describes a well-designed animal experiment comparing the characteristics of microvascular anastomoses in which absorbable or nonabsorbable sutures were used. The morphologic and histologic results clearly document superior healing when absorbable synthetic sutures (polyglycolic or polyglactin 910) were used. This is primarily due to the elimination of foreign body reaction through dissolution of the suture.
One aspect of their study, however, requires further clarification. Their tensiometric studies indicate that when vessels repaired with absorbable su- tures were stressed, they failed at lower levels than similar vessels closed with nonabsorbable sutures. These data may be very misleading since the authors do not specify their testing procedure. I assume that the specimens were stressed in a longitudinal direction with the sutures still intact. Under these conditions, vessels containing nonabsorbable sutures will always have higher breaking strength than vessels containing absorbable sutures simply because of the presence of the suture itself. However, these elevated stress levels are not physiologically meaningful and should not be interpreted as indicating that the use of absorbable sutures leads to weaker anastomoses.
Because of the results generated by inappropriate tensiometric testing, many surgeons are hesitant to employ synthetic absorbable sutures for vascular anastomoses. To my knowledge, no one has reported on a microvascular anastomosis that has failed be-