Long-term Effects Of Different Suture Materials On Healing Process Of Guinea Pigs

Objective: we use four different sutures materials which werefrequently used in Biliary Surgery,to establish the model of guinea pigsgallbladder-Jejunum anastomosis, Comparing the long-term effects ofdifferent suture materials on healing process of guinea pigs,in order to providesome ideas for the suture materials using of biliary surgery.Methods: To establish the model of guinea pigs gallbladder-Jejunumanastomosis with four sutures materials(Prolene、 PDSⅡ、 PGA、Silk).Thirty-two guinea pigs were randomly divided into four groups，Eachgroup of eight and all using continuous suture.To observe the incidence ofcomplications and one-year survival rate of guinea pigs in each group(A, B, Cthree groups using Prolene line, PDSⅡ line, PGA lines optional two kinds ofanterior and posterior anastomotic suture, D group anterior and posterior wallusing Prolene lines and Silk as the control group). Taking guinea anastomotictissue which survived more than one year, divided into four groups, Toobserve and measure anastomotic scar tissue thickening conditions, andobserve the degree of inflammatory infiltration and collagen synthesisconditions with HE and Mallory staining. Results:⑴Group D bile leakage was significantly higher than the otherthree groups, but no significant difference (P>0.05), survival rate is lowerthan the other three groups, compared to the other three groups werestatistically significant (P <0.05), and A, B no significant difference betweenthe C group,(P>0.05).⑵To observe anastomotic tissue, Prolene line groupmucosal integrity and smooth, but some lines protruding from the chamberand attached a small amount of online sludge-like material.⑶Three suturesthickened scar extent comparison, Prolene line <PDS line <PGA line, Prolenecompare with PDSⅡ line, PGA lines were statically significant (P <0.05),while the PDS compare with PGA line was no significant difference (P>0.05).⑷HE staining degree of inflammatory cell infiltration in the three groups,microscopy showed chronic inflammatory cell infiltration, mainlylymphocytes. Prolene and PDSⅡ line infiltration of inflammatory cells to alesser extent, but the degree of inflammatory cell infiltration PGA line heavier,Prolene and PDSⅡ line were significantly different comparing PGA line(P<0.05), and Prolene line with no significant difference between PDSⅡ line(P>0.05).⑸By Mallory staining, microscopic comparison Prolene grouparranged in neat lines, there is a certain direction, and little nodules, ThePDSⅡ line group is better than PGA line and PDSⅡ line, especially the PGAline group often swirling nodules. Prolene and PDSⅡ line were significantlydifferent comparing PGA line of Collagen synthesis area（P＜0.05）, TheProlene line with no significant difference between PDSⅡ lines (P>0.05). Conclusion:⑴Choledochojejunostomy anastomotic healing time islonger, chronic inflammatory cells longstanding, Mucosal repair poor,Submucosal collagen deposition over, rebuilding poor and scar serious, socause the anastomotic stenosis.⑵From this experiment，Because of its natureand characteristics， silk is not suitable for choledochojejunostomy,thestitched effect of absorbable suture, The PDSⅡline is better than PGA line,Prolene and PDSⅡ line are suitable for choledochojejunostomy, But theyhave their own advantages and disadvantages, Prolene line organization lowactivity, better compatibility, However its nature of the non-absorbent maycause bile duct stones, PDSⅡ line is absorbable suture, all aspects of the lineas much as Prolene,but easier scarring compare with Prolene line.⑶Biliarysurgery is very complicated surgery, We should fully understand the natureand characteristics of the various sutures, know how to correct application soas to obtain the maximum effect,.We recommend the use of a single strand ofwire absorbable PDSⅡ.