New approach for appreciating the surgeon's satisfaction of braided sutures

Braided suture made with different materials and sizes is commonly used in many surgical interventions. Their key properties include tensile strength during tightening, knot security, surface morphology, knot slippage, and behavior during healing period. We have developed different testing procedures to measure these properties, but selection of suture should be brought under simultaneous considerations of all preferred properties related to surgical interventions and surgeon requirement. In this study, we propose a new approach for appreciation of surgeon satisfaction by using global quality index corresponding to simultaneous satisfaction of several suture properties such as organoleptic and mechanical properties. A global quality index was developed by using desirability functions. A statistical survey based on the evaluation of suture qualities by Tunisian surgeons allowed the determination of surgeon's requirement, weights, and objectives of individual desirability functions corresponding to each suture property. Braided sutures have been submitted to different developed tests for the evaluation of suture properties during healing and tying. The obtained results are converted to individual desirability index in order to evaluate satisfaction degree of each suture property. Finally, geometric and arithmetic mean aggregation are used to determine the global quality by attributing relative weight to each individual satisfaction degree. Global quality index of polyamide-braided sutures fabricated under different braiding conditions was determined. Obtained results allow the identification of optimal suture for specific surgical interventions.