Clinical relevance: Sutures so treated may improve the ability of a tendon repair to sustain early mobilization.
Keywords: Cross-linking; repair; suture; tendon.
Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.