BIOMECHANICAL ANALYSIS OF A MODIFIED SUTURE TECHNIQUE FOR SEPTAL EXTENSION GRAFTS: TRANSLOOP SUTURE

SUMMARY Background A successful rhinoplasty procedure requires a well-defined and properly projected nasal tip; however, surgical control of the nasal tip is difficult. The aim of this investigation was to assess the efficacy and safety of a modified suture technique, which can be used to fix the caudal septal extension graft during primary rhinoplasty of the Asian population and revision septorhinoplasties of the Caucasian population, and to compare it with other commonly used techniques. Methods After peeling of perichondrium of scapular cartilages, cartilage pieces of 3 × 1 cm in size and 2 mm in thickness were divided into two from the midline. These pieces were repaired end-to-end using three different repair techniques: two simple interrupted in Group A (n=40), vertical figure-of-eight in Group B (n=40), and modified vertical figure-of-eight (transloop) in Group C (n=40). All repaired cartilage specimens were subjected to a biomechanical analysis, in which four different forces were applied: tension, lateral bending, shearing, and buckling. Results According to the tensile test, Group C had statistically significantly higher strength compared to Group A at 2 mm range. The lateral bending test similarly revealed that Group C had statistically significantly higher strength at 1.5 mm and 2 mm range compared to Group A. However, there was no statistically significant difference between the three groups in the assessment of shearing and buckling forces. Conclusion The modified transloop suture technique provides a more stable repair and we consider that it can be used as an alternative suture repair method.