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Purpose <p>We aimed to investigate whether pledget presence, pledget composition, and full versus partial thickness suture technique affect the force esophageal tissue can withstand before tearing.</p> Methods <p>A right thoracotomy was performed on 10 deceased fetal sheep, 110–114 days gestation. The esophagus was divided at the level of the carina and 2&#xa0;cm of tissue was removed to mimic long-gap esophageal atresia. The pouches were sutured with horizontal mattress non-absorbable braided polyester suture using one of three methods: polytetrafluoroethylene (PTFE) pledgets, bovine pericardial pledgets, or no pledget, in full or partial thickness manner. Each suture was attached to a tensiometer and manually tightened at 50 gram-force / 30&#xa0;s. Maximal force before esophageal tearing and time to tearing were measured. Results were compared using a linear mixed model.</p> Results <p>PTFE pledgets withstood significantly more force than pericardial pledgets (<i>p</i> = 0.029) and provided longer duration before tearing compared to no pledget (<i>p</i> = 0.017) and pericardial pledgets (<i>p</i> = 0.047). Full versus partial-thickness technique made no difference.</p> Conclusion <p>In a deceased fetal lamb long-gap esophageal atresia model, PTFE pledgets improved tissue resistance to tearing (PTFE &gt; pericardial) and prolonged stretch duration (PTFE &gt; pericardial or no pledget). Suture thickness (full vs. partial) made no difference.</p>

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Type of pledget and suture technique relative to esophageal tensile strength in long-gap esophageal atresia

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Jennifer M. Schuh,
  • Araceli A. Morelos,
  • Hannah M. Olson,
  • Emmanuel L. Abebrese,
  • Ke Yan,
  • Jian Zhang,
  • Bonnie P. Freudinger,
  • Deron W. Jones,
  • Jose H. Salazar

摘要

Purpose

We aimed to investigate whether pledget presence, pledget composition, and full versus partial thickness suture technique affect the force esophageal tissue can withstand before tearing.

Methods

A right thoracotomy was performed on 10 deceased fetal sheep, 110–114 days gestation. The esophagus was divided at the level of the carina and 2 cm of tissue was removed to mimic long-gap esophageal atresia. The pouches were sutured with horizontal mattress non-absorbable braided polyester suture using one of three methods: polytetrafluoroethylene (PTFE) pledgets, bovine pericardial pledgets, or no pledget, in full or partial thickness manner. Each suture was attached to a tensiometer and manually tightened at 50 gram-force / 30 s. Maximal force before esophageal tearing and time to tearing were measured. Results were compared using a linear mixed model.

Results

PTFE pledgets withstood significantly more force than pericardial pledgets (p = 0.029) and provided longer duration before tearing compared to no pledget (p = 0.017) and pericardial pledgets (p = 0.047). Full versus partial-thickness technique made no difference.

Conclusion

In a deceased fetal lamb long-gap esophageal atresia model, PTFE pledgets improved tissue resistance to tearing (PTFE > pericardial) and prolonged stretch duration (PTFE > pericardial or no pledget). Suture thickness (full vs. partial) made no difference.