Research progress in the selection of pancreaticojejunostomy suture in pancreaticoduodenec-tomy / 中华消化外科杂志

Pancreaticoduodenectomy (PD) is the mainstay of treatment for periampullary space-occupying disease. The occurrence of pancreatic fistula after PD is still an unsolved clinical problem, which seriously affects the safety of surgery. Various methods have been reported in clinical practice to reduce the incidence of pancreatic fistula, such as improving pancreaticoenteric anastomosis, using biological sealants, applying somatostatin analogs, and continuous peritoneal irrigation, etc., but the incidence of pancreatic fistula remains at 5%-30%. There are many risk factors related to pancreatic fistula after PD, in which reasonable selection of suture materials is an important factor and also an important factor affecting the curative effect of surgery. The authors analyze the characteristics and shortcomings of various sutures used in PD, in order to provide help to improve the safety of surgery and reduce the incidence of pancreatic fistula after PD.

A randomized controlled trial of knotless barbed suture stitching deep fascia in posterior lumbar decompression and fusion / 中国组织工程研究

BACKGROUND: Whether knotless barbed suture applied in lumbar posterior fusion can shorten the suturing time and reduce incision complication has not been confirmed in clinical practice. OBJECTIVE: To explore whether knotless barbed suture has advantages in shortening the suturing time and reducing incision complication in lumbar posterior fusion. METHODS: Sixty-two patients with lumbar degenerative disease at Dongzhimen Hospital, Beijing University of Chinese Medicine from January to December 2018 were selected, and all received lumbar posterior fusion. The patients were randomly divided Into trial group (n=33, the deep lumbar fascia was sutured using knotless barbed suture) and control group (n=29, the deep lumbar fascia was sutured using absorbable suture). The incision length, and the suturing time of deep fascia and subcutaneous tissue were compared between two groups. The suture quality was analyzed by leakage test. The Incision healing and complications were observed and recorded. The Visual Analogue Scale scores and Oswestry Dysfunction Index at baseline and 2 and 6 weeks, and 3 months after surgery were detected. The trial was approved by the Ethics Committee of Dongzhimen Hospital, Beijing University of Chinese Medicine (approval No. DZMEC-KY-2018-11). RESULTS AND CONCLUSION: (1) The Incision length and subcutaneous tissue suture time showed no significant difference (P > 0.05). The suture time of deep fascia in the trial group was shorter than that in the control group [(8.0±0.9) vs. (11.6±1.7) minutes, P 0.05). (4) These results Indicate that the knotless barbed suture can reduce suturing time and Incidence of incision complications in posterior lumbar fusion.

Importance of various skin sutures in cheiloplasty of cleft lip

Last week, after our receiving online journal regarding Journal of the Korean Association of Oral and Maxillofacial Surgeons, we found a recently published original article by Alawode et al., entitled “A comparative study of immediate wound healing complications following cleft lip repair using either absorbable or non-absorbable skin sutures”. Although this clinical article was well written and provided a great deal of information regarding the suture materials in the cleft lip repair, I would like to add a few additional comments based on the importance of skin suture during cheiloplasties in the primary cleft lip or secondary revision patients with representative figures.

Basic principles of surgical suture technology and selection of suture materials in general surgery / 中国实用外科杂志

The selection of suturing techniques and suture materials is a common problem in general surgery. In 2008,the Chinse Society of Surgery of Chinese Medical Association draw up the first edition of The Chinese Consensus Statement on General surgical suture technique and suture material. In the last ten years, it has appeared antibacterial sutures, drug elution lines, barbed lines, anti-leakage needles, stabresistant needles, bio-3D staplers in suture materials, which promoted the development of general surgery. At the same time, with the advancement of surgical techniques and the application of laparoscopic and robotic surgery, suture techniques such as triangular anastomosis and nondisconnected Roux-en-Y anastomosis have appeared. This article reviews the progress of new suture materials, introduces the achievements of suturing technique in general surgery, and discusses the significance of the 2018 edition of The Chinese Consensus Statement on General Surgical Suture Technique and Suture Material.

Comparative analysis of non-absorbable 10-0 nylon sutures with absorbable 10-0 Vicryl sutures in pediatric cataract surgery

Purpose: The purpose of the study is to compare the efficiency as well as the rate and type of suture-related complications between 10-0 monofilament nylon (Aurolab Nylon Sutures, double arm, Aurolab) and 10-0 polyglactin 910 sutures (Vicryl, single arm, Aurolab) for pediatric cataract surgery. Methods: It is a prospective, comparative study performed in children who underwent surgery for congenital or developmental cataract from March 2013 to February 2016. Patients underwent suturing with either nylon or Vicryl in unilateral cases, but in most bilateral surgeries, one eye received Vicryl sutures while the other eye received nylon. The sutures were compared for their complications and the need for suture removal. Results: Forty-one children (72 eyes) were included in the study, of which 31 children (62 eyes) underwent bilateral surgery while 10 (10 eyes) underwent unilateral surgery. Sixty-four nylon sutures were placed in 32 children (34 eyes), of which 22 (34.4%) were removed due to suture-related complications, whereas 14 (19.7%) (P = 0.03) of the 71 Vicryl sutures placed in 32 children (38 eyes) needed suture removal at an average of 2.9 weeks with the earliest at 6 days postoperatively. The odds of Vicryl suture being removed was 0.42 times with respect to nylon. The most common reason encountered for suture removal in both the materials was sutures becoming loose (16.3%), followed by vascularization (14.1%), infiltration (1.5%), and opacification (4.4%). Conclusion: Absorbable suture such as 10-0 Vicryl is preferred over nonabsorbable suture 10-0 nylon for suturing incisions in pediatric cataract surgery, to avoid subjecting the child to repeated anesthesia.

Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair / 대한정형외과학회잡지

PURPOSE: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. MATERIALS AND METHODS: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. RESULTS: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p < 0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. CONCLUSION: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

Quickert Suture Using Nonabsorbable Suture Material for Lower Lid Entropion

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.

Quickert Suture Using Nonabsorbable Suture Material for Lower Lid Entropion

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.

Treatment of Achilles Tendon Rupture with Absorbable Suture / 대한족부족관절학회지

PURPOSE: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. MATERIALS AND METHODS: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. RESULTS: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. CONCLUSION: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

Surgical Treatment of Achilles Tendon Rupture with Absorbable Suture Materials Only / 대한족부족관절학회지

PURPOSE: To report the clinical results from using absorbable suture materials instead of nonabsorbable materials which have been used more commonly to repair Achilles tendon. MATERIALS AND METHODS: We retrospectively reviewed 21 cases of acute Achilles tendon rupture, treated surgically from 2004 to 2011. Mean follow-up period is 6 months. We repaired Achilles tendon using size 1 Vicryl (Polyglactin 910, Ethicon) for core suture and size 3-0 Vicryl for epitendinous suture. At three months after surgery, we evaluated clinical results with single heel raise height by centimeters, differences of calf circumference and passive range of motion of ankle joint, compared to contralateral side. Also we recorded clinical results with subjective satisfaction grades. RESULTS: At three months after surgery, 20 of 21 patients were able to perform single heel raise over 5 cm in height. Calf circumference differences were less than 1 cm in 12 cases, between 1 cm to 3 cm in 5 cases, more than 3 cm in 4 cases. There was no difference in range of passive motion in 19 cases. All patients satisfied with daily activity except 2 cases with mild discomfort. There was no complication such as rerupture, elongation or infection. CONCLUSION: We experienced excellent clinical results from repairing Achilles tendon with using absorbable suture materials in terms of functional outcomes and patient's satisfaction without any complication. So we may consider using absorbable suture materials instead of nonabsorbable materials to repair Achilles tendon.

Role of suture material and technique of closure in wound outcome following laparotomy for peritonitis.

Background: There are no accepted guidelines for the closure of laparotomy incisions in patients of peritonitis. As these patients differ from the patients undergoing elective abdominal surgery, the same recommendations for closure may not be applicable in both groups. Aim: To compare wound outcome parameters following closure of the laparotomy incision with absorbable and non-absorbable suture material using the continuous and interrupted techniques in patients of peritonitis. Method: A single blinded randomised controlled trial using Polygalactin–910 and Polypropylene, number 1 sutures, to close midline vertical incisions, placed in continuous and interrupted manner, was performed on 174 patients. Patients were randomised into four groups: Group A (Polygalactin-910 continuous suturing, n=40), B (Polygalactin-910 interrupted suturing, n=47), C (Polypropylene continuous suturing, n=45) and D (Polypropylene interrupted suturing, n=42). The incidence of wound infection, dehiscence, suture sinus formation and incisional hernia was recorded. Patients were followed up for a period of four years. Statistical analysis involved the chi-square and Fisher’s exact tests. A ‘p’ value of <0.05 was considered significant. Results: The study included 139 male and 35 female patients between the ages of 10 and 75 years. The incidence of wound infection (p=0.656), dehiscence (p=0.997), and incisional hernia (p=0.930) at 3 months and four years (p= 0.910) was not statistically significant. There was no sinus formation in groups A and B, however 2 patients of group C and 6 patients of group D did develop suture sinus (p=0.003). Conclusion: Suture material and technique of closure does not influence wound outcome in patients of peritonitis except for a significantly lower incidence of sinus formation when non-absorbable sutures are used.

Materiales de sutura quirúrgico / Surgical suture materials

Se realizó una revisión bibliográfica sobre el tema Materiales de sutura quirúrgica, tanto nacional como internacionalmente, tratando de encontrar la información más actualizada posible, tomando como base un trabajo publicado en una revista nacional en el año 1990 y una revisión bibliográfica nuestra presentada en el hospital Amalia Simoni en 1995. Se revisaron los materiales informativos de algunas casas comerciales y a partir de aquí, se expusieron las clasificaciones conocidas con los productos que la conforman y se ofrecieron las características del producto comercial y del fabricante. Se señalaron las ventajas de los materiales de sutura de origen sintético sobre los naturales que van siendo desplazados en su utilización y preferencia. Existe el interés de ayudar a mejorar el conocimiento sobre este tema a los profesionales de la salud, personal paramédico y en formación al igual que a médicos veterinarios.

A bibliographical review on the topic of surgical suture material, so much national as internationally, trying to find the most up-to-date possible information, taking as base a work published in a national magazine in the year 1990 and a bibliographical review of ours presented in Amalia Simoni hospital in 1995. The informative materials of some business houses are reviewed and starting from here, the well-known classifications are exposed with the products that compose it and offering the characteristics of the commercial product and the manufacturer. The advantages of the suture materials of synthetic origin are pointed out on the natural ones that are displaced in their use and preference. It encourages us the interest of helping to improve the knowledge on this topic to the health professionals and in formation, paramedic personnel as well as to veterinary doctors.

A Common Bile Duct Stone formed by Suture Material after Open Cholecystectomy

The use of non-absorbable suture materials for cystic duct ligation after cholecystectomy can expose patients to the risk of recurrent stone formation in the common bile duct (CBD). However, in Korea suture materials have rarely been found to act as a nidus for common bile duct calculus formation. Recently, we experienced a case in which suture material, that had migrated from a previous cholecystectomy site into the CBD, probably served as a nidus for common bile duct stone formation. The stone was confirmed by endoscopic retrograde cholangiopancreatography (ERCP) and removed successfully using a basket. The authors report a case of surgical suture migration and discuss its subsequent role as a stone forming nucleus within the CBD in a patient who underwent open cholecystectomy; and include a review of the literature.

Clinical Applicability of Absorbable Synthetic Suture Materials (Safil(R)/Safil(R) Quick/Monosyn(R)) in Obstetrical Surgeries / 대한주산의학회잡지

OBJECTIVE: To evaluate the clinical applicability and safety of absorbable synthetic suture materials (Safil(R)/Safil(R)Quick/Monosyn(R)) in obstetrical surgeries. METHODS: This clinical trial includes 100 patients who delivered vaginally and 198 patients who were undergone cesarean section from April 2004 to September 2004. In cases of vaginal delivery, patients were divided with the same number into the study group in which Safil(R) Quick was used and the control group in which chromic catgut was used for episiotomy and perineal laceration repair. In case of cesarean delivery, patients were divided into two groups. The first group which included 100 patients was subdivided with the same number into the study group in which Monosyn(R) was used and the control group in which chromic catgut was used for uterine repair. The second group which included 98 patients was subdivided with the same number into the study group in which Safil(R) was used and the control group in which Vicryl was used for rectus fascia repair. Wound healing status and complications are assessed during postoperative stage, at hospital discharge, and at postpartum out-patients follow-up. RESULTS: Compared with chromic catgut groups, Safil(R) Quick group showed no difference in hospital stay from vaginal delivery, wound healing status and surgical complications and Monosyn(R) group showed no difference in operating time, decrease in hemoglobin at postoperative day 3 and surgical complications. Safil(R) group showed no difference in operating time, postoperative pain and surgical complications compared with Vicryl group. CONCLUSION: Safil(R)/Safil(R) Quick/Monosyn(R) were equivalent with regard to most aspects of their clinical suitability and may be useful alternative suture materials in obstetrical surgeries.

Translocation of the scleral suture knot on scleral-fixated posterior chamber intraocular lens

PURPOSE: To evaluate exposure rate of suture material at the transscleral suture fixation of posterior chamber intraocular lens (TSFPCIOL) with the method in which the scleral suture knots are trans positioned from both nasal and temporal sclera to superonasal. METHODS: With retrospective chart review 16 eyes of 15 patients who underwent TSFPCIOL with the transpositioned suture site, the authors checked their visual recovery rate and complicated disorders after the surgeries. RESULTS: Average corrected visual acuities at final visits improved to 0.67+/-0.32 from 0.14+/-0.17 at initial. Six eyes (37.5%) had complicated disorders at early postoperative period and 5 eyes (31.25%) had at their final visits. No exposure of suture material over the conjunctiva did occur. CONCLUSIONS: These results suggest that translocated suture to superotemporal sclera may be an efficient method for reducing exposure rate of suture material after TSFPCIOL.

Stability and Safety of Laploop under the Endoscopic Surgery of Rabbits / 한국간담췌외과학회지

BACKGROUND/AIMS: Along with the expansion of the field of laparoscopic surgery, many laparoscopic instruments have been developed and these all together made laparoscopic surgery possible in many operative procedures which used to be considered impossible to be done using a laparoscope. Suturing is a technique quite often required during laparoscopic surgery and so far we have used imported suture material. In this article, we have compared the safety and harmfulness of suture material developed domestically in Korea with those imported using house rabbits. METHODS: A total of 40 white house rabbits from New Zealand weighing 3.0-3.4 Kg were used from July 1, 2000 until April 30, 2001. Under general anesthesia, we created a pneumoperitoneum using a veress needle with a pressure of 10 mmHg followed by insertion of a 5mm laparoscope right above the umbilicus and two 5mm trocars were inserted in the right and left midclavicular lines 5cm below the costal margin. After perforating the pylorus of the stomach using laparoscopic scissors, we sutured two sites using Laploop and then perforated the body of the stomach and again sutured two sites but this time using Vicryl #3-0 for comparison with Laploop. 10 house rabbits were sacrificed each on post operation days 10, 20, 30 and 40 and tissues obtained from those house rabbits were compared using the Sewell method. RESULTS: Suturing and ties were done without any problems and there were no postoperative complications or deaths. On postoperation days 10 and 20, Laploop showed a moderate degree of tissue reaction proved by a Sewell score of 57 and 48 respectively and on postoperation days 30 and 40, a mild to moderate degree of tissue reaction occurred with a S score of 36 and 33 respectively. In models using Vicryl, the S scores were 67 an 62 on postoperation days 10 and 20 respectively showing a moderate degree of tissue reaction and on postoperation days 30 and 40, it showed a mild to moderate degree of tissue reaction with a S score of 52 and 44 respectively which is similar to the results obtained by Laploop. CONCLUSION: Imported Vicryl and Laploop were both applicable in terms of biologic compatibility but Laploop was easier to apply, more cost effective compared to Vicryl but most of all, there were no complications such as a loosening of a knot or a knot being undone. Therefore it could be concluded that Laploop shows a promising future as a suture material in laparoscopic surgery.

A Comparative Study of Tensile Strength in Vitro and Histologic Reaction on Rabbits between TRISORB Suture Materials and Traditional Suture Materials ( Dexon , Vicryl , Medifit ) / 대한산부인과학회잡지

Objective: Our purpost was to study effectiveness and clinical application of TRISO-RB suture materials and the find the most appropriate coating ingredient. The tensile str-ength and histologic reaction of the TRISORB are compared with those of traditional ma-terials such as Dexon , Vicryl , and Medifit . Study design:In vivo, 20 female rabbits were observed for histologic reaction at di- fferent time intervals after they were implanted with suture material. In vitro, Tensile str- ength was compared among the four suture materials after boiling in distilled water at 80degrees C. It was also compared with the tensile strength in phosphate buffer solution of pH 7.4 at 37degrees C. Results: Histologic reaction was remarkable with Medifit suture material. There was no significant differences among the other suture materials. TRISORB with A coating ingredient showed the least histologic reaction. TRISORB suture materials showed simi- lar tensile strength as those of traditional suture materials in vitro. Conclusion: TRISORB suture material is consists of same polyglycolic acid as trad- itional synthetic absorbable suture materials. It shows no significant differences in vivo and in vitro when compared with other traditional materials. It is considered to be applic- able with humans.

An Experimental Study of Testicular Fixation and Histopathologic Changes of Testis after Testicular Fixation in Rats / 대한비뇨기과학회지

Orchiopexy is the generally recommended procedure to treat and to prevent intravaginal testicular torsion. But recurrent torsion of the previously fixed testis has been reported infrequently. Failure of orchiopexy leading to recurrent torsion has been attributed by some to use of absorbable suture material and as a result nonabsorbable sutures often has been recommended. To determine whether there were differences between absorbable and nonabsorbable sutures, and also to study various surgical and chemical methods to produce fixation between the testis and scrotal wall, we used rats as an experimental model of orchiopexy. Eversion of the tunica vaginalis with absorbable and nonabsorbable suture to dartos muscle produced excellent scarification. Eversion of the tunica vaginalis without suture also produced good scarification but less than above method. Absorbable and nonabsorbable sutures between tunica albuginea and tunica vaginalis produced only minor degree of inflammation. Tetracycline instillation similarly failed to produce a significant inflammation. Histopathologic changes of testis after orchiopexy were also studied. The main histopathologic changes were inflammatory reaction, interference of local blood flow and obstruction of seminiferous tubules. So it can be suggested that testicular injury after orchiopexy can be developed.

The Effect of Fibrin Glue(Tisseel(R)) on the Filtration Surgery in Rabbits

During filtration surgery for glaucoma, the conjunctival incision site is sutured watertightly with a suture material like 10-0 nylon. However, this suture material may cause the infiltration of inflammatory cells, and the proliferation and migration of fibroblasts and collagen fibers at the junction of the conjunctiva and episclera. Subsequently, the arrangement of collagen fiber in episclera would be disrupted and the outflow of aqueous humor could be occluded. In the search for a more suitable suture material, the fibrin glue(Tisseel(R)) was introduced recently. It is claimed to be simple to use and safe, causes less damage and less inflammatory reaction than nylon. The authors used 10-0 nylon(control group) on the right eye and fibrin glue(Tisseel(R))(experimental group) on the left eye of a white rabbit's conjunctival suture. We compared and evaluated the clinical and histological effects of the suture material on the suture site as well as on the intraocular region. The results were as follows; 1. In the experimental group, conjunctival injection and chemosis were mild and disappeared rapidly. 2. The filtering bleb was macroscopically well formed and maintained from the third postoperative day in both groups, but, thereafter, it decreased in size in two cases of the control group. 3. There was no difference in the inflammatory reaction in anterior chamber in both groups postoperatively. 4. In the experimental group, there was loosening of the fibroblasts proliferation and lesser infiltration of inflammatory cells at the postoperative second and fourth week. And the arrangement of collagen fibers in episclera was intact. The above findings strongly suggest fibrin glue(Tisseel(R)) as a suture material in the filtration surgery of glaucoma is clinically promising.

Comparative Study of Absorbable Suture Material and Nonabsorbable Suture Material in Micro / 대한정형외과학회잡지

The suture materials influence the success of microvascular anastomosis importantly. The purpose of this experiment is to observe the effect of absorbable suture material and nonabsorbable suture material in microvascular anastomosis. The study was carried out on one side of carotid arteries of fourty rats which were anesthetized intraperitoneally with urethane. The experimental procedures differed in two groups, Group A in which the carotid artery was sutured with 10-0 monofilament polyglycolic acid, Group B in which the carotid artery was sutured with 10-0 monofilament nylon. Gross and histological examination were used to compare the results of end to end suture above two suture material. The results were as follows. 1. Nylon had greater tensile strength and ease of handling than polyglycolic acid, but held knots poorly. 2. Polyglycolic acid had difficult handling and lesser tenslie strength than nylon, but held knots hardly. 3. Polyglycolic acid had high patency rate, some lesser tissue response than nylon.