現今醫學美容盛行，尤其是用於臉部拉提的埋線拉提，利用帶有倒鉤的可吸收縫線，不需要動手術即可減少皺紋、使皮膚回春並且加強臉部輪廓線條。陽光中的紫外線造成皮膚層下膠原蛋白及彈性蛋白流失。埋線拉提是一種快速且具有長期效果的醫學美容方法，使用的倒鉤縫線是手術用的免打結縫合線，其表面帶有倒鉤。縫合組織的時候，這些倒鉤會刺入組織內部並且將組織鎖定到位，用於拉提可以將臉部組織提起並且提供支撐。萬能材料試驗機將穿透組織的倒鉤縫線從組織中提起並且拉出，會導致縫線表面的倒鉤以及組織受到阻力並且損傷。本研究藉由對於組織的倒鉤縫線特性觀察，分析影響倒鉤縫線效率之可能因素

Nowadays, esthetic treatment is extremely popular especially thread lift, to face lifting, reduce wrinkles, sagging skin, skin rejuvenation, and facial contouring with absorbable barbed suture without surgery. As a result of the loss of elastin and collagen under the skin layer and caused by ultraviolet A, ultraviolet B rays that are present in the sunlight. The thread lifts it is a rapid method and effective method in dissolve for a long duration. A barbed suture is a sort of knotless surgical suture that has barbs on its surface. While suturing tissue, these barbs penetrate inside the tissue and lock them into place and will support the facial tissues to lift the facial skin to not fall. And due to the penetration of barbed suture into the tissue to lifting while the barbed sutures are pulled out of the tissue by the Universal Material test machine will cause resistance and damage of barbed suture and tissues from experiments. And from the studying and observation of barbed suture characteristic of tissue which will lead to the analysis of factors affecting the efficiency of barbed suture.

Table of Contents
摘 要 i
ABSTRACT ii
Acknowledgement iii
List of Table xi
List of Figures xii
Chapter 1 Introduction 1
1.1 Preface 1
Chapter 2 Literature Review 2
2.1 Thread Lifting 2
2.1.1 Polydioxanone knotless thread lifting 4
2.2 Barbed suture 5
2.2.1 Barb as an alternative to surgical knots 6
2.3 Mechanical studies of barbed sutures 7
2.4 Barbed suture strength 8
2.5 Skin Closure 9
2.5.1 Superficial Muscular Aponeurotic System (SMAS) 9
2.5.2 Subcutaneous Fat 10
2.6 Tissue Tension in Suturing 11
2.6.1 Tissue Adhesives for Closure of Surgical Skin 11
Chapter 3 Key issues & Research method 16
3.1 Key issues 16
3.2 Research Methods Using in This Study 16
3.2.1 Tensile Strength 16
3.2.2 Suture/Tissue Pullout Test 18
3.2.3 Testing and Characterization 19
3.2.4 Stress Relaxation 20
Chapter 4 Experiment Materials and Methods 21
4.1 Tissue Preparation 21
4.1.1 Sizes Control 21
4.1.2 SMAS Tissue 22
4.1.3 Subcutaneous Fat Layer 22
4.2 Materials 23
4.2.1 PDO Barbed Suture 23
4.2.2 PP monofilament thread 23
4.2.3 Suture size 24
4.2.4 Geometry of barb suture 25
4.3 Equipment and tools 26
4.3.1 Scalpel 26
4.3.2 Vernia caliper 26
4.3.3 Blunt needle 26
4.3.4 Fixation clamp gripper 27
4.3.5 Bottom clamp gripper three side views 27
4.4 Procedure 28
4.4.1 Specimen preparation 28
4.4.2 Fix specimen on the clamp gripper 28
4.5 Experimental procedure 30
4.5.1 Pre-speed test with PP monofilament thread 30
4.5.2 Pulling knot model out of SMAS tissue layer with a speed test 300 mm/min 31
4.5.3 Pulling PDO barbed suture out of different tissue layer comparison with SMAS tissue and Subcutaneous fat tissue with non-commercial PDO barbed suture 32
4.5.4 Pulling out PDO barbed suture comparing with different commercial barbed suture 33
4.5.5 Pull-out PDO barbed suture comparing with different pull-out speed test 34
4.5.6 Pulling out PDO barbed suture comparing with different number of barbs on the PDO suture thread 35
Chapter 5 Results and Analysis 36
5.1 Tensile strength of pre-speed test with Polypropylene monofilament thread 36
5.1.1 Force-Displacement Result 36
5.1.2 Stress-Strain Result 38
5.1.3 Comparing force with different speed result 40
5.1.4 Young’s Modulus 40
5.2 Tensile strength of pulling speed 300mm/min with PP monofilament thread in different pattern blinding a knot 41
5.2.1 Tensile strength of pulling speed 300mm/min with PP monofilament thread in Part A. 41
5.2.2 Tensile strength of pulling speed 300mm/min with PP monofilament thread in Part B. 42
5.2.3 Tensile strength of pulling speed 300mm/min with PP monofilament thread in Part C. 43
5.2.4 Tensile strength of pulling speed 300mm/min with PP monofilament thread in Part D. 44
5.2.5 Stress-Strain Result 45
5.3 Tensile strength of pulling speed 100mm/min with PDO barbed suture that insert at different tissue layer between SMAS layer and Subcutaneous fat layer 48
5.3.1 Force-Displacement Result of PDO barbed suture at 1st SMAS tissue layer position 48
5.3.2 Force-Displacement Result of PDO barbed suture at 2nd SMAS tissue layer position 48
5.3.3 Force-Displacement Result of PDO barbed suture at 3rd SMAS tissue layer position 49
5.3.4 Force-Displacement Result of PDO barbed suture at 4th SMAS tissue layer position 49
5.3.5 Force-Displacement Result of PDO barbed suture at 5th SMAS tissue layer position 50
5.3.6 Comparison of Force-Displacement Result of PDO barbed suture in 5 experimental on SMAS tissue layer position 50
5.3.7 Stress-Strain Result of PDO barbed suture at 1st SMAS tissue layer position 51
5.3.8 Stress-Strain Result of PDO barbed suture at 2nd SMAS tissue layer position 51
5.3.9 Stress-Strain Result of PDO barbed suture at 3rd SMAS tissue layer position 52
5.3.10 Stress-Strain Result of PDO barbed suture at 4th SMAS tissue layer position 52
5.3.11 Stress-Strain Result of PDO barbed suture at 5th SMAS tissue layer position 53
5.3.12 Comparison of Stress-Strain Result of PDO barbed suture in 5 experimental on SMAS tissue layer position 53
5.3.13 Force-Displacement Result of PDO barbed suture at 1st Subcutaneous fat layer position 54
5.3.14 Force-Displacement Result of PDO barbed suture at 2nd Subcutaneous fat layer position 54
5.3.15 Force-Displacement Result of PDO barbed suture at 3rd Subcutaneous fat layer position 55
5.3.16 Force-Displacement Result of PDO barbed suture at 4th Subcutaneous fat layer position 55
5.3.17 Force-Displacement Result of PDO barbed suture at 5th Subcutaneous fat layer position 56
5.3.18 Comparison of Force-Displacement Result of PDO barbed suture in 5 experimental on Subcutaneous fat layer position 56
5.3.19 Stress-Strain Result of PDO barbed suture at 1st Subcutaneous fat layer position 57
5.3.20 Stress-Strain Result of PDO barbed suture at 2nd Subcutaneous fat layer position 57
5.3.21 Stress-Strain Result of PDO barbed suture at 3rd Subcutaneous fat layer position 58
5.3.22 Stress-Strain Result of PDO barbed suture at 4th Subcutaneous fat layer position 58
5.3.23 Stress-Strain Result of PDO barbed suture at 5th Subcutaneous fat layer position 59
5.3.24 Comparison of Stress-Strain Result of PDO barbed suture in 5 experimental on Subcutaneous fat layer position 59
5.3.25 Comparing force with different tissue result 60
5.3.26 Young’s Modulus 60
5.3.27 The physical characteristic changing of PDO barbed suture after pulling out of different tissue layer position 61
5.4 Tensile strength of pulling speed 100mm/min with compared with commercial barbed suture between Laya™ and Quill™ knotless tissue-closure device 62
5.4.1 Force-Displacement Result of Laya™ PDO barbed suture that pulling out of SMAS layer position (1st) 62
5.4.2 Force-Displacement Result of Laya™ PDO barbed suture that pulling out of SMAS layer position (2nd) 62
5.4.3 Comparison of Force-Displacement Result of Laya™ PDO barbed suture in SMAS layer position 63
5.4.4 The physical characteristic changing of Laya™ PDO barbed suture after pulling out of different tissue layer position 63
5.4.5 Stress- Strain result of Laya™ PDO barbed suture that pulling out of SMAS layer position (1st) 64
5.4.6 Stress- Strain result of Laya™ PDO barbed suture that pulling out of SMAS layer position (2nd) 64
5.4.7 Force-Displacement Result of Quill™ PDO barbed suture that pulling out of SMAS layer position (1st) 65
5.4.8 Force-Displacement Result of Quill™ PDO barbed suture that pulling out of SMAS layer position (2nd ) 65
5.4.9 Comparison of Force-Displacement Result of Quill™ PDO barbed suture in SMAS layer position 66
5.4.10 The physical characteristic changing of Quill™ PDO barbed suture after pulling out of different tissue layer position 66
5.4.11 Stress- Strain result of Quill™ PDO barbed suture that pulling out of SMAS layer position (1st) 67
5.4.12 Stress- Strain result of Quill™ PDO barbed suture that pulling out of SMAS layer position (2nd) 67
5.4.13 Comparing force with commercial barbed suture 68
5.4.14 Young’s Modulus 68
5.5 Tensile strength of PDO barbed suture comparing with different pull-out speed test in observation 69
5.5.1 Force-Displacement Result at pull-out speed 10 mm/min 69
5.5.2 Force-Displacement Result at pull-out speed 100 mm/min 69
5.5.3 Force-Displacement Result at pull-out speed 500 mm/min 70
5.5.4 Force-Displacement Result at pull-out speed 1,000 mm/min 70
5.5.5 Stress-strain result 71
5.5.6 Young’s Modulus 73
5.5.7 The physical characteristic changing of PDO barbed suture after pulling out of different speed test 74
5.6 Pulling out PDO barbed suture comparing with different number of barbs on the PDO barbed suture thread at pull-out test of SMAS by speed 100 mm/min. 78
5.6.1 Force-Displacement Result with the number of 14 barbs on the PDO barbed suture 78
5.6.2 Force-Displacement Result with the number of 28 barbs on the PDO barbed suture 78
5.6.3 Stress-stress results the number of 14 barbs on the PDO barbed suture 79
5.6.4 Stress-stress results the number of 28 barbs on the PDO barbed suture 79
79
5.6.5 Comparing force with different number of barbs on suture 80
5.6.6 Young’s Modulus 80
80
5.6.7 The physical characteristic changing of PDO barbed suture after pulling out of SMAS with different number of barbs on suture thread 81
Chapter 6 Discussion 83
6.1 Pre-Speed Test with PP Monofilament Thread 83
6.2 Pulling Knot Model Out of SMAS Tissue Layer with a Speed Test 300 mm/min 84
6.3 Pulling PDO Barbed Suture Out of Different Tissue Layer Comparison with SMAS Tissue and Subcutaneous Fat Tissue with Non-Commercial PDO Barbed Suture with Speed 100mm/min 85
6.4 Pulling out PDO Barbed Suture Comparing with Different Commercial Barbed Suture in SMAS Layer at 100 mm/min 85
6.5 Pulling Out PDO Barbed Suture Comparing with Different Pull-Out Speed Test 86
6.6 Pulling Out PDO Barbed Suture Comparing with Different Number of Barbs on the Suture Thread 86
Chapter 7 Conclusion 87
Bibliography 88

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